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ventilation perfusion scintigraphy

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https://www.readbyqxmd.com/read/28491475/referral-patterns-and-diagnostic-yield-of-lung-scintigraphy-in-the-diagnosis-of-acute-pulmonary-embolism
#1
Matthieu Pelletier-Galarneau, Erik Zannier, Lionel S Zuckier, Gregoire Le Gal
Introduction. The purpose of this study is to assess referral patterns and the yield of ventilation-perfusion (V/Q) scintigraphy in patients referred for acute pulmonary embolism (PE). Methods. We retrospectively reviewed the charts of all patients who underwent V/Q studies between April 1, 2008, and March 31, 2010. Patients were subdivided into 4 groups based on their referral source: emergency department (ED), hospital inpatient ward, outpatient thrombosis clinic, and all other outpatient sources. Results...
2017: Thrombosis
https://www.readbyqxmd.com/read/28418953/pulmonary-perfusion-scan-mimicking-hepatobiliary-scintigraphy-in-a-patient-with-an-uncommon-manifestation-of-granulomatosis-with-polyangiitis
#2
Michelle D Hopstone, Evan A Raff, Patrick M Colletti
A 36-year-old man with known granulomatosis with polyangiitis underwent quantitative ventilation-perfusion pulmonary scintigraphy as part of an initial evaluation for lung transplant candidacy. Radiotracer uptake on the perfusion study has the appearance of the hepatic silhouette, drawing initial concern that there may have been a misadministration of Tc with a hepatobiliary agent. Comparison CT reveals extensive cystic bronchiectasis, parenchymal destruction, and volume loss involving the entire left lung and basal portions of the right lung, with the residual portions of functional lung parenchyma conforming to a shape similar to the liver...
April 17, 2017: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/28408698/reproducibility-of-lobar-perfusion-and-ventilation-quantification-using-a-spect-ct-segmentation-software-in-lung-cancer-patients
#3
Karine Provost, Antoine Leblond, Annie Gauthier Lemire, Edith Fillion, Houda Bahig, Martin Lord
Planar perfusion scintigraphy with Tc99m-labelled macroaggregated albumin (Tc99m-MAA) is often used for pre-therapy quantification of regional lung perfusion in lung cancer patients, particularly in patients with poor respiratory function. However, subdividing lung parenchyma in rectangular regions of interests, as done on planar images, is a poor reflection of true lobar anatomy. New tridimensional methods using SPECT and SPECT/CT have been introduced, including a semi-automatic lung segmentation software (Hermes Medical Solutions)...
April 13, 2017: Journal of Nuclear Medicine Technology
https://www.readbyqxmd.com/read/28376242/lung-perfusion-mri-vs-spect-for-screening-in-suspected-chronic-thromboembolic-pulmonary-hypertension
#4
Christopher S Johns, Andrew J Swift, Smitha Rajaram, Paul J C Hughes, David J Capener, David G Kiely, James M Wild
PURPOSE: To assess the diagnostic accuracy of magnetic resonance imaging (MRI) perfusion against perfusion single photon emission tomography (SPECT) screening for chronic thromboembolic pulmonary hypertension (CTEPH). Ventilation/perfusion (V/Q) scintigraphy is recommended to screen for suspected CTEPH. It has previously been shown that 3D dynamic contrast-enhanced (DCE) lung perfusion MRI has a similar sensitivity for diagnosing CTEPH in comparison to planar perfusion scintigraphy; however, planar scintigraphy has now been largely replaced by SPECT, due to higher spatial resolution and sensitivity...
April 4, 2017: Journal of Magnetic Resonance Imaging: JMRI
https://www.readbyqxmd.com/read/28330686/imaging-of-acute-and-chronic-thromboembolic-disease-state-of-the-art
#5
REVIEW
A Ruggiero, N J Screaton
Acute pulmonary embolism (PE) is a life-threatening condition that requires prompt diagnosis and treatment. Recent advances in imaging allow acute and rapid recognition even by the non-specialist radiologist. Most acute emboli resolve on anticoagulation without sequelae; however, some emboli fail to fully resolve becoming endothelialised with the development of chronic thromboembolic disease (CTED). Increased pulmonary vascular resistance arising from CTED may lead to chronic thromboembolic pulmonary hypertension (CTEPH) a debilitating disease affecting up to 5% of survivors of acute PE...
