Journal of Nuclear Medicine and Radiation Sciences最新文献

{"title":"Efficacy of Ventilation Perfusion Lung Scanning and Computed Tomography Pulmonary Angiography for Chronic Thrombo-Embolic Pulmonary Hypertension","authors":"G. Currie, Janelle Wheat, Michael Tong","doi":"10.31487/j.jnmrs.2020.01.01","DOIUrl":"https://doi.org/10.31487/j.jnmrs.2020.01.01","url":null,"abstract":"Introduction: The diagnostic approach for patients with suspected Chronic Thrombo-Embolic Pulmonary\u0000Hypertension (CTEPH) is a combination of clinical and pre-test probability assessment, and diagnostic\u0000imaging of computed tomography pulmonary angiogram (CTPA) or lung ventilation and perfusion\u0000scintigraphy (V/Q). There is a paucity of literature, particularly for Southeast Asia (SEA) populations,\u0000regarding the efficacy of these imaging approaches. This study investigated the sensitivity and specificity\u0000of V/Q and CTPA in the diagnosis of CTEPH.\u0000Methods: A retrospective analysis was undertaken on 133 consecutive patients presenting for pulmonary\u0000hypertension (PH). The population included 42 males, 91 females, 683 V/Q images and 6288 CTPA images\u0000for patients in the age range 18 to 93 years (mean 66). All data was retrospectively analysed by two nuclear\u0000medicine physicians and classified as findings consistent with CTEPH or inconsistent with CTEPH. These\u0000classifications were independently and collectively correlated with a final diagnosis of CTEPH or no\u0000CTEPH.\u0000Results: The accuracy, sensitivity, and specificity of V/Q for detection of CTEPH was 83.5%, 57.5% and\u000097.7% respectively, with a positive predictive value (PPV) of 93.1% and a negative predictive value (NPV)\u0000of 80.8% when only high probability reports were considered CTEPH positive. The accuracy, sensitivity,\u0000and specificity of V/Q for detection of CTEPH was 96.2%, 97.9% and 95.4% respectively, with a PPV of\u000092.0% and a NPV of 98.8% when both high probability and intermediate probability reports were considered\u0000CTEPH positive. The accuracy, sensitivity and specificity of CTPA for detection of CTEPH were 70.7%,\u000019.2% and 98.8% respectively, with 90% PPV and 69.1% NPV. All 47 CTEPH studies were reported as\u0000having abnormal lung perfusion.\u0000Conclusion: This investigation has shown that V/Q is a more valuable diagnostic imaging tool in detecting\u0000CTEPH than CTPA. In suspected CTEPH, a high/intermediate V/Q report is consistent with a positive\u0000diagnosis. This is an important finding as CTEPH is a potentially treatable condition.","PeriodicalId":373809,"journal":{"name":"Journal of Nuclear Medicine and Radiation Sciences","volume":"25 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114552289","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}