Abstract: The aim was to compare ventilation/perfusion SPECT lung scintigraphy (V/Q-SPECT) and computed
tomography pulmonary angiography (CTPA) in patients with suspicion of pulmonary embolism (PE).
Material and methods: This prospectively designed study included 53 patients with intermediate or high
clinical probability of PE. A V/Q-SPECT and CTPA was performed on all patients. The V/Q-SPECT was
interpreted according to the European Association of Nuclear Medicine and Molecular Imaging (EANMMI)
guidelines. CTPA was reported as positive, negative, or indeterminate.
Results: CTPA was positive in 22 cases, negative in 28, and indeterminate in 3. V/Q-SPECT was positive in
27 cases, negative in 24, and non-diagnostic in 2. In the 22 with positive CTPA, V/Q-SPECT was positive
in 18, negative in 3, and non-diagnostic in 1. In the 28 with negative CTPA, V/Q-SPECT was positive in 8,
negative in 19, and non-diagnostic in 1. In the 3 with indeterminate CTPA, V/Q-SPECT was positive in 1
and negative in 2. In the 2 non-diagnostic cases V/Q-SPECT, CTPA was positive in 1 and negative in one.
In the 10 high clinical probabilities, CTPA and V/Q-SPECT were positive in 7, negative in 2, and in 1, CTPA
was positive and V/Q-SPECT negative. In the 38 intermediate probability group, CTPA and V/Q-SPECT
were positive in 11, negative in 17, with CTPA negative and V/Q-SPECT positive in 8, and in 2 CTPA was
positive and V/Q-SPECT negative. The results show that V/Q-SPECT detected PE in 5 patients more than
CTPA.
Conclusion: Our results show a 77% concordance of both techniques. Overall V/Q-SPECT detected PE in
18% more patients than CTPA in the intermediate group. Both techniques have a complementary role
when a diagnosis cannot be made with one of them.
