Lung Scintigraphy for Pulmonary Embolism Diagnosis in COVID-19 Patients: A Multicenter Study

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FIGURE 1.
Results of central review. P = perfusion.
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FIGURE 2.
Examples of negative perfusion SPECT/CT results, with perfusion defects (arrows) matched with chest CT findings of COVID-19 disease. P = perfusion.
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FIGURE 3.
Examples of false-positive perfusion SPECT/CT results. Perfusion SPECT images showed perfusion defects (arrows), without significant abnormality on CT images. Perfusion SPECT/CT scans would therefore have been read as positive for PE. However, ventilation SPECT demonstrated matched defects. V/Q SPECT/CT scans were therefore interpreted as negative for PE. P = perfusion; V = ventilation.
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FIGURE 4.
Examples of positive V/P SPECT/CT results. Perfusion SPECT images showed perfusion defects (arrows), whereas coregistered ventilation SPECT images showed normal ventilation (mismatched V/P defects). P = perfusion; V = ventilation.

TABLE 1.

Practices of Nuclear Medicine Facilities

Practice	Centers (n)
Aerosol precautions	12 (100%)
Mask	12 (100%)
Filtering facepiece 1	1 (8%)
Filtering facepiece 2	11 (92%)
Goggles	12 (100%)
Long cap	12 (100%)
Gloves	12 (100%)
Gown	12 (100%)
Specific COVID-19 cleaning and disinfecting procedures	12 (100%)
Organizational adaptation in nuclear medicine facility
Camera or room dedicated to COVID-19 patients	8 (67%)
Scans performed at end of day	10 (83%)
Dedicated circuit within nuclear medicine department	3 (25%)
Standard lung scan protocol for COVID-19 patients
Systematic ventilation scan	11 (92%)
Technegas	8 (73%)
^81mKr gas	3 (27%)
First-line imaging
Planar	3 (25%)
SPECT	0 (0%)
SPECT/CT	9 (75%)