Accuracy Studies of SPECT
Study | Reference standard | SPECT criteria | Ventilation agent | SPECT sensitivity | SPECT specificity | SPECT PPV | Prospective | Patient characteristic |
---|---|---|---|---|---|---|---|---|
Corbus (4) | Conventional angio | Revised PIOPED: high or inter = PE; low or normal = no PE | 99mTc-DTPA | Not done | Not done | 18/29 (62%) | No | Consecutive suspected PE |
Bajc (30) | CT angio | ≥2 mismatches = PE; 1 mismatch = no PE | Technegas | 24/26 (92%) | 54/76 (71%) | No | Consecutive suspected PE | |
Bajc (30) | Consensus, SPECT, CT angio | ≥2 mismatches = PE; 1 mismatch = no PE | Technegas | 601/608 (99%) | 1,153/1,177 (98%) | No | Consecutive suspected PE | |
Palla (2) | Conventional angio if planar V/Q perfusion defects | Defects in ≥ 1 segment | 133Xe | 56/62 (90%) | 75/118 (64%) | Yes | All referred for suspected PE, not consecutive | |
Collart (20) | Consensus V/Q, sonography, CT angio, D-dimer | Wedge-shaped defect | Not done | 12/15 (80%) | 49/51 (96%) | Yes | Consecutive suspected PE in emergency department | |
Reinartz (22) | Not stated | ≥1 mismatch | Technegas | Reader 1, 96% | Reader 1, 96% | No | Consecutive suspected PE | |
Reader 2, 93% | Reader 2, 100% | |||||||
Reader 3, 89% | Reader 3, 100% | |||||||
Reinartz (23) | Consensus, including SPECT and CT angio | ≥1 mismatch | Technegas | 36/37 (97%) | 42/46 (91%) | No | Suspected PE | |
Bajc (19) | Consensus, including SPECT and CT angio | ≥2 seg or subseg mismatches = PE; 0 mismatch = no PE | 99mTc-DTPA | Reader A, 13/13 (100%) | Reader A, 37/40 (93%) | Yes | 51 suspected PE | |
Reader B, 13/13 (100%) | Reader B, 37/39 (95%) | 2 treated PE | ||||||
Hata (32) | CT angio if high or inter SPECT | Seg perfusion defect, 2 or 3 planes | Not done | Not done | Not done | 4/8 (50%) | Yes | Screening after cancer surgery |
Lemb (31) | SPECT better, new defects, or normalized = PE; SPECT unchanged = no PE | ≥1 mismatch = PE; 0 mismatch = no PE | Technegas | 44/46 (96%) | 38/39 (97%) | No | All referred for suspected PE |
PPV = positive predictive value; angio = angiography; inter = intermediate; seg = segmental; subseg = subsegmental.