• Natalie C Lawrence and Samuel Kyle.
• Department of Diagnostic Imaging, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.
• J Med Imaging Radiat Oncol. 2018 Dec 1; 62 (6): 777-780.

IntroductionVentilation perfusion single photon emission computed tomography (V/Q SPECT) and CTPA are the two leading imaging studies used to investigate acute pulmonary embolism. V/Q SPECT is often the first line investigation for pregnant patients and young females. Historically, V/Q Planar studies have high rates of indeterminate findings resulting in a preference for CTPA studies. The purpose of this research is to examine current V/Q SPECT referral practices in the quaternary clinical setting and to confirm V/Q SPECT studies have low rates of equivocal findings.MethodsRetrospective study of a 6-month period of all completed V/Q SPECT studies (± LDCT) indicated for investigation of acute PE. V/Q SPECT studies were reported using the European Association of Nuclear Medicine guidelines. Patient demographic data and V/Q SPECT findings were recorded. CTPA and Doppler Ultrasound report findings were included if performed 48 hours prior to, or following V/Q SPECT study. Standard descriptive statistical analysis was undertaken.ResultsNinety-nine percent of V/Q SPECT studies had reports positive or negative for acute PE, with 1% inconclusive. Twenty-two percent of patients had either CTPA or Doppler Ultrasound studies within a 48- hour period prior to, or following V/Q SPECT, with the majority having a negative Doppler ultrasound prior to negative V/Q SPECT. Sixty-eight percent of patients referred for V/Q SPECT were females under the age of 55, 40% of whom were pregnant.ConclusionsVentilation perfusion single photon emission computed tomography has low rates of equivocal findings with referral practices indicating pregnant patients and young women are considered to most benefit from V/Q SPECT as a first line investigation for acute PE.© 2018 The Royal Australian and New Zealand College of Radiologists.

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