EANM guideline for ventilation/perfusion single-photon emission computed tomography (SPECT) for diagnosis of pulmonary embolism and beyond

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Bajc , M , Schümichen , C , Grüning , T , Lindqvist , A , Le Roux , P-Y , Alatri , A , Bauer , R W , Dilic , M , Neilly , B , Verberne , H J , Delgado Bolton , R C & Jonson , B 2019 , ' EANM guideline for ventilation/perfusion single-photon emission computed tomography (SPECT) for diagnosis of pulmonary embolism and beyond ' , European Journal of Nuclear Medicine and Molecular Imaging , vol. 46 , no. 12 , pp. 2429-2451 . https://doi.org/10.1007/s00259-019-04450-0

Title: EANM guideline for ventilation/perfusion single-photon emission computed tomography (SPECT) for diagnosis of pulmonary embolism and beyond
Author: Bajc, Marika; Schümichen, Carl; Grüning, Thomas; Lindqvist, Ari; Le Roux, Pierre-Yves; Alatri, Adriano; Bauer, Ralf W.; Dilic, Mirza; Neilly, Brian; Verberne, Hein J.; Delgado Bolton, Roberto C.; Jonson, Bjorn
Contributor: University of Helsinki, HUS Heart and Lung Center
Date: 2019-11
Language: eng
Number of pages: 23
Belongs to series: European Journal of Nuclear Medicine and Molecular Imaging
ISSN: 1619-7070
URI: http://hdl.handle.net/10138/306922
Abstract: These guidelines update the previous EANM 2009 guidelines on the diagnosis of pulmonary embolism (PE). Relevant new aspects are related to (a) quantification of PE and other ventilation/perfusion defects; (b) follow-up of patients with PE; (c) chronic PE; and (d) description of additional pulmonary physiological changes leading to diagnoses of left ventricular heart failure (HF), chronic obstructive pulmonary disease (COPD) and pneumonia. The diagnosis of PE should be reported when a mismatch of one segment or two subsegments is found. For ventilation, Technegas or krypton gas is preferred over diethylene triamine pentaacetic acid (DTPA) in patients with COPD. Tomographic imaging with V/P-SPECT has higher sensitivity and specificity for PE compared with planar imaging. Absence of contraindications makes V/P-SPECT an essential method for the diagnosis of PE. When V/P-SPECT is combined with a low-dose CT, the specificity of the test can be further improved, especially in patients with other lung diseases. Pitfalls in V/P-SPECT interpretation are discussed. In conclusion, V/P-SPECT is strongly recommended as it accurately establishes the diagnosis of PE even in the presence of diseases like COPD, HF and pneumonia and has no contraindications.
Subject: Pulmonary embolism
Ventilation-perfusion
SPECT
CTPA
V
P SPECT
CT
COPD
Left heart failure
Pneumonia
Chronic pulmonary embolism
Pulmonary hypertension
ACUTE KIDNEY INJURY
AMERICAN THORACIC SOCIETY/SOCIETY
IODINE-INDUCED HYPERTHYROIDISM
ASSESSING CLINICAL PROBABILITY
DEEP-VEIN THROMBOSIS
RULE-OUT CRITERIA
DUAL-ENERGY CT
V/Q SPECT
PERFUSION SCINTIGRAPHY
EMERGENCY-DEPARTMENT
3126 Surgery, anesthesiology, intensive care, radiology
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