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Original Research: VENOUS THROMBOEMBOLISM |

A Comparison of Single-Photon Emission CT Lung Scintigraphy and CT Pulmonary Angiography for the Diagnosis of Pulmonary Embolism

Susan Miles, BMed; Kerry M. Rogers, PhD; Paul Thomas, BMed; Barry Soans, MBBS; John Attia, MD, PhD; Christian Abel, BMed; Elizabeth Holt, MBBS; Catherine A. D'Este, BMath, PhD; Michael J. Hensley, MBBS, PhD; Writing Group for the Christopher Study Investigators
Author and Funding Information

Affiliations: From the Department of General Medicine (Dr. Miles), Calvary Mater Newcastle, Newcastle, NSW, Australia; Department of Respiratory and Sleep Medicine (Drs. Miles and Hensley), John Hunter Hospital, Newcastle, NSW, Australia; Departments of Nuclear Medicine (Drs. Rogers and Thomas) and Radiology (Drs. Soans, Abel, and Holt), Hunter New England Imaging, John Hunter Hospital, Newcastle, NSW, Australia; Queensland PET Service (Dr. Thomas), Department of Nuclear Medicine, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia; the Centre for Clinical Epidemiology and Biostatistics (Drs. Attia and D'Este), University of Newcastle, Newcastle, NSW, Australia; Hunter Medical Research Institute (Dr. Attia), Department of Medicine, John Hunter Hospital, Newcastle, NSW, Australia; and the School of Medicine and Public Health (Dr. Hensley), University of Newcastle, Newcastle, NSW, Australia.

Correspondence to: Susan Miles, BMed, Calvary Mater Newcastle, Locked Mail Bag 7, Hunter Region Mail Centre, NSW, Australia 2310; e-mail: susan.miles@mater.health.nsw.gov.au


Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestjournal.org/site/misc/reprints.xhtml).


© 2009 American College of Chest Physicians


Chest. 2009;136(6):1546-1553. doi:10.1378/chest.09-0361
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Background:  This study compared single-photon emission CT (SPECT) ventilation/perfusion (V̇/Q̇) scintigraphy with multislice CT pulmonary angiography (CTPA).

Methods:  In a prospective, observational study, 100 patients who were ≥ 50 years of age were recruited. Seventy-nine patients underwent both diagnostic 16-detector CTPA, and planar and SPECT V̇/Q̇ scintigraphy. The agreement between the CTPA and the SPECT V̇/Q̇ 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 V̇/Q̇ scintigraphy reports, clinical information, and 3-month follow-up data.

Results:  The observed percentage of agreement between SPECT V̇/Q̇ scintigraphy and CTPA data for the diagnosis of PE was 95%. When calculated against the respiratory physicians' reference diagnosis, SPECT V̇/Q̇ scintigraphy had a sensitivity of 83% and a specificity of 98%.

Conclusions:  This study indicates that SPECT V̇/Q̇ 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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