Susan Miles1, Kerry M Rogers2, Paul Thomas3, Barry Soans4, John Attia5, Christian Abel4, Elizabeth Holt4, Catherine A D'Este6, Michael J Hensley7. 1. Department of General Medicine, Calvary Mater Newcastle, Newcastle, NSW, Australia; Department of Respiratory and Sleep Medicine, John Hunter Hospital, Newcastle, NSW, Australia. Electronic address: susan.miles@mater.health.nsw.gov.au. 2. Department of Nuclear Medicine, Hunter New England Imaging, John Hunter Hospital, Newcastle, NSW, Australia. 3. Department of Nuclear Medicine, Hunter New England Imaging, John Hunter Hospital, Newcastle, NSW, Australia; Department of Queensland PET Service, Department of Nuclear Medicine, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia. 4. Department of Radiology, Hunter New England Imaging, John Hunter Hospital, Newcastle, NSW, Australia. 5. Department of Hunter Medical Research Institute, Department of Medicine, John Hunter Hospital, Newcastle, NSW, Australia; Department of Centre for Clinical Epidemiology and Biostatistics, University of Newcastle, Newcastle, NSW, Australia. 6. Department of Centre for Clinical Epidemiology and Biostatistics, University of Newcastle, Newcastle, NSW, Australia. 7. Department of Respiratory and Sleep Medicine, John Hunter Hospital, Newcastle, NSW, Australia; Department of School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia.
Abstract
BACKGROUND: This study compared single-photon emission CT (SPECT) ventilation/perfusion (V/Q) scintigraphy with multislice CT pulmonary angiography (CTPA). METHODS: In a prospective, observational study, 100 patients who were >or= 50 years of age were recruited. Seventy-nine patients underwent both diagnostic 16-detector CTPA, and planar and SPECT V/Q scintigraphy. The agreement between the CTPA and the SPECT V/Q scintigraphy for the diagnosis of pulmonary embolism (PE) was calculated. The sensitivity and specificity of blinded SPECT scintigraphy reporting was calculated against a reference diagnosis made by a panel of respiratory physicians that was provided with CTPA and planar V/Q scintigraphy reports, clinical information, and 3-month follow-up data. RESULTS: The observed percentage of agreement between SPECT V/Q scintigraphy and CTPA data for the diagnosis of PE was 95%. When calculated against the respiratory physicians' reference diagnosis, SPECT V/Q scintigraphy had a sensitivity of 83% and a specificity of 98%. CONCLUSIONS: This study indicates that SPECT V/Q scintigraphy is a viable alternative to CTPA for the diagnosis of PE and has potential advantages in that it was feasible in more patients and had fewer contraindications; lower radiation dose; and, arguably, fewer nondiagnostic findings than CTPA. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry Registration Number: ACTRN12609000089235.
BACKGROUND: This study compared single-photon emission CT (SPECT) ventilation/perfusion (V/Q) scintigraphy with multislice CT pulmonary angiography (CTPA). METHODS: In a prospective, observational study, 100 patients who were >or= 50 years of age were recruited. Seventy-nine patients underwent both diagnostic 16-detector CTPA, and planar and SPECT V/Q scintigraphy. The agreement between the CTPA and the SPECT V/Q scintigraphy for the diagnosis of pulmonary embolism (PE) was calculated. The sensitivity and specificity of blinded SPECT scintigraphy reporting was calculated against a reference diagnosis made by a panel of respiratory physicians that was provided with CTPA and planar V/Q scintigraphy reports, clinical information, and 3-month follow-up data. RESULTS: The observed percentage of agreement between SPECT V/Q scintigraphy and CTPA data for the diagnosis of PE was 95%. When calculated against the respiratory physicians' reference diagnosis, SPECT V/Q scintigraphy had a sensitivity of 83% and a specificity of 98%. CONCLUSIONS: This study indicates that SPECT V/Q scintigraphy is a viable alternative to CTPA for the diagnosis of PE and has potential advantages in that it was feasible in more patients and had fewer contraindications; lower radiation dose; and, arguably, fewer nondiagnostic findings than CTPA. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry Registration Number: ACTRN12609000089235.
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