May 2017: Clinical Radiology
https://www.readbyqxmd.com/read/28298387/diagnosis-of-chronic-thromboembolic-pulmonary-hypertension
#6
REVIEW
Deepa Gopalan, Marion Delcroix, Matthias Held
Chronic thromboembolic pulmonary hypertension (CTEPH) is the only potentially curable form of pulmonary hypertension. Rapid and accurate diagnosis is pivotal for successful treatment. Clinical signs and symptoms can be nonspecific and risk factors such as history of venous thromboembolism may not always be present. Echocardiography is the recommended first diagnostic step. Cardiopulmonary exercise testing is a complementary tool that can help to identify patients with milder abnormalities and chronic thromboembolic disease, triggering the need for further investigation...
January 2017: European Respiratory Review: An Official Journal of the European Respiratory Society
https://www.readbyqxmd.com/read/28293001/-congenital-bronchial-atresia-requiring-differentiation-from-intralobar-sequestration
#7
Yusuke Tanaka, Isao Matsumoto, Daisuke Saito, Syuhei Yoshida, Seiichi Kakegawa, Masaya Tamura, Hirofumi Takemura, Kaori Yoshimura, Hiroko Ikeda
We reported a case of bronchial atresia requiring differentiation from the intralobar sequestration. A 42-year-old man was referred to our institution with suspicion of intralobar sequestration, based on a 3-dimensional computed tomography (CT) angiography that showed abnormal blood vessels from the right inferior phrenic artery flowing into the right lower lobe. CT revealed a lesion between S9 and S10 wherein there were refluxed blood vessels from A9 without an accompanying bronchus, with polycysts and emphysematous changes...
March 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28262522/a-clinically-meaningful-interpretation-of-the-prospective-investigation-of-pulmonary-embolism-diagnosis-pioped-scintigraphic-data
#8
Paul Cronin, Ben A Dwamena
RATIONALE AND OBJECTIVES: Pulmonary embolism (PE) is a common condition associated with significant morbidity and mortality. Diagnostic test characteristics reported in terms of sensitivity and specificity are difficult to translate at the clinical level. More relevant measures are likelihood ratios (LRs), which can convert a pretest into a posttest probability. The aim of our study was to calculate the LRs and posttest probabilities for multiple-level test result for ventilation/perfusion (V/Q) lung scintigraphy and for perfusion scintigraphy combined with chest radiography using modified Prospective Investigation of Pulmonary Embolism Diagnosis (PIOPED) II and the Prospective Investigative Study of Pulmonary Embolism Diagnosis (PISAPED) criteria for each clinical probability level for the most commonly used clinical prediction rules (CPR) using the PIOPED data...
May 2017: Academic Radiology
https://www.readbyqxmd.com/read/28095020/current-status-of-ventilation-perfusion-scintigraphy-for-suspected-pulmonary-embolism
#9
REVIEW
Darlene Metter, Mark Tulchinsky, Leonard M Freeman
OBJECTIVE: The purpose of this article is to outline recent progress made in ventilation-perfusion (V/Q) scintigraphy imaging techniques and the interpretation systems used for the diagnosis of pulmonary embolism (PE). Various state-of-the-art approaches that can be selected according to the needs dictated by the medical practice environment and specific patient groups are presented. CONCLUSION: Although advances in tomographic imaging have certainly improved the sensitivity of V/Q scans for the diagnosis of PE, they may lead to overdiagnosis by revealing small and clinically insignificant PEs...
March 2017: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/27977536/incidence-of-a-single-subsegmental-mismatched-perfusion-defect-in-single-photon-emission-computed-tomography-and-planar-ventilation-perfusion-scans
#10
Matthew Stubbs, Kenneth Chan, Helena McMeekin, Shaunak Navalkissoor, Thomas Wagner
OBJECTIVE: This study aims to compare the incidence of ventilation/perfusion (V/Q) scans interpreted as indeterminate for the diagnosis of pulmonary embolism (PE) using single-photon emission computed tomography (SPECT) versus planar scintigraphy and to consider the effect of variable interpretation of single subsegmental V/Q mismatch (SSM). METHODS: A total of 1300 consecutive V/Q scans were retrospectively reviewed. After exclusion and matching for age and sex, 542 SPECT and 589 planar scans were included in the analysis...
