Quantification of the pulmonary vascular obstruction index on ventilation/perfusion lung scintigraphy: Comparison of a segmental visual scoring to the Meyer score
IntroductionQuantifying the pulmonary vascular obstruction index (PVOI) is essential for the management of patients with pulmonary embolism or chronic thromboembolic pulmonary hypertension (CTEPH). The reference method for quantifying the PVOI with planar lung ventilation/perfusion (V/Q) scintigraph...
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Frontiers Media S.A.
2022-10-01
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| Series: | Frontiers in Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fmed.2022.970808/full |
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| author | Romain Le Pennec Cécile Tromeur Charles Orione Philippe Robin Raphaël Le Mao Christophe Gut-Gobert Grégoire Le Gal Grégoire Le Gal Pierre Yves Salaün Pierre Yves Le Roux |
| author_facet | Romain Le Pennec Cécile Tromeur Charles Orione Philippe Robin Raphaël Le Mao Christophe Gut-Gobert Grégoire Le Gal Grégoire Le Gal Pierre Yves Salaün Pierre Yves Le Roux |
| author_sort | Romain Le Pennec |
| collection | DOAJ |
| description | IntroductionQuantifying the pulmonary vascular obstruction index (PVOI) is essential for the management of patients with pulmonary embolism or chronic thromboembolic pulmonary hypertension (CTEPH). The reference method for quantifying the PVOI with planar lung ventilation/perfusion (V/Q) scintigraphy is the Meyer score, which was validated using pulmonary angiography as a reference standard. However, it is complex to use in daily practice. In contrast, a rapid and fast quantification method consists in estimating the PVOI based on the number of segmental perfusion defects. However, the accuracy of this method has never been evaluated. In this study, we aimed to compare PVOI quantification on planar V/Q scintigraphy assessed by a segmental visual scoring (SVS) to the Meyer score.Materials and methodsThe eligible study population consisted of consecutive patients who underwent planar V/Q scan for CTEPH screening. A central review was performed by three nuclear medicine physicians. PVOI was assessed by summing the number of segmental perfusion defects or equivalent (2 sub-segments = 1 segment = 5%) and by Meyer’s method. The two interpretations were performed 6 months apart. A Spearman rank correlation coefficient was calculated to evaluate correlation between the two measurement methods. An intra-class correlation (ICC) was calculated to assess agreement. A Bland et Altman plot analysis was used to evaluate agreement between the two measurements.ResultsA total of 226 V/Q scans were interpreted. Spearman rank correlation coefficient between SVS and Meyer was 0.963 (95%CI 0.952–0.971) for mismatched perfusion defects and 0.963 (95%CI 0.953–0.972) for perfusion defects regardless of ventilation. Intra-class correlation (ICC) for agreement was 0.978 (95%CI 0.972–0.983) for mismatched perfusion defects and 0.968 (95%CI 0.959–0.976) for perfusion defects regardless of ventilation. In Bland & Altmann analysis, the mean difference between the SVS method and the Meyer score was 0.42 and 0.61 for the mismatched or matched evaluation, respectively.ConclusionOur study shows a high correlation, and low differences in PVOI quantification when using a segmental visual scoring (SVS) as compared to the Meyer score. The SVS has the great advantage to be easy and rapid to apply in daily practice. |
| first_indexed | 2024-04-13T18:15:22Z |
| format | Article |
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| issn | 2296-858X |
| language | English |
| last_indexed | 2024-04-13T18:15:22Z |
| publishDate | 2022-10-01 |
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| spelling | doaj.art-a537939cb370425d8da084e2fa3d35622022-12-22T02:35:42ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2022-10-01910.3389/fmed.2022.970808970808Quantification of the pulmonary vascular obstruction index on ventilation/perfusion lung scintigraphy: Comparison of a segmental visual scoring to the Meyer scoreRomain Le Pennec0Cécile Tromeur1Charles Orione2Philippe Robin3Raphaël Le Mao4Christophe Gut-Gobert5Grégoire Le Gal6Grégoire Le Gal7Pierre Yves Salaün8Pierre Yves Le Roux9U1304 (GETBO) IFR 148, CHRU de Brest, Service de Médecine Nucléaire, Université de Bretagne Occidentale, Brest, FranceDépartement de Médecine Interne et Pneumologie, U1304 (GETBO), CHRU de Brest, Université de Bretagne Occidentale, Brest, FranceDépartement de Médecine Interne et Pneumologie, U1304 (GETBO), CHRU de Brest, Université de Bretagne Occidentale, Brest, FranceU1304 (GETBO) IFR 148, CHRU de Brest, Service de Médecine Nucléaire, Université de Bretagne Occidentale, Brest, FranceDépartement de Médecine Interne et Pneumologie, U1304 (GETBO), CHRU de Brest, Université de Bretagne