Utility of Lung Perfusion SPECT/CT in Detection of Pulmonary Thromboembolic Disease: Outcome Analysis.

IF 1.3 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Nuclear Medicine and Molecular Imaging Pub Date : 2023-02-01 DOI:10.1007/s13139-021-00726-2

Teik Hin Tan, Rosmadi Ismail

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引用次数: 6

Abstract

Purpose: To evaluate the clinical outcome of Q-SPECT/CT in pulmonary thromboembolic disease.

Methods: From Jan 2020 to Jan 2021, 30 consecutive patients (M:F = 8:22; median age = 52 year (21-89)) suspected of having acute pulmonary embolism (PE) or chronic thromboembolic pulmonary hypertension (CTEPH) were referred for non-contrasted Q-SPECT/CT. All patients were COVID-19 PCR negative. MSKCC Q-SPECT/CT and/or PISAPED criteria were used to determine the presence of thromboembolic disease in Q-SPECT/CT. Final diagnosis was made based on composite reference standards that included at least 2-month clinical cardiorespiratory assessment and follow-up imaging.

Results: Q-SPECT/CT was positive in 19 patients: indeterminate in 1 and 10 were negative. Three false positive cases were observed during follow-up. Of the remaining 16 true positives, all patients' cardiorespiratory symptom were improved or stabilised after treatment with anticoagulants. The overall sensitivity, specificity, PPV, NPV and accuracy of Q-SPECT/CT were 100% (95% CI, 79.41-100%), 78.57% (95% CI, 49.20-95.34%), 84.21% (95% CI, 66.41-93.57%), 100% and 90.00% (95% CI, 73.47-97.89%) respectively.

Conclusions: In the current COVID-19 pandemic, Q-SPECT/CT can be an alternative modality to detect pulmonary thromboembolic disease. Normal Q-SPECT/CT excludes pulmonary thromboembolic disease with high degree of certainty. However, false positive has been observed.

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肺灌注SPECT/CT在肺血栓栓塞性疾病检测中的应用:结果分析。

目的:评价Q-SPECT/CT诊断肺血栓栓塞性疾病的临床效果。方法:2020年1月至2021年1月，连续30例患者(男:女= 8:22;中位年龄= 52岁(21-89岁))，怀疑患有急性肺栓塞(PE)或慢性血栓栓塞性肺动脉高压(CTEPH)，转介进行非对比Q-SPECT/CT检查。所有患者均为COVID-19 PCR阴性。使用MSKCC Q-SPECT/CT和/或pisped标准来确定Q-SPECT/CT是否存在血栓栓塞性疾病。最终诊断基于综合参考标准，包括至少2个月的临床心肺评估和随访影像。结果:19例患者Q-SPECT/CT阳性，1例不确定，10例阴性。随访中观察到3例假阳性。在其余16例真阳性患者中，所有患者的心肺症状在抗凝治疗后均得到改善或稳定。Q-SPECT/CT的总体灵敏度、特异度、PPV、NPV和准确度分别为100% (95% CI, 79.41 ~ 100%)、78.57% (95% CI, 49.20 ~ 95.34%)、84.21% (95% CI, 66.41 ~ 93.57%)、100%和90.00% (95% CI, 73.47 ~ 97.89%)。结论:在当前的COVID-19大流行中，Q-SPECT/CT可作为检测肺血栓栓塞性疾病的替代方式。正常的Q-SPECT/CT高度肯定地排除肺血栓栓塞性疾病。然而，已经观察到假阳性。

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来源期刊

Nuclear Medicine and Molecular Imaging RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-

CiteScore

2.20

自引率

7.70%

发文量

期刊介绍： Nuclear Medicine and Molecular Imaging (Nucl Med Mol Imaging) is an official journal of the Korean Society of Nuclear Medicine, which bimonthly publishes papers on February, April, June, August, October, and December about nuclear medicine and related sciences such as radiochemistry, radiopharmacy, dosimetry and pharmacokinetics / pharmacodynamics of radiopharmaceuticals, nuclear and molecular imaging analysis, nuclear and molecular imaging instrumentation, radiation biology and radionuclide therapy. The journal specially welcomes works of artificial intelligence applied to nuclear medicine. The journal will also welcome original works relating to molecular imaging research such as the development of molecular imaging probes, reporter imaging assays, imaging cell trafficking, imaging endo(exo)genous gene expression, and imaging signal transduction. Nucl Med Mol Imaging publishes the following types of papers: original articles, reviews, case reports, editorials, interesting images, and letters to the editor. The Korean Society of Nuclear Medicine (KSNM) KSNM is a scientific and professional organization founded in 1961 and a member of the Korean Academy of Medical Sciences of the Korean Medical Association which was established by The Medical Services Law. The aims of KSNM are the promotion of nuclear medicine and cooperation of each member. The business of KSNM includes holding academic meetings and symposia, the publication of journals and books, planning and research of promoting science and health, and training and qualification of nuclear medicine specialists.