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Related Experiment Videos

Indeterminate lung imaging. Can the number be reduced?

R B Davis, D S Schauwecker, A R Siddiqui

    Clinical Nuclear Medicine
    |August 1, 1986
    PubMed
    Summary

    Pulmonary embolism diagnosis using ventilation/perfusion scans is less reliable over time. Indeterminate scan results increase as the interval between imaging and symptom onset grows, impacting accuracy.

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    Area of Science:

    • Radiology
    • Nuclear Medicine
    • Pulmonary Medicine

    Background:

    • Pulmonary embolism (PE) diagnosis relies on imaging techniques.
    • Ventilation/perfusion (V/Q) lung scans are a common diagnostic tool for PE.
    • Interpreting V/Q scans can be challenging, especially in patients with underlying lung disease.

    Purpose of the Study:

    • To retrospectively evaluate the diagnostic accuracy of V/Q scans for pulmonary embolism.
    • To assess the impact of time intervals and radiographic findings on V/Q scan interpretation.
    • To determine the reliability of V/Q scans in patients with chronic obstructive pulmonary disease (COPD).

    Main Methods:

    • Retrospective analysis of 150 patients with suspected PE who underwent both V/Q scans and pulmonary angiography.

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  • Re-evaluation of V/Q scans using established criteria (Biello and Alderson).
  • Inclusion of 20 patients with COPD and Xe-133 retention for specific analysis of V/Q matching.

    • Main Results:

    • 62% of V/Q scans were classified as indeterminate based on reference criteria.
    • In COPD patients, V/Q matching was accurately determined in 15 of 20 cases, with 15 reclassified as low-probability.
    • Increasing time from V/Q imaging to symptom onset correlated with decreased high-probability diagnoses and increased indeterminate results.

    Conclusions:

    • The diagnostic accuracy of V/Q scans for pulmonary embolism decreases with longer intervals between imaging and symptom onset.
    • Development of infiltrates on chest radiographs can convert high-probability V/Q scans to indeterminate.
    • V/Q scan interpretation requires careful consideration of timing and potential confounding radiographic findings.