Diagnostic value of hybrid perfusion SPECT/CT and CTPA for detection of pulmonary embolism
AbstractThe diagnosis of pulmonary embolism (PE) employs a combination of clinical assessment, D-dimer assay and imaging with pulmonary ventilation-perfusion (V/P) scintigraphy and/or computed tomography pulmonary angiography (CTPA). It is generally accepted that V/P SPECT and CTPA have high diagnos...
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2023-12-01
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| Series: | Biotechnology & Biotechnological Equipment |
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| Online Access: | https://www.tandfonline.com/doi/10.1080/13102818.2022.2153081 |
| _version_ | 1797357467648131072 |
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| author | Sevda Naydenska Konstantin Grudkov Daniela Petrova Dora Zlatareva Bilyukov Radoslav Daniela Krasimirova Ventsislava Pencheva |
| author_facet | Sevda Naydenska Konstantin Grudkov Daniela Petrova Dora Zlatareva Bilyukov Radoslav Daniela Krasimirova Ventsislava Pencheva |
| author_sort | Sevda Naydenska |
| collection | DOAJ |
| description | AbstractThe diagnosis of pulmonary embolism (PE) employs a combination of clinical assessment, D-dimer assay and imaging with pulmonary ventilation-perfusion (V/P) scintigraphy and/or computed tomography pulmonary angiography (CTPA). It is generally accepted that V/P SPECT and CTPA have high diagnostic accuracy. Nonetheless, there are only limited data directly comparing these two modalities. This prospective cross-sectional study included 184 hospitalized patients with clinically suspected PE. Clinical assessment, electrocardiography (ECG), vein ultrasound, echocardiography, arterial blood gas test, D-dimer assay, perfusion single photon-emission computed tomography/computed tomography (P-SPECT/CT) and CTPA were carried out. PE was diagnosed in 109 of 146 patients (74.66%) by P-SPECT/CT and 47 of 89 patients (52.81%) by CTPA. The sensitivity and specificity of P-SPECT/CT were 82.9%, respectively, 64.7%. The positive predictive value of SPECT/CT was 94.7%, the negative predictive value was 33.3% and the validity was 80.8%. For CTPA the sensitivity was 58.2% and specificity 90%. The positive predictive value of CTPA was 97.9%, the negative predictive value 21.4% and the accuracy (performance) 61.8%. There was no significant difference between the two methods regarding the diagnosis of PE at sub-segmental and segmental level. The sensitivity of P-SPECT/CT was significantly higher compared with CTPA, whereas the specificity was significantly higher at CTPA for diagnosis of PE. The P-SPECT/CT showed excellent diagnostic performance with high sensitivity and a very high positive predictive value. Thus, it could serve as first-line imaging for PE in the number of prevalent cases. |
| first_indexed | 2024-03-08T14:45:35Z |
| format | Article |
| id | doaj.art-019cdb2f914e49bb8364ddc5ef3fd092 |
| institution | Directory Open Access Journal |
| issn | 1310-2818 1314-3530 |
| language | English |
| last_indexed | 2024-03-08T14:45:35Z |
| publishDate | 2023-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Biotechnology & Biotechnological Equipment |
