Ventilation/perfusion SPECT in children: Feasibility, impact on clinical decision-making and interrater agreement

Abstract

Introduction

It remains to be established whether it provides any clinical or diagnostic benefits to perform ventilation/perfusion (V/Q) scintigraphy as a single photon emission computed tomography in children. Here, we report our experience with this modality, evaluate its impact on clinical decision-making and assess its interrater agreement.

Methods

All V/Q scintigraphies performed in children over a 1-year period were identified, and patient files were reviewed. Two nuclear medicine physicians, blinded to patient data and each other's readings, interpreted all scintigraphies.

Results

A total of 20 planar and SPECT V/Q scintigraphies were identified. In 17/20 cases (85%), the results of the scan were found to directly inform clinical decision-making. SPECT mainly ruled out the presence of ventilation and perfusion defects that were suspected on planar scintigraphy. In terms of interrater agreement, Cohen's ϰ coefficients for planar ventilation and perfusion scintigraphy were 0.34 and 0.38 (fair agreement), respectively, while the corresponding values for SPECT were 0.42 and 0.61 (moderate to substantial agreement).

Conclusion

It is both feasible and clinically meaningful to perform V/Q SPECT in children. In this patient group, V/Q SPECT furthermore seems to have better interrater agreement than planar scintigraphy.