Detection of pulmonary embolism with combined ventilation-perfusion SPECT and low-dose CT: head-to-head comparison with multidetector CT angiography

Research output: Contribution to journalJournal articleResearchpeer-review

Standard

Detection of pulmonary embolism with combined ventilation-perfusion SPECT and low-dose CT: head-to-head comparison with multidetector CT angiography. / Gutte, Henrik; Mortensen, Jann; Jensen, Claus Verner; Johnbeck, Camilla Bardram; von der Recke, Peter; Petersen, Claus Leth; Kjaergaard, Jesper; Kristoffersen, Ulrik Sloth; Kjaer, Andreas.

In: Journal of Nuclear Medicine, Vol. 50, No. 12, 2009, p. 1987-92.

Research output: Contribution to journalJournal articleResearchpeer-review

Harvard

Gutte, H, Mortensen, J, Jensen, CV, Johnbeck, CB, von der Recke, P, Petersen, CL, Kjaergaard, J, Kristoffersen, US & Kjaer, A 2009, 'Detection of pulmonary embolism with combined ventilation-perfusion SPECT and low-dose CT: head-to-head comparison with multidetector CT angiography', Journal of Nuclear Medicine, vol. 50, no. 12, pp. 1987-92. https://doi.org/10.2967/jnumed.108.061606

APA

Gutte, H., Mortensen, J., Jensen, C. V., Johnbeck, C. B., von der Recke, P., Petersen, C. L., ... Kjaer, A. (2009). Detection of pulmonary embolism with combined ventilation-perfusion SPECT and low-dose CT: head-to-head comparison with multidetector CT angiography. Journal of Nuclear Medicine, 50(12), 1987-92. https://doi.org/10.2967/jnumed.108.061606

Vancouver

Gutte H, Mortensen J, Jensen CV, 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 multidetector CT angiography. Journal of Nuclear Medicine. 2009;50(12):1987-92. https://doi.org/10.2967/jnumed.108.061606

Author

Gutte, Henrik ; Mortensen, Jann ; Jensen, Claus Verner ; Johnbeck, Camilla Bardram ; von der Recke, Peter ; Petersen, Claus Leth ; Kjaergaard, Jesper ; Kristoffersen, Ulrik Sloth ; Kjaer, Andreas. / Detection of pulmonary embolism with combined ventilation-perfusion SPECT and low-dose CT: head-to-head comparison with multidetector CT angiography. In: Journal of Nuclear Medicine. 2009 ; Vol. 50, No. 12. pp. 1987-92.

Bibtex

@article{96306040359b11df8ed1000ea68e967b,
title = "Detection of pulmonary embolism with combined ventilation-perfusion SPECT and low-dose CT: head-to-head comparison with multidetector CT angiography",
abstract = "The diagnosis of pulmonary embolism (PE) is usually established by a combination of clinical assessment, D-dimer testing, and imaging with either pulmonary ventilation-perfusion (V/Q) scintigraphy or pulmonary multidetector CT (MDCT) angiography. Both V/Q SPECT and MDCT angiography seem to have high diagnostic accuracy. However, only limited data directly comparing these 2 modalities are available. Hybrid gamma-camera/MDCT systems have been introduced and allow simultaneous 3-dimensional lung V/Q SPECT and MDCT angiography, suitable for diagnosing PE. The aim of our study was to compare, in a prospective design, the diagnostic ability of V/Q SPECT, V/Q SPECT combined with low-dose CT, and pulmonary MDCT angiography obtained simultaneously using a combined SPECT/MDCT scanner in patients suspected of having PE. METHODS: Consecutive patients from June 2006 to February 2008 suspected of having acute PE were referred to the Department of Nuclear Medicine at Rigshospitalet or Frederiksberg Hospital, Denmark, for V/Q SPECT as a first-line imaging procedure. The number of eligible patients was 196. Patients with positive D-dimer results (>0.5 mmol/mL) or a clinical assessment with a Wells score greater than 2 were included and underwent V/Q SPECT, low-dose CT, and pulmonary MDCT angiography in a single session. Patient follow-up was 6 mo. RESULTS: A total of 81 simultaneous studies were available for analysis, of which 38{\%} were from patients with PE. V/Q SPECT had a sensitivity of 97{\%} and a specificity of 88{\%}. When low-dose CT was added, the sensitivity was still 97{\%} and the specificity increased to 100{\%}. Perfusion SPECT with low-dose CT had a sensitivity of 93{\%} and a specificity of 51{\%}. MDCT angiography alone had a sensitivity of 68{\%} and a specificity of 100{\%}. CONCLUSION: We conclude that V/Q SPECT in combination with low-dose CT without contrast enhancement has an excellent diagnostic performance and should therefore probably be considered first-line imaging in the work-up of PE in most cases.",
author = "Henrik Gutte and Jann Mortensen and Jensen, {Claus Verner} and Johnbeck, {Camilla Bardram} and {von der Recke}, Peter and Petersen, {Claus Leth} and Jesper Kjaergaard and Kristoffersen, {Ulrik Sloth} and Andreas Kjaer",
note = "Keywords: Aged; Female; Humans; Male; Middle Aged; Perfusion Imaging; Pulmonary Artery; Pulmonary Embolism; Pulmonary Ventilation; Radiation Dosage; Sensitivity and Specificity; Time Factors; Tomography, Emission-Computed, Single-Photon; Tomography, X-Ray Computed",
year = "2009",
doi = "10.2967/jnumed.108.061606",
language = "English",
volume = "50",
pages = "1987--92",
journal = "The Journal of Nuclear Medicine",
issn = "0161-5505",
publisher = "Society of Nuclear Medicine",
number = "12",

