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The conclusions drawn from ventilation/perfusion single-photon emission computed tomography compared with lung perfusion single-photon emission computed tomography and chest radiography in patients with suspected pulmonary thromboembolism

Abubakar, Sofiullaha; Jacobs, Donovanb; Kotze, Tessaa

Nuclear Medicine Communications: October 2018 - Volume 39 - Issue 10 - p 908–914
doi: 10.1097/MNM.0000000000000886

Purpose There are conflicting results from studies on whether ventilation scintigraphy can be safely omitted or replaced by chest radiography. These studies were based on planar ventilation/perfusion (V/Q) scintigraphy. We evaluated the value of the ventilation single-photon emission computed tomography (SPECT) on the final conclusion drawn from a V/Q SPECT and the possible role of the chest radiography as a surrogate for the ventilation SPECT.

Patients and methods Raw data of V/Q SPECT images and chest radiography acquired within 48 h over an 18-month period were retrieved, reprocessed and reviewed in batches. The ventilation SPECT, perfusion SPECT and chest radiography were reviewed separately and in combination. Data on the presence and nature of defects and chest radiography abnormalities were recorded. The V/Q SPECT images were interpreted using the criteria in the EANM guideline and the perfusion SPECT and chest radiography images were interpreted using the PISAPED criteria. Agreement between the diagnosis on the V/Q SPECT review and the perfusion SPECT and chest radiography review was analysed.

Results Overall, 21.1% of the patients were classified as ‘PE present’ on the V/Q SPECT review, whereas 48.9% were classified as ‘PE present’ on the perfusion SPECT and chest radiography review. Only 5.4% of defects observed on ventilation SPECT had matched chest radiography lung field opacity.

Conclusion Our study showed that the omission of a ventilation SPECT led to a high rate of false-positive diagnoses and that the ventilation scan cannot be replaced by a chest radiography.

aNuclear Medicine Division

bRadiology Division, Groote Schuur Hospital and University of Cape Town, Cape Town, South Africa

Correspondence to Sofiullah Abubakar, MBBS, Nuclear Medicine Division, C3/C4, New Main Building, Groote Schuur Hospital, Anzio Road, Observatory, Cape Town 7925, South Africa Tel: +27 214 044 003/+27 613 740 711; fax: +27 214 044 314;e-mails:,

Received March 27, 2018

Received in revised form May 30, 2018

Accepted July 6, 2018

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