The diagnostic accuracy of perfusion-only scan in the diagnosis of pulmonary embolism in the era of COVID-19: A single-center study of 434 patients
INTRODUCTION: There is a paucity of data in the literature regarding the diagnostic accuracy of perfusion (Q)-only studies in the absence of ventilation images. This study aims to assess the diagnostic accuracy of Q-only imaging in the pandemic era. METHODS: Patients who underwent Q-only imaging for...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2023-01-01
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| Series: | Annals of Thoracic Medicine |
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| Online Access: | http://www.thoracicmedicine.org/article.asp?issn=1817-1737;year=2023;volume=18;issue=4;spage=199;epage=205;aulast=Cengiz |
| _version_ | 1797352323103588352 |
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| author | Turgut Bora Cengiz Ahmed Abdelrahman Scott A Rohren John Doucette Munir Ghesani |
| author_facet | Turgut Bora Cengiz Ahmed Abdelrahman Scott A Rohren John Doucette Munir Ghesani |
| author_sort | Turgut Bora Cengiz |
| collection | DOAJ |
| description | INTRODUCTION: There is a paucity of data in the literature regarding the diagnostic accuracy of perfusion (Q)-only studies in the absence of ventilation images. This study aims to assess the diagnostic accuracy of Q-only imaging in the pandemic era.
METHODS: Patients who underwent Q-only imaging for pulmonary embolism between March 2020 and February 2021 were analyzed. Patients who underwent lung quantification analysis were excluded. Q-only test results were reported as per modified PIOPED II criteria and single positron emission tomography/computed tomography (SPECT/CT) imaging was performed as needed. Patients were considered concordant or discordant by correlating the Q-only results with CT angiogram (CTA) or clinical diagnosis made through chart review. The diagnostic accuracy was calculated after excluding intermediate probability and nondiagnostic studies.
RESULTS: Four hundred and thirty-four patients were identified. One hundred and twenty-eight patients (29.4%) underwent ultrasound Doppler, 37 patients (8.5%) underwent CTA, and 16 patients (3.6%) underwent both. After excluding patients with intermediate probability or nondiagnostic studies and who did not have follow-up (a total of 87 patients [20%]), 347 patients were enrolled in the final analysis. The combined planar and SPECT/CT sensitivity and specificity were 85.4% (72.2%–93.9% confidence interval [CI]) and 98.7% (96.9%–98.6% CI), respectively. The positive predictive value (PPV) of the Q-only imaging was 89.1% (77.3%–95.1% CI) and the negative predictive value (NPV) was 98.2% (96.4%–99% CI). The sensitivity with SPECT/CT reached 100% (CI: 71.5%–100%) with a specificity of 92.3% (CI: 64%–99.8%). The PPV was 85.7% (CI: 62.1%–95.6%) and the NPV was 100%.
CONCLUSION: Q-only imaging provides clinically acceptable results. The sensitivity of the Q-only scan is increased when coupled with SPECT/CT. |
| first_indexed | 2024-03-08T13:13:47Z |
| format | Article |
| id | doaj.art-dbebda4740304b15a17f491dca7db299 |
| institution | Directory Open Access Journal |
| issn | 1817-1737 1998-3557 |
| language | English |
| last_indexed | 2024-03-08T13:13:47Z |
| publishDate | 2023-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Annals of Thoracic Medicine |
| spelling | doaj.art-dbebda4740304b15a17f491dca7db2992024-01-18T10:33:53ZengWolters Kluwer Medknow PublicationsAnnals of Thoracic Medicine1817-17371998-35572023-01-0118419920510.4103/atm.atm_42_23The diagnostic accuracy of perfusion-only scan in the diagnosis of pulmonary embolism in the era of COVID-19: A single-center study of 434 patientsTurgut Bora CengizAhmed AbdelrahmanScott A RohrenJohn DoucetteMunir GhesaniINTRODUCTION: There is a paucity of data in the literature regarding the diagnostic accuracy of perfusion (Q)-only studies in the absence of ventilation images. This study aims to assess the diagnostic accuracy of Q-only imaging in the pandemic era. METHODS: Patients who underwent Q-only imaging for pulmonary embolism between March 2020 and February 2021 were analyzed. Patients who underwent lung quantification analysis were excluded. Q-only test results were reported as per modified PIOPED II criteria and single positron emission tomography/computed tomography (SPECT/CT) imaging was performed as needed. Patients were considered concordant or discordant by correlating the Q-only results with CT angiogram (CTA) or clinical diagnosis made through chart review. The diagnostic accuracy was calculated after excluding intermediate probability and nondiagnostic studies. RESULTS: Four hundred and thirty-four patients were identified. One hundred and twenty-eight patients (29.4%) underwent ultrasound Doppler, 37 patients (8.5%) underwent CTA, and 16 patients (3.6%) underwent both. After excluding patients with intermediate probability or nondiagnostic studies and who did not have follow-up (a total of 87 patients [20%]), 347 patients were enrolled in the final analysis. The combined planar and SPECT/CT sensitivity and specificity were 85.4% (72.2%–93.9% confidence interval [CI]) and 98.7% (96.9%–98.6% CI), respectively. The positive predictive value (PPV) of the Q-only imaging was 89.1% (77.3%–95.1% CI) and the negative predictive value (NPV) was 98.2% (96.4%–99% CI). The sensitivity with SPECT/CT reached 100% (CI: 71.5%–100%) with a specificity of 92.3% (CI: 64%–99.8%). The PPV was 85.7% (CI: 62.1%–95.6%) and the NPV was 100%. CONCLUSION: Q-only imaging provides clinically acceptable results. The sensitivity of the Q-only scan is increased when coupled with SPECT/CT.http://www.thoracicmedicine.org/article.asp?issn=1817-1737;year=2023;volume=18;issue=4;spage=199;epage=205;aulast=Cengizpulmonary embolismscintigraphyventilation/perfusion |
| spellingShingle | Turgut Bora Cengiz Ahmed Abdelrahman Scott A Rohren John Doucette Munir Ghesani The diagnostic accuracy of perfusion-only scan in the diagnosis of pulmonary embolism in the era of COVID-19: A single-center study of 434 patients Annals of Thoracic Medicine pulmonary embolism scintigraphy ventilation/perfusion |
| title | The diagnostic accuracy of perfusion-only scan in the diagnosis of pulmonary embolism in the era of COVID-19: A single-center study of 434 patients |
| title_full | The diagnostic accuracy of perfusion-only scan in the diagnosis of pulmonary embolism in the era of COVID-19: A single-center study of 434 patients |
| title_fullStr | The diagnostic accuracy of perfusion-only scan in the diagnosis of pulmonary embolism in the era of COVID-19: A single-center study of 434 patients |
| title_full_unstemmed | The diagnostic accuracy of perfusion-only scan in the diagnosis of pulmonary embolism in the era of COVID-19: A single-center study of 434 patients |
| title_short | The diagnostic accuracy of perfusion-only scan in the diagnosis of pulmonary embolism in the era of COVID-19: A single-center study of 434 patients |
| title_sort | diagnostic accuracy of perfusion only scan in the diagnosis of pulmonary embolism in the era of covid 19 a single center study of 434 patients |
| topic | pulmonary embolism scintigraphy ventilation/perfusion |
| url | http://www.thoracicmedicine.org/article.asp?issn=1817-1737;year=2023;volume=18;issue=4;spage=199;epage=205;aulast=Cengiz |
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