The diagnostic accuracy of perfusion-only scan in the diagnosis of pulmonary embolism in the era of COVID-19: A single-center study of 434 patients

被引:2
作者
Cengiz, Turgut Bora [1 ]
Abdelrahman, Ahmed [1 ]
Rohren, Scott A. [1 ]
Doucette, John [1 ]
Ghesani, Munir [1 ]
机构
[1] Mt Sinai Hosp, Dept Diagnost Mol & Intervent Radiol, Div Nucl Med, New York, NY 10029 USA
关键词
Pulmonary embolism; scintigraphy; ventilation/perfusion; SCINTIGRAPHY;
D O I
10.4103/atm.atm_42_23
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
INTRODUCTION: There is a paucity of data in the literature regarding the diagnostic accuracy of perfusion (Q)-only studies in the absence of ventilation images. This study aims to assess the diagnostic accuracy of Q-only imaging in the pandemic era. METHODS: Patients who underwent Q-only imaging for pulmonary embolism between March 2020 and February 2021 were analyzed. Patients who underwent lung quantification analysis were excluded. Q-only test results were reported as per modified PIOPED II criteria and single positron emission tomography/computed tomography (SPECT/CT) imaging was performed as needed. Patients were considered concordant or discordant by correlating the Q-only results with CT angiogram (CTA) or clinical diagnosis made through chart review. The diagnostic accuracy was calculated after excluding intermediate probability and nondiagnostic studies. RESULTS: Four hundred and thirty-four patients were identified. One hundred and twenty-eight patients (29.4%) underwent ultrasound Doppler, 37 patients ( 8.5%) underwent CTA, and 16 patients (3.6%) underwent both. After excluding patients with intermediate probability or nondiagnostic studies and who did not have follow-up (a total of 87 patients [20%]), 347 patients were enrolled in the final analysis. The combined planar and SPECT/CT sensitivity and specificity were 85.4% (72.2%-93.9% confidence interval [CI]) and 98.7% (96.9%-98.6% CI), respectively. The positive predictive value (PPV) of the Q-only imaging was 89.1% (77.3%-95.1% CI) and the negative predictive value (NPV) was 98.2% (96.4%-99% CI). The sensitivity with SPECT/CT reached 100% (CI: 71.5%-100%) with a specificity of 92.3% (CI: 64%-99.8%). The PPV was 85.7% (CI: 62.1%-95.6%) and the NPV was 100%. CONCLUSION: Q-only imaging provides clinically acceptable results. The sensitivity of the Q-only scan is increased when coupled with SPECT/CT.
引用
收藏
页码:199 / 205
页数:7
相关论文
共 23 条
[1]   Computed tomographic pulmonary angiography vs ventilation-perfusion lung scanning in patients with suspected pulmonary embolism - A Randomized controlled trial [J].
Anderson, David R. ;
Kahn, Susan R. ;
Rodger, Marc A. ;
Kovacs, Michael J. ;
Morris, Tim ;
Hirsch, Andrew ;
Lang, Eddy ;
Stiell, Ian ;
Kovacs, George ;
Dreyer, Jon ;
Dennie, Carol ;
Cartier, Yannick ;
Barnes, David ;
Burton, Erica ;
Pleasance, Susan ;
Skedgel, Chris ;
O'Rouke, Keith ;
Wells, Philip S. .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2007, 298 (23) :2743-2753
[2]   Ventilation-Perfusion Scans After the COVID-19 Pandemic: Point-Ventilation Studies Are Dispensable [J].
Boone, Sean L. ;
Zuckier, Lionel S. .
AMERICAN JOURNAL OF ROENTGENOLOGY, 2022, 218 (01) :29-30
[3]   Clinical utility of perfusion (Q)-single-photon emission computed tomography (SPECT)/CT for diagnosing pulmonary embolus (PE) in COVID-19 patients with a moderate to high pre-test probability of PE [J].
Das, Jeeban P. ;
Yeh, Randy ;
Schoder, Heiko .
EUROPEAN JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING, 2021, 48 (03) :794-799
[4]  
de Groot MR, 2000, THROMB HAEMOSTASIS, V83, P412
[5]   COVID-19 and Venous Thromboembolism: A Meta-analysis of Literature Studies [J].
Di Minno, Alessandro ;
Ambrosino, Pasquale ;
Calcaterra, Ilenia ;
Di Minno, Matteo Nicola Dario .
SEMINARS IN THROMBOSIS AND HEMOSTASIS, 2020, 46 (07) :763-771
[6]   The impact of COVID-19 on the sensitivity of D-dimer for pulmonary embolism [J].
Elberts, Samuel J. ;
Bateman, Ryan ;
Koutsoubis, Alexandra ;
London, Kory S. ;
White, Jennifer L. ;
Fields, J. Matthew .
ACADEMIC EMERGENCY MEDICINE, 2021, 28 (10) :1142-1149
[7]  
Klok FA, 2020, THROMB RES, V191, P145, DOI [10.1016/j.thromres.2020.04.013, 10.1016/j.thromres.2020.04.041]
[8]   Pulmonary Vascular Manifestations of COVID-19 Pneumonia [J].
Lang, Min ;
Som, Avik ;
Carey, Denston ;
Reid, Nicholas ;
Mendoza, Dexter P. ;
Flores, Efren J. ;
Li, Matthew D. ;
Shepard, Jo-Anne O. ;
Little, Brent P. .
RADIOLOGY-CARDIOTHORACIC IMAGING, 2020, 2 (03)
[9]   Ventilation-Perfusion Scans After the COVID-19 Pandemic: Counterpoint -Ventilation Studies Are Here to Stay [J].
Lavely, William C. ;
Patel, Vishal K. .
AMERICAN JOURNAL OF ROENTGENOLOGY, 2022, 218 (01) :31-32
[10]   Perfusion SPECT/CT to diagnose pulmonary embolism during COVID-19 pandemic [J].
Lu, Yang ;
Macapinlac, Homer A. .
EUROPEAN JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING, 2020, 47 (09) :2064-2065