February 2017: Nuclear Medicine Communications
https://www.readbyqxmd.com/read/27764879/state-of-the-art-imaging-in-pulmonary-embolism-ventilation-perfusion-single-photon-emission-computed-tomography-versus-computed-tomography-angiography-controversies-results-and-recommendations-from-a-systematic-review
#11
REVIEW
Søren Hess, Evan C Frary, Oke Gerke, Poul Henning Madsen
Pulmonary embolism (PE) is a common, ubiquitous, and potentially lethal disease. As symptoms and clinical findings are notoriously nonspecific, diagnostic imaging is essential to avoid undertreatment as well as overtreatment. Controversies remain regarding first-line imaging in suspected PE. The two main contemporary contenders are ventilation/perfusion scintigraphy with single-photon emission computed tomography (V/Q SPECT) with or without additional low-dose CT (SPECT/CT) and CT angiography (CTA). We present our results from a systematic review and meta-analysis of the diagnostic performances of these modalities: V/Q SPECT, V/Q SPECT/CT, and CTA are all viable options, but we consider V/Q SPECT/CT to be superior in most clinical settings with better overall diagnostic performance, that is, pooled sensitivities (97...
November 2016: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/27758995/pulmonary-stenting-for-the-treatment-of-sarcoid-induced-pulmonary-vascular-stenosis
#12
Jose F Condado, Vasilis Babaliaros, Travis S Henry, Brian Kaebnick, Dennis Kim, Gerald W Staton
BACKGROUND: The best treatment of patients with external pulmonary vascular compression due to advanced sarcoidosis is unknown. OBJECTIVES: To report a single-center experience of percutaneous treatment for pulmonary vascular stenosis caused by external compression due to advanced sarcoidosis. METHODS: We report a case series of 5 patients with biopsy confirmed advanced sarcoidosis, seen at our academic institution with worsening dyspnea despite increase of immunosuppressive therapy...
October 7, 2016: Sarcoidosis, Vasculitis, and Diffuse Lung Diseases: Official Journal of WASOG
https://www.readbyqxmd.com/read/27726408/overview-of-the-novel-and-improved-pulmonary-ventilation-perfusion-imaging-applications-in-the-era-of-spect-ct
#13
REVIEW
Saeed Elojeimy, Irene Cruite, Stephen Bowen, Jing Zeng, Hubert Vesselle
OBJECTIVE: In this article, we describe the concepts of ventilation-perfusion planar, SPECT, and SPECT/CT and outline the advantages of integrated ventilation-perfusion SPECT/CT over planar imaging. We present an overview of the traditional and new applications of ventilation-perfusion scintigraphy. CONCLUSION: SPECT/CT has improved the diagnostic accuracy of ventilation-perfusion imaging and opened the door for a new spectrum of applications.
December 2016: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/27719980/imaging-of-pulmonary-hypertension
#14
REVIEW
Christopher J François, Mark L Schiebler
Multimodality, noninvasive imaging is increasingly used in the identification and management of pulmonary hypertension (PH). Chest radiography, ventilation-perfusion scintigraphy, and Doppler echocardiography are frequently the initial studies used to evaluate patients suspected of having PH. However, their ability to evaluate the right ventricle (RV) and pulmonary vasculature is limited. Computed tomography (CT) and magnetic resonance (MR) imaging are increasingly used to identify causes of PH and assess the effect of PH on RV function...
November 2016: Radiologic Clinics of North America
https://www.readbyqxmd.com/read/27648373/the-benefit-of-personalized-hybrid-spect-ct-pulmonary-imaging
#15
Milan Simanek, Pavel Koranda
Hybrid pulmonary imaging in the present day has seen a fusion of various uses of CT scans, including angiography (CTAG), diagnostic CT, low dose CT (LDCT), and perfusion or ventilation scintigraphy in tomographic or planar imaging. Determining the most effective individualized test for the complete diagnostics of patients with pulmonary symptoms for various groups of patients is a major issue. The aim of the present study was to assess the effectiveness of the implementation of hybrid imaging in current methods of nuclear medicine in differential diagnostics of pulmonary embolism (PE)...