}

RIS

TY - JOUR

T1 - Detection of pulmonary embolism with combined ventilation-perfusion SPECT and low-dose CT: head-to-head comparison with multidetector CT angiography

AU - Gutte, Henrik

AU - Mortensen, Jann

AU - Jensen, Claus Verner

AU - Johnbeck, Camilla Bardram

AU - von der Recke, Peter

AU - Petersen, Claus Leth

AU - Kjaergaard, Jesper

AU - Kristoffersen, Ulrik Sloth

AU - Kjaer, Andreas

N1 - Keywords: Aged; Female; Humans; Male; Middle Aged; Perfusion Imaging; Pulmonary Artery; Pulmonary Embolism; Pulmonary Ventilation; Radiation Dosage; Sensitivity and Specificity; Time Factors; Tomography, Emission-Computed, Single-Photon; Tomography, X-Ray Computed

PY - 2009

Y1 - 2009

N2 - The diagnosis of pulmonary embolism (PE) is usually established by a combination of clinical assessment, D-dimer testing, and imaging with either pulmonary ventilation-perfusion (V/Q) scintigraphy or pulmonary multidetector CT (MDCT) angiography. Both V/Q SPECT and MDCT angiography seem to have high diagnostic accuracy. However, only limited data directly comparing these 2 modalities are available. Hybrid gamma-camera/MDCT systems have been introduced and allow simultaneous 3-dimensional lung V/Q SPECT and MDCT angiography, suitable for diagnosing PE. The aim of our study was to compare, in a prospective design, the diagnostic ability of V/Q SPECT, V/Q SPECT combined with low-dose CT, and pulmonary MDCT angiography obtained simultaneously using a combined SPECT/MDCT scanner in patients suspected of having PE. METHODS: Consecutive patients from June 2006 to February 2008 suspected of having acute PE were referred to the Department of Nuclear Medicine at Rigshospitalet or Frederiksberg Hospital, Denmark, for V/Q SPECT as a first-line imaging procedure. The number of eligible patients was 196. Patients with positive D-dimer results (>0.5 mmol/mL) or a clinical assessment with a Wells score greater than 2 were included and underwent V/Q SPECT, low-dose CT, and pulmonary MDCT angiography in a single session. Patient follow-up was 6 mo. RESULTS: A total of 81 simultaneous studies were available for analysis, of which 38% were from patients with PE. V/Q SPECT had a sensitivity of 97% and a specificity of 88%. When low-dose CT was added, the sensitivity was still 97% and the specificity increased to 100%. Perfusion SPECT with low-dose CT had a sensitivity of 93% and a specificity of 51%. MDCT angiography alone had a sensitivity of 68% and a specificity of 100%. CONCLUSION: We conclude that V/Q SPECT in combination with low-dose CT without contrast enhancement has an excellent diagnostic performance and should therefore probably be considered first-line imaging in the work-up of PE in most cases.

AB - The diagnosis of pulmonary embolism (PE) is usually established by a combination of clinical assessment, D-dimer testing, and imaging with either pulmonary ventilation-perfusion (V/Q) scintigraphy or pulmonary multidetector CT (MDCT) angiography. Both V/Q SPECT and MDCT angiography seem to have high diagnostic accuracy. However, only limited data directly comparing these 2 modalities are available. Hybrid gamma-camera/MDCT systems have been introduced and allow simultaneous 3-dimensional lung V/Q SPECT and MDCT angiography, suitable for diagnosing PE. The aim of our study was to compare, in a prospective design, the diagnostic ability of V/Q SPECT, V/Q SPECT combined with low-dose CT, and pulmonary MDCT angiography obtained simultaneously using a combined SPECT/MDCT scanner in patients suspected of having PE. METHODS: Consecutive patients from June 2006 to February 2008 suspected of having acute PE were referred to the Department of Nuclear Medicine at Rigshospitalet or Frederiksberg Hospital, Denmark, for V/Q SPECT as a first-line imaging procedure. The number of eligible patients was 196. Patients with positive D-dimer results (>0.5 mmol/mL) or a clinical assessment with a Wells score greater than 2 were included and underwent V/Q SPECT, low-dose CT, and pulmonary MDCT angiography in a single session. Patient follow-up was 6 mo. RESULTS: A total of 81 simultaneous studies were available for analysis, of which 38% were from patients with PE. V/Q SPECT had a sensitivity of 97% and a specificity of 88%. When low-dose CT was added, the sensitivity was still 97% and the specificity increased to 100%. Perfusion SPECT with low-dose CT had a sensitivity of 93% and a specificity of 51%. MDCT angiography alone had a sensitivity of 68% and a specificity of 100%. CONCLUSION: We conclude that V/Q SPECT in combination with low-dose CT without contrast enhancement has an excellent diagnostic performance and should therefore probably be considered first-line imaging in the work-up of PE in most cases.

U2 - 10.2967/jnumed.108.061606

DO - 10.2967/jnumed.108.061606

M3 - Journal article

VL - 50

SP - 1987

EP - 1992

JO - The Journal of Nuclear Medicine

JF - The Journal of Nuclear Medicine

SN - 0161-5505

IS - 12

ER -

ID: 18764029