TY - JOUR AU - Skarlovnik, Ajda AU - Hrastnik, Damjana AU - Fettich, Jure AU - Grmek, Marko PY - 2014/05/09 Y2 - 2024/03/29 TI - Lung Scintigraphy: Current Methods and Interpretation Criteria in Clinical Practice JF - Radiology and Oncology JA - Radiol Oncol VL - 48 IS - 2 SE - Nuclear medicine DO - UR - https://www.radioloncol.com/index.php/ro/article/view/1798 SP - AB - <p class="Standard"><em>Introduction.</em> In current clinical practice lung scintigraphy is mainly used to exclude pulmonary embolism (PE). Recently new scintigraphic methods (single photon emission computed tomography - SPECT), as well as simplified criteria for scan interpretation have been developed.</p> <p class="Standard"><em>Methods.</em> We retrospectively collected data from the emergency department (ED) on 98 outpatients who underwent planar ventilation/perfusion (V/Q) scintigraphy and 49 outpatients from the ED who underwent V/Q SPECT. V/Q planar images were interpreted according to PIOPED and 0.5 segment mismatch criteria, and perfusion scans according to PISA-PED criteria. SPECT images were interpreted according to the criteria suggested in EANM guidelines. <span lang="EN-GB">Final diagnosis of PE</span> was based on the clinical decision of the attending physician and evaluation of a 12 months follow-up period.</p> <p class="Standard"><em>Results.</em> Using PIOPED and 0.5 segment mismatch criteria, planar V/Q scans were diagnostic in 84% and 93% of cases, respectively. Among the diagnostic scan readings, specificities of PE negative scans were 98% for PIOPED and 99% for 0.5 segment mismatch criteria. V/Q SPECT showed a sensitivity of 100% and a specificity of 98%, without non-diagnostic scans. In patients with low pretest probability, perfusion scans without ventilation gave definitive readings in 80% of cases, with a specificity of 91%.</p> <p class="Standard"><em>Conclusions.</em> In outpatients from the ED, lung scintigraphy yielded diagnostically definitive results and was reliable in ruling out PE. V/Q SPECT showed excellent specificity and sensitivity without non-diagnostic results. Using 0.5 segment mismatch criteria, there were considerably less non-diagnostic readings in comparison to PIOPED. In all patients and in the group of patients with low pretest probability, diagnostic accuracy of perfusion scintigraphy according to PISA-PED criteria was inferior to that of combined V/Q scintigraphy.</p> ER -