TY - JOUR
T1 - Perfusion Lung Scintigraphy for the Diagnosis of Pulmonary Embolism
T2 - A Reappraisal and Review of the Prospective Investigative Study of Acute Pulmonary Embolism Diagnosis Methods
AU - Miniati, Massimo
AU - Sostman, Henry Dirk
AU - Gottschalk, Alexander
AU - Monti, Simonetta
AU - Pistolesi, Massimo
PY - 2008/11
Y1 - 2008/11
N2 - In this article, we review the evolution of scintigraphy for the diagnosis of acute pulmonary embolism (PE). We begin with perfusion (Q) scintigraphy, review the development of diagnostic systems that combine ventilation (V) scintigraphy and chest radiography with the Q scan, and describe in detail the Prospective Investigative Study of Acute Pulmonary Embolism Diagnosis (PISAPED) criteria for diagnostic categorization of the Q scan read in conjunction with the chest radiograph. Finally, we review the results obtained with the PISAPED criteria in clinical research studies. The PISAPED method for lung scan interpretation provides sensitivity and specificity for diagnosing acute PE that is comparable to V/Q scanning and to computed tomography angiography (CTA), with fewer nondiagnostic results than either V/Q or CTA. The criteria can be used effectively in a diagnostic management approach that incorporates the use of a clinical prediction rule. Clinical outcomes in patients in whom PE is excluded in this way are comparable to outcomes for patients in whom the diagnosis is excluded by CTA or conventional angiography.
AB - In this article, we review the evolution of scintigraphy for the diagnosis of acute pulmonary embolism (PE). We begin with perfusion (Q) scintigraphy, review the development of diagnostic systems that combine ventilation (V) scintigraphy and chest radiography with the Q scan, and describe in detail the Prospective Investigative Study of Acute Pulmonary Embolism Diagnosis (PISAPED) criteria for diagnostic categorization of the Q scan read in conjunction with the chest radiograph. Finally, we review the results obtained with the PISAPED criteria in clinical research studies. The PISAPED method for lung scan interpretation provides sensitivity and specificity for diagnosing acute PE that is comparable to V/Q scanning and to computed tomography angiography (CTA), with fewer nondiagnostic results than either V/Q or CTA. The criteria can be used effectively in a diagnostic management approach that incorporates the use of a clinical prediction rule. Clinical outcomes in patients in whom PE is excluded in this way are comparable to outcomes for patients in whom the diagnosis is excluded by CTA or conventional angiography.
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U2 - 10.1053/j.semnuclmed.2008.06.001
DO - 10.1053/j.semnuclmed.2008.06.001
M3 - Review article
C2 - 19331839
AN - SCOPUS:52949139355
VL - 38
SP - 450
EP - 461
JO - Seminars in Nuclear Medicine
JF - Seminars in Nuclear Medicine
SN - 0001-2998
IS - 6
ER -