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Ventilation/Perfusion SPECT for diagnostics of pulmonary embolism in clinical practice.

Bajc, Marika LU ; Olsson, Berit LU ; Palmer, John LU and Jonson, Björn LU (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:
author
organization
publishing date
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
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
2008-11-06 14:59:12
date last changed
2017-09-24 04:03:12
@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},
  keyword      = {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},
  volume       = {264},
  year         = {2008},
}