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J Med Imaging Radiat Oncol. 2018 Dec;62(6):777-780. doi: 10.1111/1754-9485.12803. Epub 2018 Sep 20.

Ventilation perfusion single photon emission computed tomography: Referral practices and diagnosis of acute pulmonary embolism in the quaternary clinical setting.

Author information

1
Department of Diagnostic Imaging, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.
2
Department of Nuclear Medicine and Specialised PET Services, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.
3
School of Medicine, University of Queensland, Brisbane, Queensland, Australia.

Abstract

INTRODUCTION:

Ventilation perfusion single photon emission computed tomography (V/Q SPECT) and CTPA are the two leading imaging studies used to investigate acute pulmonary embolism. V/Q SPECT is often the first line investigation for pregnant patients and young females. Historically, V/Q Planar studies have high rates of indeterminate findings resulting in a preference for CTPA studies. The purpose of this research is to examine current V/Q SPECT referral practices in the quaternary clinical setting and to confirm V/Q SPECT studies have low rates of equivocal findings.

METHODS:

Retrospective study of a 6-month period of all completed V/Q SPECT studies (± LDCT) indicated for investigation of acute PE. V/Q SPECT studies were reported using the European Association of Nuclear Medicine guidelines. Patient demographic data and V/Q SPECT findings were recorded. CTPA and Doppler Ultrasound report findings were included if performed 48 hours prior to, or following V/Q SPECT study. Standard descriptive statistical analysis was undertaken.

RESULTS:

Ninety-nine percent of V/Q SPECT studies had reports positive or negative for acute PE, with 1% inconclusive. Twenty-two percent of patients had either CTPA or Doppler Ultrasound studies within a 48- hour period prior to, or following V/Q SPECT, with the majority having a negative Doppler ultrasound prior to negative V/Q SPECT. Sixty-eight percent of patients referred for V/Q SPECT were females under the age of 55, 40% of whom were pregnant.

CONCLUSIONS:

Ventilation perfusion single photon emission computed tomography has low rates of equivocal findings with referral practices indicating pregnant patients and young women are considered to most benefit from V/Q SPECT as a first line investigation for acute PE.

KEYWORDS:

V/Q SPECT; female; inconclusive; pregnancy; referral

PMID:
30238629
DOI:
10.1111/1754-9485.12803
[Indexed for MEDLINE]

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