Occidentale, Brest, FranceDépartement de Médecine Interne et Pneumologie, U1304 (GETBO), CHRU de Brest, Université de Bretagne Occidentale, Brest, FranceCentre d’Investigation Clinique, Centre Hospitalier Régional et Universitaire de Brest, Brest, FranceDepartment of Medicine, Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON, CanadaU1304 (GETBO) IFR 148, CHRU de Brest, Service de Médecine Nucléaire, Université de Bretagne Occidentale, Brest, FranceU1304 (GETBO) IFR 148, CHRU de Brest, Service de Médecine Nucléaire, Université de Bretagne Occidentale, Brest, FranceIntroductionQuantifying the pulmonary vascular obstruction index (PVOI) is essential for the management of patients with pulmonary embolism or chronic thromboembolic pulmonary hypertension (CTEPH). The reference method for quantifying the PVOI with planar lung ventilation/perfusion (V/Q) scintigraphy is the Meyer score, which was validated using pulmonary angiography as a reference standard. However, it is complex to use in daily practice. In contrast, a rapid and fast quantification method consists in estimating the PVOI based on the number of segmental perfusion defects. However, the accuracy of this method has never been evaluated. In this study, we aimed to compare PVOI quantification on planar V/Q scintigraphy assessed by a segmental visual scoring (SVS) to the Meyer score.Materials and methodsThe eligible study population consisted of consecutive patients who underwent planar V/Q scan for CTEPH screening. A central review was performed by three nuclear medicine physicians. PVOI was assessed by summing the number of segmental perfusion defects or equivalent (2 sub-segments = 1 segment = 5%) and by Meyer’s method. The two interpretations were performed 6 months apart. A Spearman rank correlation coefficient was calculated to evaluate correlation between the two measurement methods. An intra-class correlation (ICC) was calculated to assess agreement. A Bland et Altman plot analysis was used to evaluate agreement between the two measurements.ResultsA total of 226 V/Q scans were interpreted. Spearman rank correlation coefficient between SVS and Meyer was 0.963 (95%CI 0.952–0.971) for mismatched perfusion defects and 0.963 (95%CI 0.953–0.972) for perfusion defects regardless of ventilation. Intra-class correlation (ICC) for agreement was 0.978 (95%CI 0.972–0.983) for mismatched perfusion defects and 0.968 (95%CI 0.959–0.976) for perfusion defects regardless of ventilation. In Bland & Altmann analysis, the mean difference between the SVS method and the Meyer score was 0.42 and 0.61 for the mismatched or matched evaluation, respectively.ConclusionOur study shows a high correlation, and low differences in PVOI quantification when using a segmental visual scoring (SVS) as compared to the Meyer score. The SVS has the great advantage to be easy and rapid to apply in daily practice.https://www.frontiersin.org/articles/10.3389/fmed.2022.970808/fullV/Q—ventilation/perfusionlung scan ventilation/perfusionpulmonary vascular obstructionquantificationlung scintigraphy |
| spellingShingle | Romain Le Pennec Cécile Tromeur Charles Orione Philippe Robin Raphaël Le Mao Christophe Gut-Gobert Grégoire Le Gal Grégoire Le Gal Pierre Yves Salaün Pierre Yves Le Roux Quantification of the pulmonary vascular obstruction index on ventilation/perfusion lung scintigraphy: Comparison of a segmental visual scoring to the Meyer score Frontiers in Medicine V/Q—ventilation/perfusion lung scan ventilation/perfusion pulmonary vascular obstruction quantification lung scintigraphy |
| title | Quantification of the pulmonary vascular obstruction index on ventilation/perfusion lung scintigraphy: Comparison of a segmental visual scoring to the Meyer score |
| title_full | Quantification of the pulmonary vascular obstruction index on ventilation/perfusion lung scintigraphy: Comparison of a segmental visual scoring to the Meyer score |
| title_fullStr | Quantification of the pulmonary vascular obstruction index on ventilation/perfusion lung scintigraphy: Comparison of a segmental visual scoring to the Meyer score |
| title_full_unstemmed | Quantification of the pulmonary vascular obstruction index on ventilation/perfusion lung scintigraphy: Comparison of a segmental visual scoring to the Meyer score |
| title_short | Quantification of the pulmonary vascular obstruction index on ventilation/perfusion lung scintigraphy: Comparison of a segmental visual scoring to the Meyer score |
| title_sort | quantification of the pulmonary vascular obstruction index on ventilation perfusion lung scintigraphy comparison of a segmental visual scoring to the meyer score |
| topic | V/Q—ventilation/perfusion lung scan ventilation/perfusion pulmonary vascular obstruction quantification lung scintigraphy |
| url | https://www.frontiersin.org/articles/10.3389/fmed.2022.970808/full |
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