Transition from planar to SPECT V/Q scintigraphy: rationale, practicalities, and challenges

Area of Science:

• Nuclear Medicine
• Radiology
• Pulmonary Imaging

Background:

• Pulmonary embolism (PE) diagnosis relies on ventilation/perfusion (V/Q) scintigraphy.
• Planar V/Q scintigraphy has limitations in sensitivity, specificity, and reporting clarity.
• Single-photon emission computed tomography (SPECT) offers potential advantages over planar imaging.

Purpose of the Study:

• To evaluate the benefits of SPECT V/Q scintigraphy for pulmonary embolism detection.
• To identify challenges and facilitators for transitioning from planar to SPECT imaging.
• To highlight the improved diagnostic performance of SPECT V/Q imaging.

Main Methods:

• Comparison of SPECT V/Q scintigraphy with planar V/Q scintigraphy.
• Assessment of sensitivity, specificity, accuracy, reproducibility, and report conclusiveness.
• Exploration of SPECT-specific technical and reporting considerations.

Main Results:

• SPECT V/Q scintigraphy demonstrates superior sensitivity, specificity, accuracy, and reproducibility compared to planar imaging.
• SPECT imaging results in fewer inconclusive reports for pulmonary embolism detection.
• SPECT acquisition times are comparable or shorter than planar imaging, with easier acquisition for technologists.

Conclusions:

• SPECT V/Q scintigraphy offers significant diagnostic advantages for pulmonary embolism detection.
• Addressing challenges like 3D imaging familiarity and reporting protocols is crucial for SPECT adoption.
• Generating planar-like images from SPECT data can aid in the transition for reporting specialists.