JNM: Molecular imaging effective for diagnosing pulmonary embolism

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Research published in the December issue of the Journal of Nuclear Medicine suggests that SPECT, when combined with low-dose CT, can provide an accurate diagnosis for pulmonary embolism.

"Pulmonary embolism is very difficult to diagnose clinically," said J. Anthony Parker, MD, PhD, from Beth Israel Deaconess Medical Center in Boston, who authored an perspective on the study in December issue. "More accurate diagnosis, including both improved sensitivity and specificity, should result in better patient outcomes."

In a related article also published in this month's issue Paul D. Stein, MD, from Michigan State University in East Lansing and other researchers discussed the renewed interest in SPECT as the initial imaging test for pulmonary embolism as a result of improved instrumentation and improved interpretation of lung scans.

In the study, Henrik Gutte, MD, and colleagues from Copenhagen University Hospital in Copenhagen, Denmark  showed that ventilation–perfusion (V/Q) SPECT/CT imaging may considerably improve the diagnosis of pulmonary embolism.

In the study, 196 patients suspected of having acute pulmonary embolism were included and the patient follow-up was six months. Out of the total 81 simultaneous studies available for analysis, 38 percent were from patients with pulmonary embolism.

The reserachers reported that SPECT plus low-dose CT had a sensitivity of 97 percent and a specificity of 100 percent, whereas of multidetector CT angiography alone had a sensitivity of 68 percent and a specificity of 100 percent.

The investigators concluded 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 diagnosing pulmonary embolism.