[Lung scintigraphy].

Area of Science:

• Nuclear Medicine
• Radiology
• Pulmonary Medicine

Background:

• The S1 guideline for lung scintigraphy has been updated.
• Lung scintigraphy is crucial for diagnosing pulmonary embolism (PE).
• Advances in imaging necessitate guideline revisions.

Purpose of the Study:

• To update and extend the S1 guideline for lung scintigraphy.
• To emphasize the advantages of scintigraphy in detecting peripheral and chronic PE.
• To incorporate new data on subsegmental PE and other indications.

Main Methods:

• Ventilation/perfusion (V/P) SPECT and V/P SPECT/CT are the preferred methods.
• A threshold for V/P mismatch (≥1 segment or ≥2 subsegments) is introduced.
• Guideline incorporates new clinical and therapeutic data on subsegmental PE.

Main Results:

• V/P SPECT/CT offers high specificity for PE detection.
• A V/P mismatch threshold helps avoid overtreatment of PE.
• The guideline includes expanded sections on open questions and secondary diagnoses.

Conclusions:

• Lung scintigraphy, especially V/P SPECT/CT, is highly effective for diagnosing acute and chronic PE.
• The updated guideline provides criteria to optimize PE diagnosis and treatment.
• New data enhance the utility of V/P SPECT for various pulmonary conditions.