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CC BY-NC-ND 4.0 · World J Nucl Med 2020; 19(02): 137-140
DOI: 10.4103/wjnm.WJNM_64_19
Original Article

The diagnostic accuracy of prospective investigative study of acute pulmonary embolism diagnosis criteria for the detection of acute pulmonary thromboembolism in acutely ill patients

Mehrnaz Gharabaghi
Advanced Thoracic Research Center, Tehran University of Medical Sciences, Tehran, Iran
,
Fatemeh Sarv
Advanced Thoracic Research Center, Tehran University of Medical Sciences, Tehran, Iran
,
Saeed Farzanehfar
1   Department of Nuclear Medicine, Vali-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran
,
Mehrshad Abbasi
1   Department of Nuclear Medicine, Vali-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran
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Abstract

The practical diagnostic performance of Prospective Investigative Study of Acute Pulmonary Embolism Diagnosis (PISAPED) criteria for the detection of acute pulmonary thromboembolism (APTE) in hospitalized patients is not yet well determined. This is the report of the initial results of our recently implemented protocol to employ PISAPED. One hundred and forty-seven pulmonary perfusion scans with 1–3 mCi 99mTc-MAA of patients of a single pulmonologist were included. Patients with suspicious perfusion defects underwent single-photon emission computed tomography. Interpretations were done by consensus of two nuclear medicine specialists. Comparisons were done with chest X-ray or chest computed tomography when available. The interpreters had access to the clinical records. The scans were reported based on the PISAPED criteria as negative or positive for APTE or indeterminate. Patients were followed up for 6.2 ± 5.3 months when the final diagnosis confirming or excluding APTE was achieved. Patients aged 55.9 (17.2) years; 78 (53.1%) of them were female and 64 (43.8%) had high Wells' score. The scans were positive, negative, and indeterminate in 17 (11.6%), 126 (85.7%), and 4 (2.7%) patients, respectively. In 6 out of 147 patients, follow-up was not completed and the final diagnosis was not achieved. APTE was finally diagnosed in 21 (14.3%) patients; 12 (57.1%) of them had positive scans. APTE was excluded in 116 (78.9%) patients; 112 (96.5%) of them had negative scans. The accuracy of the test for the diagnosis of APTE was 87.9%. Lung metastasis was the most frequent reason among false-negative cases. The lung perfusion scan using PISAPED criteria could be used with good accuracy in inpatient settings.

Keywords

Diagnostic accuracy - perfusion lung scan - Prospective Investigative Study of Acute Pulmonary Embolism Diagnosis criteria - pulmonary thromboembolism

Financial support and sponsorship

Nil.




Publication History

Received: 11 August 2019

Accepted: 15 November 2019

Article published online:
19 April 2022

© 2020. Sociedade Brasileira de Neurocirurgia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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