2016: American Journal of Nuclear Medicine and Molecular Imaging
https://www.readbyqxmd.com/read/27620309/radionuclide-diagnosis-of-pulmonary-embolism
#16
Søren Hess, Poul Henning Madsen
Diagnostic imaging plays an integral role in the diagnostic workup of suspected pulmonary embolism, and several modalities have been employed over the years. In recent years, the choice has been narrowed to either computer tomographic or radionuclide based methods, i.e. computer tomographic angiography (CTA) and ventilation-perfusion scintigraphy (V/Q-scan). Both methods display advantages and shortcomings, and while we provide some insights into CTA and alternative methods, the paper's main focus is a review of the V/Q-scan...
September 13, 2016: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/27556796/deep-vein-thrombosis-presenting-on-pulmonary-ventilation-and-perfusion-scintigraphy
#17
Malak Itani, Joanna Fair, Zachary Hillman, Fatemeh Behnia, Saeed Elojeimy
A 52-year-old woman presenting with dyspnea was referred for a ventilation and perfusion scan (VQ). VQ images (with Tc-DTPA [diethylene triamine pentaacetic acid aerosol] and Tc-MAA [macroaggregated albumin]) initially appeared normal; however, count rates on perfusion images were similar to ventilation images, implying little Tc-MAA had reached the lungs. Spot images of the injected extremity demonstrated focal Tc-MAA accumulation worrisome for a venous thrombus, subsequently confirmed by Doppler ultrasound...
October 2016: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/27540433/vertebral-uptake-of-tc-99m-macroaggregated-albumin-maa-with-spect-ct-occurring-in-superior-vena-cava-obstruction
#18
Shawn Karls, Hani Hassoun, Vilma Derbekyan
A 67-year-old male presented with dyspnea for which lung scintigraphy was ordered to rule out pulmonary embolus. Planar images demonstrated abnormal midline uptake of Tc-99m macroaggregated albumin, which SPECT/CT localized to several thoracic vertebrae. Thoracic vertebral uptake on perfusion lung scintigraphy was previously described on planar imaging. Radionuclide venography and contrast-enhanced CT subsequently demonstrated superior vena cava (SVC) obstruction with collateralization through the azygous/hemiazygous system and vertebral venous plexus...
September 2016: Nuclear Medicine and Molecular Imaging
https://www.readbyqxmd.com/read/27497375/dual-energy-computed-tomographic-imaging-of-pulmonary-hypertension
#19
REVIEW
Anne-Lise Hachulla, Frédéric Lador, Paola M Soccal, Xavier Montet, Maurice Beghetti
Dual-energy computed tomography (DECT) angiography of the chest provides a combined morphological and functional analysis of the lung, usually obtained in a single acquisition without extra radiation or injection of extra intravenous iodine contrast. The parenchymal iodine maps generated by DECT are well correlated with scintigraphy, and are becoming an essential tool for evaluating patients with pulmonary vascular diseases. With a single DECT acquisition, complete imaging of pulmonary hypertension is now available, displaying vascular anatomy, parenchymal morphology and functional assessment...
2016: Swiss Medical Weekly
https://www.readbyqxmd.com/read/27494075/d-dimer-test-for-excluding-the-diagnosis-of-pulmonary-embolism
#20
REVIEW
Fay Crawford, Alina Andras, Karen Welch, Karen Sheares, David Keeling, Francesca M Chappell
BACKGROUND: Pulmonary embolism (PE) can occur when a thrombus (blood clot) travels through the veins and lodges in the arteries of the lungs, producing an obstruction. People who are thought to be at risk include those with cancer, people who have had a recent surgical procedure or have experienced long periods of immobilisation and women who are pregnant. The clinical presentation can vary, but unexplained respiratory symptoms such as difficulty breathing, chest pain and an increased respiratory rate are common...
August 5, 2016: Cochrane Database of Systematic Reviews
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