• Marika Bajc, Carl-Gustav Olsson, Berit Olsson, John Palmer, and Björn Jonson.
• Center for Medical Imaging and Clinical Physiology, University Hospital Lund, 221-85 Lund, Sweden. marika.bajc@klinfys.lu.se
• Clin Physiol Funct Imaging. 2004 Sep 1; 24 (5): 249-56.

AbstractPlanar lung ventilation/perfusion scintigraphy (V/P(PLANAR)) is a standard method for diagnosis of pulmonary embolism (PE). The goals of this study were to test whether the diagnostic information of ventilation/perfusion tomography (V/P(SPET)) applied in clinical routine might enhance information compared with V/P(PLANAR) and to streamline data processing for the demands of clinical routine. This prospective study includes 53 patients suspected for PE referred for lung scintigraphy. After inhalation of (99m)Tc-DTPA planar ventilation imaging was followed by tomography, using a dual-head gamma camera. (99m)Tc-MAA was injected i.v. for perfusion tomography followed by planar imaging. Patients were examined in supine position, unchanged during V/P tomography. Two reviewers evaluated V/P(PLANAR) and V/P(SPET) images separately and randomly. Mismatch points were calculated on the basis of extension of perfusion defects with preserved ventilation. Patients were followed up clinically for at least 6 months. With V/P(SPET) the number of patients with PE was higher and 53% more mismatch points were found. In V/P(SPET) interobserver variation was less compared with V/P(PLANAR). Ancillary findings were observed by both techniques in half of the patients but more precisely interpreted with V/P(SPET). V/P(SPET) shows more and better delineated mismatch defects, improved quantification and less interobserver variation compared with V/P(PLANAR). V/P(SPET) is amenable to implementation for clinical routine and suitable even when there is demand for a high patient throughput.

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