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Original Research: PULMONARY VASCULAR DISEASE |

Diagnostic Accuracy of Single-Photon Emission Tomography Ventilation/Perfusion Lung Scan in the Diagnosis of Pulmonary EmbolismVentilation/Perfusion Single-Photon Emission CT

Alexandra Le Duc-Pennec, MD; Pierre-Yves Le Roux, MD; Jean-Christophe Cornily, MD, PhD; Morgan Jaffrelot, MD; Aurélien Delluc, MD; Luc de Saint-Martin, MD; Philippe Guillo, MD; Grégoire Le Gal, MD, PhD; Pierre-Yves Salaun, MD, PhD; Christophe Leroyer, MD, PhD
Author and Funding Information

From the Université Européenne de Bretagne (Drs Le Duc-Pennec, Le Roux, Cornily, Delluc, de Saint-Martin, Guillo, Le Gal, Salaun, and Leroyer); EA3878 (GETBO) IFR 148 (Drs Le Duc-Pennec, Le Roux, Delluc, de Saint-Martin, Guillo, Salaun, and Leroyer) and EA4324 (ORPHY) IFR 148 (Dr Cornily), Université de Brest; and Service de médecine nucléaire (Drs Le Duc-Pennec, Le Roux, Guillo, and Salaun), Département de cardiologie (Dr Cornily), Service des urgences (Dr Jaffrelot), and Département de médecine interne et de pneumologie (Drs Delluc, de Saint-Martin, Le Gal and Leroyer), CHU de la Cavale Blanche, Brest, France.

Correspondence to: Christophe Leroyer, MD, PhD, Département de médecine interne et de pneumologie, Centre Hospitalier, Universitaire de la Cavale Blanche, 29609 Brest, France; e-mail: christophe.leroyer@chu-brest.fr


Funding/Support: This study was partially funded by the Projet Hospitalier de Recherche Clinique 2004 (French Ministry of Health).

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


© 2012 American College of Chest Physicians


Chest. 2012;141(2):381-387. doi:10.1378/chest.11-0090
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Background:  Planar ventilation/perfusion (V˙/Q˙ ) lung scintigraphy is a validated tool for the diagnosis of pulmonary embolism (PE). Nevertheless, given the high rate of nonconclusive V˙/Q˙ , further investigation is often necessary. V˙/Q˙  single-photon emission CT (SPECT) scan could improve V˙/Q˙  performance, but sparse data are available on its accuracy. This study assessed the diagnostic performance of V˙/Q˙  SPECT scan in a cohort of consecutive patients with suspected PE.

Methods:  Three hundred twenty-one consecutive patients with a clinical suspicion of PE were prospectively included. Patients suspected of having PE were managed according to a reference diagnostic strategy validated by a 3-month follow-up. In addition to the reference strategy, patients had a V˙/Q˙  SPECT scan, the results of which were compared with the initial work-up results.

Results:  Prevalence of PE was 0 of 41 (0%; 95% CI, 0%-9%), six of 134 (4%; 95% CI, 2%-9%), 15 of 36 (42%; 95% CI, 27%-58%), and 28 of 32 (88%; 95% CI, 72%-95%) in the normal, low, intermediate, and high V˙/Q˙  SPECT scan probability groups, respectively. The combination of V˙/Q˙  SPECT scan with clinical probability was diagnostic in 88% of patients.

Conclusions:  V˙/Q˙  SPECT scan results show satisfactory accuracy for PE diagnosis. Validation of dedicated interpretation criteria is required, followed by outcome studies that use V˙/Q˙  SPECT scan as part of a diagnostic strategy to rule out PE.

Trial registry:  ClinicalTrials.gov; No.: NCT01183026; URL: www.clinicaltrials.gov

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