| spelling | doaj.art-019cdb2f914e49bb8364ddc5ef3fd0922024-01-11T09:31:23ZengTaylor & Francis GroupBiotechnology & Biotechnological Equipment1310-28181314-35302023-12-01371344110.1080/13102818.2022.2153081Diagnostic value of hybrid perfusion SPECT/CT and CTPA for detection of pulmonary embolismSevda Naydenska0Konstantin Grudkov1Daniela Petrova2Dora Zlatareva3Bilyukov Radoslav4Daniela Krasimirova5Ventsislava Pencheva6Department of Propedeutics of Internal Diseases, Faculty of Medicine, Medical University of Sofia, Sofia, BulgariaDepartment of Surgery, Faculty of Medicine, Sofia University St. Kliment, Sofia, BulgariaDepartment of Propedeutics of Internal Diseases, Faculty of Medicine, Medical University of Sofia, Sofia, BulgariaDepartment of Diagnostic Imaging, Faculty of Medicine, Medical University of Sofia, Sofia, BulgariaDepartment of Propedeutics of Internal Diseases, Faculty of Medicine, Medical University of Sofia, Sofia, BulgariaDepartment of Propedeutics of Internal Diseases, Faculty of Medicine, Medical University of Sofia, Sofia, BulgariaDepartment of Propedeutics of Internal Diseases, Faculty of Medicine, Medical University of Sofia, Sofia, BulgariaAbstractThe diagnosis of pulmonary embolism (PE) employs a combination of clinical assessment, D-dimer assay and imaging with pulmonary ventilation-perfusion (V/P) scintigraphy and/or computed tomography pulmonary angiography (CTPA). It is generally accepted that V/P SPECT and CTPA have high diagnostic accuracy. Nonetheless, there are only limited data directly comparing these two modalities. This prospective cross-sectional study included 184 hospitalized patients with clinically suspected PE. Clinical assessment, electrocardiography (ECG), vein ultrasound, echocardiography, arterial blood gas test, D-dimer assay, perfusion single photon-emission computed tomography/computed tomography (P-SPECT/CT) and CTPA were carried out. PE was diagnosed in 109 of 146 patients (74.66%) by P-SPECT/CT and 47 of 89 patients (52.81%) by CTPA. The sensitivity and specificity of P-SPECT/CT were 82.9%, respectively, 64.7%. The positive predictive value of SPECT/CT was 94.7%, the negative predictive value was 33.3% and the validity was 80.8%. For CTPA the sensitivity was 58.2% and specificity 90%. The positive predictive value of CTPA was 97.9%, the negative predictive value 21.4% and the accuracy (performance) 61.8%. There was no significant difference between the two methods regarding the diagnosis of PE at sub-segmental and segmental level. The sensitivity of P-SPECT/CT was significantly higher compared with CTPA, whereas the specificity was significantly higher at CTPA for diagnosis of PE. The P-SPECT/CT showed excellent diagnostic performance with high sensitivity and a very high positive predictive value. Thus, it could serve as first-line imaging for PE in the number of prevalent cases.https://www.tandfonline.com/doi/10.1080/13102818.2022.2153081Pulmonary embolismdiagnosisperfusion SPECT/CTSPECT–low dose CTCTPA |
| spellingShingle | Sevda Naydenska Konstantin Grudkov Daniela Petrova Dora Zlatareva Bilyukov Radoslav Daniela Krasimirova Ventsislava Pencheva Diagnostic value of hybrid perfusion SPECT/CT and CTPA for detection of pulmonary embolism Biotechnology & Biotechnological Equipment Pulmonary embolism diagnosis perfusion SPECT/CT SPECT–low dose CT CTPA |
| title | Diagnostic value of hybrid perfusion SPECT/CT and CTPA for detection of pulmonary embolism |
| title_full | Diagnostic value of hybrid perfusion SPECT/CT and CTPA for detection of pulmonary embolism |
| title_fullStr | Diagnostic value of hybrid perfusion SPECT/CT and CTPA for detection of pulmonary embolism |
| title_full_unstemmed | Diagnostic value of hybrid perfusion SPECT/CT and CTPA for detection of pulmonary embolism |
| title_short | Diagnostic value of hybrid perfusion SPECT/CT and CTPA for detection of pulmonary embolism |
| title_sort | diagnostic value of hybrid perfusion spect ct and ctpa for detection of pulmonary embolism |
| topic | Pulmonary embolism diagnosis perfusion SPECT/CT SPECT–low dose CT CTPA |
| url | https://www.tandfonline.com/doi/10.1080/13102818.2022.2153081 |
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