Advertisement

Ventilation/Perfusion Imaging with SPECT-CT

  • Henrik Gutte
  • Jann Mortensen
  • Andreas Kjær
Chapter
  • 1.3k Downloads

Abstract

Acute pulmonary embolism (PE) is a severe and potentially fatal disease with a mortality rate of approximately 30% if untreated. The incidence is 2 per 1,000 person years in the Western countries. PE is a blockage of the main pulmonary artery or one of its branches by a thrombus, typically a blood clot from the deep veins of the lower extremities. PE reduces the cross-sectional area of the pulmonary blood vessels, resulting in an increase in total pulmonary vascular resistance and pulmonary hypertension.

Keywords

Acute Pulmonary Embolism Lung Volume Reduction Surgery MDCT Angiography Lung Scintigraphy Pulmonary Blood Vessel 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. 1.
    Blachere H, Latrabe V, Montaudon M, Valli N, Couffinhal T, Raherisson C, et al. Pulmonary embolism revealed on helical CT angiography: comparison with ventilation–perfusion radionuclide lung scanning. Am J Roentgenol. 2000;174(4):1041–7.Google Scholar
  2. 2.
    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(22):2317–27.PubMedCrossRefGoogle Scholar
  3. 3.
    Stein PD, Woodard PK, Weg JG, Wakefield TW, Tapson VF, Sostman HD, et al. Diagnostic pathways in acute pulmonary embolism: recommendations of the PIOPED II investigators. Radiology. 2007;242(1):15–21.PubMedCrossRefGoogle Scholar
  4. 4.
    Strashun AM. A reduced role of V/Q scintigraphy in the diagnosis of acute pulmonary embolism. J Nucl Med. 2007;48(9):1405–7.PubMedCrossRefGoogle Scholar
  5. 5.
    Mayo JR, Remy-Jardin M, Muller NL, Remy J, Worsley DF, Hossein-Foucher C, et al. Pulmonary embolism: prospective comparison of spiral CT with ventilation-perfusion scintigraphy. Radiology. 1997;205(2):447–52.PubMedGoogle Scholar
  6. 6.
    Coche E, Verschuren F, Keyeux A, Goffette P, Goncette L, Hainaut P, et al. Diagnosis of acute pulmonary embolism in outpatients: comparison of thin-collimation multi-detector row spiral CT and planar ventilation-perfusion scintigraphy. Radiology. 2003;229(3):757–65.PubMedCrossRefGoogle Scholar
  7. 7.
    PIOPED Investigators. Value of the ventilation/perfusion scan in acute pulmonary embolism. Results of the prospective investigation of pulmonary embolism diagnosis (PIOPED). The PIOPED investigators. JAMA. 1990;263(20):2753–9.CrossRefGoogle Scholar
  8. 8.
    Gutte H, Mortensen J, Jensen C, von der Recke P, Petersen CL, Kristoffersen US, et al. Comparison of V/Q-SPECT and planar V/Q-lung scintigraphy in diagnosing acute pulmonary embolism. Nucl Med Commun. 2010;31(1):82–6.PubMedCrossRefGoogle Scholar
  9. 9.
    Gutte H, Mortensen J, Jensen C, von der Recke P, Kristoffersen US, Kjær A. Added value of combined simultaneous lung ventilation-perfusion single-photon emission computed tomography/multi-slice-computed tomography ­angiography in two patients suspected of having acute pulmonary embolism. Clin Respir J. 2008;1(1):52–5.CrossRefGoogle Scholar
  10. 10.
    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(9):1501–8.PubMedGoogle Scholar
  11. 11.
    Gutte H, Mortensen J, Jensen C, Johnbeck CB, von der Recke P, Petersen CL, et al. Detection of pulmonary embolism with combined ventilation-perfusion SPECT and low-dose CT: head-to-head comparison with CT angiography. J Nucl Med. 2009;50:1987–92.PubMedGoogle Scholar
  12. 12.
    Petersson J, Sanchez-Crespo A, Larsson SA, Mure M. Physiological imaging of the lung: single-photon-emission computed tomography (SPECT). J Appl Physiol. 2007;102(1):468–76.PubMedCrossRefGoogle Scholar
  13. 13.
    Bailey D, Roach P, Bailey E, Hewlett J, Keijzers R. Development of a cost-effective modular SPECT/CT scanner. Eur J Nucl Med Mol Imaging. 2007;34(9):1415–26.PubMedCrossRefGoogle Scholar
  14. 14.
    Miles S, Rogers KM, Thomas P, Soans B, Attia J, Abel C, et al. A comparison of SPECT lung scintigraphy and CTPA for the diagnosis of pulmonary embolism. Chest. 2009;136(6):1546–3.PubMedCrossRefGoogle Scholar
  15. 15.
    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(5):249–56.PubMedCrossRefGoogle Scholar
  16. 16.
    Roach PJ, Bailey DL, Harris BE. Enhancing lung scintigraphy with single-photon emission computed tomography. Semin Nucl Med. 2008;38(6):441–9.PubMedCrossRefGoogle Scholar
  17. 17.
    Schumichen C. V/Q-scanning/SPECT for the diagnosis of pulmonary embolism. Respiration. 2003;70(4):329–42.PubMedCrossRefGoogle Scholar
  18. 18.
    Bajc M, Neilly J, Miniati M, Schuemichen C, Meignan M, Jonson B. EANM guidelines for ventilation/perfusion scintigraphy. Eur J Nucl Med Mol Imaging. 2009;36(8):1356–70.PubMedCrossRefGoogle Scholar
  19. 19.
    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(8):667–72.PubMedCrossRefGoogle Scholar
  20. 20.
    Bajc M, Olsson B, Palmer J, Jonson B. Ventilation/perfusion SPECT for diagnostics of pulmonary embolism in clinical practice. J Intern Med. 2008;264(4):379–87.PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2011

Authors and Affiliations

  • Henrik Gutte
    • 1
  • Jann Mortensen
    • 1
  • Andreas Kjær
    • 1
  1. 1.Department of Clinical Physiology, Nuclear Medicine and PETCopenhagen University HospitalCopenhagenDenmark

Personalised recommendations