Skip to main content

Advertisement

Log in

Ventilation/perfusion SPECT — an essential but underrated method for diagnosis of pulmonary embolism and other diseases

  • Letter to the Editor
  • Published:
European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

References

  1. Freeman LM, Haramati LB. V/Q scintigraphy: alive, well and equal to the challenge of CT angiography. Eur J Nucl Med Mol Imaging 2009;36:499–504. doi:10.1007/s00259-009-1068-2.

    Article  PubMed  Google Scholar 

  2. Reid JH, Coche EE, Inoue T, Kim EE, Dondi M, Watanabe N, et al. Is the lung scan alive and well? Facts and controversies in defining the role of lung scintigraphy for the diagnosis of pulmonary embolism in the era of MDCT. Eur J Nucl Med Mol Imaging 2009;36:505–21. doi:10.1007/s00259-008-1014-8.

    Article  PubMed  Google Scholar 

  3. The PIOPED Investigators. Value of the ventilation/perfusion scan in acute pulmonary embolism. Results of the prospective investigation of pulmonary embolism diagnosis (PIOPED). JAMA 1990;263:2753–9. doi:10.1001/jama.263.20.2753.

    Article  Google Scholar 

  4. Stein PD, Fowler SE, Goodman LR, Gottschalk A, Hales CA, Hull RD, et al. Multidetector computed tomography for acute pulmonary embolism. N Engl J Med 2006;354:2317–27. doi:10.1056/NEJMoa052367.

    Article  PubMed  CAS  Google Scholar 

  5. Bajc M, Bitzen U, Olsson B, de Sa Perez V, Palmer J, Jonson B. Lung ventilation/perfusion SPECT in the artificially embolized pig. J Nucl Med 2002;43:640–7.

    PubMed  Google Scholar 

  6. Bajc M, Olsson CG, Olsson B, Palmer J, Jonson B. Diagnostic evaluation of planar and tomographic ventilation/perfusion lung images in patients with suspected pulmonary emboli. Clin Physiol Funct Imaging 2004;24:249–56. doi:10.1111/j.1475-097X.2004.00546.x.

    Article  PubMed  Google Scholar 

  7. Collart JP, Roelants V, Vanpee D, Lacrosse M, Trigaux JP, Delaunois L, et al. Is a lung perfusion scan obtained by using single photon emission computed tomography able to improve the radionuclide diagnosis of pulmonary embolism? Nucl Med Commun 2002;23:1107–13. doi:10.1097/00006231-200211000-00011.

    Article  PubMed  Google Scholar 

  8. Reinartz P, Wildberger JE, Schaefer W, Nowak B, Mahnken AH, Buell U. Tomographic imaging in the diagnosis of pulmonary embolism: a comparison between V/Q lung scintigraphy in SPECT technique and multislice spiral CT. J Nucl Med 2004;45:1501–8.

    PubMed  Google Scholar 

  9. Schuemichen C. Pulmonary embolism: is multislice CT the method of choice? Against. Eur J Nucl Med Mol Imaging 2005;32:107–12. doi:10.1007/s00259-004-1679-6.

    Article  PubMed  Google Scholar 

  10. Miniati M, Pistolesi M, Marini C, Di Ricco G, Formichi B, Prediletto R, et al. Value of perfusion lung scan in the diagnosis of pulmonary embolism: results of the Prospective Investigative Study of Acute Pulmonary Embolism Diagnosis (PISA-PED). Am J Respir Crit Care Med 1996;154:1387–93.

    PubMed  CAS  Google Scholar 

  11. Sostman HD, Miniati M, Gottschalk A, Matta F, Stein PD, Pistolesi M. Sensitivity and specificity of perfusion scintigraphy combined with chest radiography for acute pulmonary embolism in PIOPED II. J Nucl Med 2008;49:1741–8. doi:10.2967/jnumed.108.052217.

