Ventilation/Perfusion SPECT for diagnostics of pulmonary embolism in clinical practice.
(2008) In Journal of Internal Medicine 264(4). p.379-387- Abstract
- AIM: The aim of this retrospective study is to illustrate clinical utility and impact of pulmonary embolism (PE) diagnostics of up to date Ventilation/Perfusion SPECT (V/P (SPECT)) applying holistic interpretation criteria. MATERIAL AND METHODS: During a 2-year period 2328 consecutive patients referred to V/P(SPECT) for clinically suspected PE were examined. Final diagnosis was established by physicians clinically responsible for patient care. To establish the performance of V/P(SPECT) negative for PE, patients were followed up by medical records for 6 months. RESULTS: Ventilation/Perfusion SPECT was feasible in 99% of the patients. Data for follow-up were available in 1785 patients (77%). PE was reported in 607 patients (34%). Normal... (More)
- AIM: The aim of this retrospective study is to illustrate clinical utility and impact of pulmonary embolism (PE) diagnostics of up to date Ventilation/Perfusion SPECT (V/P (SPECT)) applying holistic interpretation criteria. MATERIAL AND METHODS: During a 2-year period 2328 consecutive patients referred to V/P(SPECT) for clinically suspected PE were examined. Final diagnosis was established by physicians clinically responsible for patient care. To establish the performance of V/P(SPECT) negative for PE, patients were followed up by medical records for 6 months. RESULTS: Ventilation/Perfusion SPECT was feasible in 99% of the patients. Data for follow-up were available in 1785 patients (77%). PE was reported in 607 patients (34%). Normal pattern was described in 420 patients (25%). Pathology other than PE such as a pneumonia, left heart failure, obstructive lung disease, tumour was described in 724 patients (41%). Report was nondiagnostic in 19 patients (1%). Six cases were classified as falsely negative because PE was diagnosed at follow-up and was fatal in one case. Six cases were classified as falsely positive because the clinician decided not to treat. In 608 patients with final PE diagnosis, 601 patients had positive V/P(SPECT) (99%). In 1177 patients without final PE diagnosis 1153 patients had negative V/P(SPECT) (98%). CONCLUSIONS: Holistic interpretation of V/P(SPECT,) yields high negative and positive predictive values and only 1% of nondiagnostic findings and was feasible in 99% of patients. It is a responsibility and a challenge of nuclear medicine to provide optimal care of patients with suspected PE by making V/P(SPECT) available. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/1262722
- author
- Bajc, Marika LU ; Olsson, Berit LU ; Palmer, John LU and Jonson, Björn LU
- organization
- publishing date
- 2008
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Pulmonary Artery: radiography, Pulmonary Embolism: radiography, Pulmonary Embolism: radionuclide imaging, Tomography, Single-Photon: methods, Emission-Computed, Pulmonary Embolism: mortality
- in
- Journal of Internal Medicine
- volume
- 264
- issue
- 4
- pages
- 379 - 387
- publisher
- Wiley-Blackwell
- external identifiers
-
- wos:000259152400008
- pmid:18823506
- scopus:51749124034
- pmid:18823506
- ISSN
- 1365-2796
- DOI
- 10.1111/j.1365-2796.2008.01980.x
- language
- English
- LU publication?
- yes
- id
- 3d770d82-7445-4c89-9a5a-8c5852c8a8d6 (old id 1262722)
- alternative location
- http://www.ncbi.nlm.nih.gov/pubmed/18823506?dopt=Abstract
- date added to LUP
- 2016-04-01 14:01:16
- date last changed
- 2022-02-12 00:22:18
@article{3d770d82-7445-4c89-9a5a-8c5852c8a8d6,
abstract = {{AIM: The aim of this retrospective study is to illustrate clinical utility and impact of pulmonary embolism (PE) diagnostics of up to date Ventilation/Perfusion SPECT (V/P (SPECT)) applying holistic interpretation criteria. MATERIAL AND METHODS: During a 2-year period 2328 consecutive patients referred to V/P(SPECT) for clinically suspected PE were examined. Final diagnosis was established by physicians clinically responsible for patient care. To establish the performance of V/P(SPECT) negative for PE, patients were followed up by medical records for 6 months. RESULTS: Ventilation/Perfusion SPECT was feasible in 99% of the patients. Data for follow-up were available in 1785 patients (77%). PE was reported in 607 patients (34%). Normal pattern was described in 420 patients (25%). Pathology other than PE such as a pneumonia, left heart failure, obstructive lung disease, tumour was described in 724 patients (41%). Report was nondiagnostic in 19 patients (1%). Six cases were classified as falsely negative because PE was diagnosed at follow-up and was fatal in one case. Six cases were classified as falsely positive because the clinician decided not to treat. In 608 patients with final PE diagnosis, 601 patients had positive V/P(SPECT) (99%). In 1177 patients without final PE diagnosis 1153 patients had negative V/P(SPECT) (98%). CONCLUSIONS: Holistic interpretation of V/P(SPECT,) yields high negative and positive predictive values and only 1% of nondiagnostic findings and was feasible in 99% of patients. It is a responsibility and a challenge of nuclear medicine to provide optimal care of patients with suspected PE by making V/P(SPECT) available.}},
author = {{Bajc, Marika and Olsson, Berit and Palmer, John and Jonson, Björn}},
issn = {{1365-2796}},
keywords = {{Pulmonary Artery: radiography; Pulmonary Embolism: radiography; Pulmonary Embolism: radionuclide imaging; Tomography; Single-Photon: methods; Emission-Computed; Pulmonary Embolism: mortality}},
language = {{eng}},
number = {{4}},
pages = {{379--387}},
publisher = {{Wiley-Blackwell}},
series = {{Journal of Internal Medicine}},
title = {{Ventilation/Perfusion SPECT for diagnostics of pulmonary embolism in clinical practice.}},
url = {{http://dx.doi.org/10.1111/j.1365-2796.2008.01980.x}},
doi = {{10.1111/j.1365-2796.2008.01980.x}},
volume = {{264}},
year = {{2008}},
}