OBJECTIVES: The aim of the study was to assess the potential interest of combining a low-dose computed tomography (ldCT) to ventilation/perfusion (V/Q) single-photon emission computed tomography (SPECT) for the diagnosis of pulmonary embolism (PE). We addressed three main questions: Could ldCT be used in substitution to ventilation SPECT? Could ldCT improve the diagnostic performance of V/Q SPECT? Could ldCT provide alternative diagnoses to PE? METHODS: A total of 393 patients previously analysed in a management outcome study that aimed at assessing the safety of V/Q SPECT for PE diagnosis were assessed. All patients underwent an ldCT under the same SPECT-computed tomography camera, which was not used at the time of initial interpretation. Three retrospective analyses were performed: Q SPECT combined with ldCT, V/Q SPECT combined with ldCT and ldCT only. RESULTS: On the basis of initial V/Q SPECT interpretation, 110 (28%) patients were positive and 283 (72%) were negative for PE.With Q SPECT-ldCT, 139 (35%) patients were positive and 254 (65%) were negative, with 55 (19%) discrepancies when compared with V/Q SPECT. Of the 283 patients with negative V/Q SPECT, 42 were positive with V/Q SPECT-ldCT, and among the 110 patients with positive V/Q SPECT 13 were negative with V/Q SPECT-ldCT. On using V/Q SPECT-ldCT, 97 (25%) patients were positive and 296 (75%) were negative, with 13 (3%) discrepancies when compared with V/Q SPECT (all had had a positive V/Q SPECT but a negative V/Q SPECT-ldCT). Finally, 67 (24%) ldCT scans showed a potential alternative diagnosis to PE. CONCLUSION: For PE diagnosis with lung SPECT, the use of ldCT in substitution to ventilation SPECT is associated with a high risk of overdiagnosis. The diagnostic value of ldCT in addition to V/Q SPECT remains unclear. Further studies are needed to determine its potential role in PE diagnosis.
OBJECTIVES: The aim of the study was to assess the potential interest of combining a low-dose computed tomography (ldCT) to ventilation/perfusion (V/Q) single-photon emission computed tomography (SPECT) for the diagnosis of pulmonary embolism (PE). We addressed three main questions: Could ldCT be used in substitution to ventilation SPECT? Could ldCT improve the diagnostic performance of V/Q SPECT? Could ldCT provide alternative diagnoses to PE? METHODS: A total of 393 patients previously analysed in a management outcome study that aimed at assessing the safety of V/Q SPECT for PE diagnosis were assessed. All patients underwent an ldCT under the same SPECT-computed tomography camera, which was not used at the time of initial interpretation. Three retrospective analyses were performed: Q SPECT combined with ldCT, V/Q SPECT combined with ldCT and ldCT only. RESULTS: On the basis of initial V/Q SPECT interpretation, 110 (28%) patients were positive and 283 (72%) were negative for PE.With Q SPECT-ldCT, 139 (35%) patients were positive and 254 (65%) were negative, with 55 (19%) discrepancies when compared with V/Q SPECT. Of the 283 patients with negative V/Q SPECT, 42 were positive with V/Q SPECT-ldCT, and among the 110 patients with positive V/Q SPECT 13 were negative with V/Q SPECT-ldCT. On using V/Q SPECT-ldCT, 97 (25%) patients were positive and 296 (75%) were negative, with 13 (3%) discrepancies when compared with V/Q SPECT (all had had a positive V/Q SPECT but a negative V/Q SPECT-ldCT). Finally, 67 (24%) ldCT scans showed a potential alternative diagnosis to PE. CONCLUSION: For PE diagnosis with lung SPECT, the use of ldCT in substitution to ventilation SPECT is associated with a high risk of overdiagnosis. The diagnostic value of ldCT in addition to V/Q SPECT remains unclear. Further studies are needed to determine its potential role in PE diagnosis.
Authors: Pierre-Yves Le Roux; Amir Iravani; Jason Callahan; Kate Burbury; Peter Eu; Daniel P Steinfort; Eddie Lau; Beverly Woon; Pierre-Yves Salaun; Rodney J Hicks; Michael S Hofman Journal: Eur J Nucl Med Mol Imaging Date: 2019-05-01 Impact factor: 9.236
Authors: Ana Cristina Lopes Albricker; Cláudia Maria Vilas Freire; Simone Nascimento Dos Santos; Monica Luiza de Alcantara; Mohamed Hassan Saleh; Armando Luis Cantisano; José Aldo Ribeiro Teodoro; Carmen Lucia Lascasas Porto; Salomon Israel do Amaral; Orlando Carlos Gloria Veloso; Ana Cláudia Gomes Pereira Petisco; Fanilda Souto Barros; Márcio Vinícius Lins de Barros; Adriano José de Souza; Marcone Lima Sobreira; Robson Barbosa de Miranda; Domingos de Moraes; Carlos Gustavo Yuji Verrastro; Alexandre Dias Mançano; Ronaldo de Souza Leão Lima; Valdair Francisco Muglia; Cristina Sebastião Matushita; Rafael Willain Lopes; Artur Martins Novaes Coutinho; Diego Bromfman Pianta; Alair Augusto Sarmet Moreira Damas Dos Santos; Bruno de Lima Naves; Marcelo Luiz Campos Vieira; Carlos Eduardo Rochitte Journal: Arq Bras Cardiol Date: 2022-04 Impact factor: 2.000
Authors: David Bourhis; Laura Wagner; Julien Rioult; Philippe Robin; Romain Le Pennec; Cécile Tromeur; Pierre Yves Salaün; Pierre Yves Le Roux Journal: EJNMMI Phys Date: 2021-07-05