    Article  PubMed  Google Scholar 

  12. Miniati M, Bottai M, Monti S, Salvadori M, Serasini L, Passera M. Simple and accurate prediction of the clinical probability of pulmonary embolism. Am J Respir Crit Care Med 2008;178:290–4. doi:10.1164/rccm.200802-207OC.

    Article  PubMed  Google Scholar 

  13. Perrier A. D-dimer for suspected pulmonary embolism: whom should we test? Chest 2004;125:807–9. doi:10.1378/chest.125.3.807.

    Article  PubMed  Google Scholar 

  14. Wells PS, Anderson DR, Rodger M, Stiell I, Dreyer JF, Barnes D, et al. Excluding pulmonary embolism at the bedside without diagnostic imaging: management of patients with suspected pulmonary embolism presenting to the emergency department by using a simple clinical model and d-dimer. Ann Intern Med 2001;135:98–107.

    PubMed  CAS  Google Scholar 

  15. Bajc M, Olsson B, Palmer J, Jonson B. Ventilation/perfusion SPECT for diagnostics of pulmonary embolism in clinical practise. J Intern Med 2008;264:379–87. doi:10.1111/j.1365-2796.2008.01980.x.

    Article  PubMed  CAS  Google Scholar 

  16. Leblanc M, Leveillee F, Turcotte E. Prospective evaluation of the negative predictive value of V/Q SPECT using 99mTc-Technegas. Nucl Med Commun 2007;28:667–72. doi:10.1097/MNM.0b013e32827a8e99.

    Article  PubMed  Google Scholar 

  17. Lemb M, Pohlabeln H. Pulmonary thromboembolism: a retrospective study on the examination of 991 patients by ventilation/perfusion SPECT using Technegas. Nuclearmedizin 2001;40:179–86.

    CAS  Google Scholar 

  18. Freeman LM, Krynyckyi B, Zuckier LS. Enhanced lung scan diagnosis of pulmonary embolism with the use of ancillary scintigraphic findings and clinical correlation. Semin Nucl Med 2001;31:143–57. doi:10.1053/snuc.2001.21273.

    Article  PubMed  CAS  Google Scholar 

  19. Chapman CN, Sziklas JJ, Spencer RP, Rosenberg RJ. Pulmonary perfusion "without ventilation". J Nucl Med 1983;24:1149–50.

    PubMed  CAS  Google Scholar 

  20. Sostman HD, Neumann RD, Gottschalk A, Greenspan RH. Perfusion of nonventilated lung: failure of hypoxic vasoconstriction? AJR Am J Roentgenol 1983;141:151–6.

    PubMed  CAS  Google Scholar 

  21. Carvalho P, Lavender JP. The incidence and etiology of the ventilation/perfusion reverse mismatch defect. Clin Nucl Med 1989;14:571–6. doi:10.1097/00003072-198908000-00004.

    Article  PubMed  CAS  Google Scholar 

  22. Li DJ, Stewart I, Miles KA, Wraight EP. Scintigraphic appearances in patients with pulmonary infection and lung scintigrams of intermediate or low probability for pulmonary embolism. Clin Nucl Med 1994;19:1091–3. doi:10.1097/00003072-199419120-00011.

    Article  PubMed  CAS  Google Scholar 

  23. Sostman HD, Gottschalk A. Prospective validation of the stripe sign in ventilation-perfusion scintigraphy. Radiology 1992;184:455–9.

    PubMed  CAS  Google Scholar 

  24. Sostman HD, Ravin CE, Sullivan DC, Mills SR, Glickman MG, Dorfman GS. Use of pulmonary angiography for suspected pulmonary embolism: influence of scintigraphic diagnosis. AJR Am J Roentgenol 1982;139:673–7.

    PubMed  CAS  Google Scholar 

  25. Friedman WF, Braunwald E. Alterations in regional pulmonary blood flow in mitral valve disease studied by radioisotope scanning. A simple nontraumatic technique for estimation of left atrial pressure. Circulation 1966;34:363–76.

