Nucl Med Mol Imaging.  2023 Feb;57(1):1-8. 10.1007/s13139-021-00726-2.

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

• Tan TH
• Ismail R

• KMID: 2539525
• DOI: http://doi.org/10.1007/s13139-021-00726-2

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.

Keyword

Perfusion; SPECT/CT; Thromboembolic; Pulmonary embolism; Chronic thromboembolic pulmonary hypertension