Background: Computed tomography (CT) pulmonary angiography has simplified the diagnostic approach to patients with clinically suspected pulmonary embolism (PE), but alternative imaging tests are still advocated.
Aims: We aimed to systematically assess the diagnostic accuracy of ventilation/perfusion (V/Q) and Q single-photon emission CT combined with low-dose CT (SPECT/CT) for PE diagnosis.
Methods: Studies evaluating the diagnostic accuracy of SPECT/CT for the diagnosis of PE were systematically searched in MEDLINE and EMBASE databases (up to July 2021). QUADAS-2 tool was used for risk of bias assessment of the primary studies. A bivariate random-effects regression approach was used for summary estimates of both sensitivity and specificity. PROSPERO registration number is CRD42021276538
Results: Six studies, for a total of 974 patients, were included. Weighted mean prevalence of PE was 24.9% at random-effect model. Weighted mean inconclusive SPECT/CT results were 2.5% (95% CI, 0.2-6.9%) at random-effect model. After exclusion of technical inadequate results, SPECT/CT bivariate weighted mean sensitivity was 96% (95% confidence interval [CI], 93-98%), with a bivariate weighted mean specificity of 96% (95% CI, 94-97%).
At subgroup analysis, for V/Q SPECT/CT bivariate weighted mean sensitivity and specificity were 97% (95% CI, 92-99%) and 97% (95% CI, 95-98%), while for Q SPECT/CT they were 95% (95% CI, 90-98%) and 84% (95% CI, 61-95%), respectively.
Conclusion(s): V/Q SPECT/CT has high sensitivity and specificity for the diagnosis of PE, meanwhile Q SPECT/CT has high sensitivity but limited specificity for the diagnosis of PE. Management studies will conclusively ascertain the actual role of SPECT/CT in the diagnostic workup of patients with suspected PE.
To cite this abstract in AMA style:Venturini A, Squizzato A, Pelitti V, Bellini B, Bernasconi M, Corso A, Riva N, Depalo T. Diagnostic accuracy of V/Q and Q SPECT/CT in patients with suspected pulmonary embolism: a systematic review and meta-analysis [abstract]. https://abstracts.isth.org/abstract/diagnostic-accuracy-of-v-q-and-q-spect-ct-in-patients-with-suspected-pulmonary-embolism-a-systematic-review-and-meta-analysis/. Accessed October 1, 2023.
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