Comparison of V/Q SPECT and planar V/Q lung scintigraphy in diagnosing acute pulmonary embolism

Nucl Med Commun. 2010 Jan;31(1):82-6. doi: 10.1097/MNM.0b013e3283336747.


Purpose: Planar ventilation/perfusion (V/Q) scintigraphy is currently the standard method for the diagnosis of pulmonary embolism (PE) in most nuclear medicine centers. However, recent studies have shown a superior sensitivity and specificity when applying V/Q single photon emission computed tomography (SPECT) in diagnosing PE. This study evaluated the diagnostic performance of three-dimensional V/Q SPECT in comparison with planar V/Q scintigraphy.

Materials and methods: Consecutive patients suspected of acute PE from June 2006 to February 2008 were referred to the Department of Nuclear Medicine at Frederiksberg Hospital, Denmark to a V/Q SPECT, as the first-line imaging procedure. Patients with positive D-dimer (>0.5 mg/l) or after clinical assessment with a Wells score of more than 2 were included and had a V/Q SPECT, low-dose CT, planar V/Q scintigraphy, and pulmonary multidetector computer tomography angiography performed the same day. Ventilation studies were performed using Kr. Patient follow-up was at least 6 months.

Results: A total of 36 patient studies were available for analysis, of which 11 (31%) had PE. V/Q SPECT had a sensitivity of 100% and a specificity of 87%. Planar V/Q scintigraphy had a sensitivity of 64% and a specificity of 72%.

Conclusion: We conclude that V/Q SPECT has a superior diagnostic performance compared with planar V/Q scintigraphy and should be preferred when diagnosing PE.

Publication types

  • Clinical Trial
  • Comparative Study

MeSH terms

  • Aged
  • Angiography
  • Echocardiography
  • Electrocardiography
  • Female
  • Follow-Up Studies
  • Humans
  • Lower Extremity / blood supply
  • Lung / diagnostic imaging*
  • Lung / physiopathology
  • Male
  • Perfusion Imaging*
  • Pulmonary Embolism / diagnostic imaging*
  • Pulmonary Embolism / physiopathology
  • Pulmonary Ventilation*
  • Radiation Dosage
  • Tomography, Emission-Computed, Single-Photon*
  • Veins / diagnostic imaging