    PubMed  CAS  Google Scholar 

  26. Pistolesi M, Miniati M, Bonsignore M, Andreotti F, Di Ricco G, Marini C, et al. Factors affecting regional pulmonary blood flow in chronic ischemic heart disease. J Thorac Imaging 1988;3:65–72.

    Article  PubMed  CAS  Google Scholar 

  27. Jogi J, Palmer J, Jonson B, Bajc M. Heart failure diagnostics based on ventilation/perfusion single photon emission computed tomography pattern and quantitative perfusion gradients. Nucl Med Commun 2008;29:666–73.

    Article  PubMed  Google Scholar 

  28. Freeman LM. Don't bury the V/Q scan: it's as good as multidetector CT angiograms with a lot less radiation exposure. J Nucl Med 2008;49:5–8. doi:10.2967/jnumed.107.048066.

    Article  PubMed  Google Scholar 

  29. Andreou AK, Curtin JJ, Wilde S, Clark A. Does pregnancy affect vascular enhancement in patients undergoing CT pulmonary angiography? Eur Radiol 2008;18:2716–22.

    Article  PubMed  Google Scholar 

  30. U-King-Im JM, Freeman SJ, Boylan T, Cheow HK. Quality of CT pulmonary angiography for suspected pulmonary embolus in pregnancy. Eur Radiol 2008;18:2709–15.

    Article  PubMed  Google Scholar 

  31. Schaefer-Prokop C, Prokop M. CTPA for the diagnosis of acute pulmonary embolism during pregnancy. Eur Radiol 2008;18:2705–8.

    Article  PubMed  Google Scholar 

  32. Bajc M. Value of ventilation/perfusion SPECT detecting extensive pulmonary embolism in a patient with pneumonia. Thromb Haemost 2005;93:993–4.

    PubMed  Google Scholar 

  33. Olsson CG, Bitzen U, Olsson B, Magnusson P, Carlsson MS, Jonson B, et al. Outpatient tinzaparin therapy in pulmonary embolism quantified with ventilation/perfusion scintigraphy. Med Sci Monit 2006;12:PI9–13.

    PubMed  Google Scholar 

  34. ICRP. Radiation dose to patients from radiopharmaceuticals, publication 53. Oxford, New York: ICRP; 1988. p. 121.

    Google Scholar 

  35. ICRP. Radiation dose to patients from radiopharmaceuticals, publication 80 (addendum to ICRP 53). Ann ICRP 1998;28.

  36. Hurwitz LM, Yoshizumi T, Reiman RE, Goodman PC, Paulson EK, Frush DP, et al. Radiation dose to the fetus from body MDCT during early gestation. AJR Am J Roentgenol 2006;186:871–6. doi:10.2214/AJR.04.1915.

    Article  PubMed  Google Scholar 

  37. Valentin J; International Commission on Radiation Protection. Managing patient dose in multi-detector computed tomography (MDCT). ICRP publication 102. Ann ICRP 2007;37:1–79.

    CAS  Google Scholar 

  38. Hurwitz LM, Yoshizumi TT, Goodman PC, Nelson RC, Toncheva G, Nguyen GB, et al. Radiation dose savings for adult pulmonary embolus 64-MDCT using bismuth breast shields, lower peak kilovoltage, and automatic tube current modulation. AJR Am J Roentgenol 2009;192:244–53. doi:10.2214/AJR.08.1066.

    Article  PubMed  Google Scholar 

  39. Hurwitz LM, Yoshizumi TT, Reiman RE, Paulson EK, Frush DP, Nguyen GT, et al. Radiation dose to the female breast from 16-MDCT body protocols. AJR Am J Roentgenol 2006;186:1718–22. doi:10.2214/AJR.04.1917.

    Article  PubMed  Google Scholar 

Download references

Conflict of interest

None.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Marika Bajc.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Bajc, M., Jonson, B. Ventilation/perfusion SPECT — an essential but underrated method for diagnosis of pulmonary embolism and other diseases. Eur J Nucl Med Mol Imaging 36, 875–878 (2009). https://doi.org/10.1007/s00259-009-1125-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00259-009-1125-x

Keywords

Navigation