Clinical utility of perfusion (Q)-single-photon emission computed tomography (SPECT)/CT for diagnosing pulmonary embolus (PE) in COVID-19 patients with a moderate to high pre-test probability of PE Journal Article


Authors: Das, J. P.; Yeh, R.; Schöder, H.
Article Title: Clinical utility of perfusion (Q)-single-photon emission computed tomography (SPECT)/CT for diagnosing pulmonary embolus (PE) in COVID-19 patients with a moderate to high pre-test probability of PE
Abstract: Purpose: We reviewed the clinical utility of perfusion (Q)-single-photon emission computed tomography (SPECT)/CT for diagnosing pulmonary embolus (PE) in patients hospitalized with severe acute respiratory syndrome coronavirus 2 (SARS-CoV2). Methods: Following the World Health Organization’s declaration of a global pandemic, our department policy recommended Q-only SPECT/CT for all patients undergoing nuclear medicine evaluation for suspected PE to reduce the risk of aerosolization of respiratory droplets. We performed a retrospective review of sequential patients admitted with COVID-19 imaged with Q-SPECT/CT between March 17, 2020, and June 30, 2020, at Memorial Sloan Kettering Cancer Center. We recorded patient demographics, clinical symptoms, Wells score (to stratify patients according to pre-test probability for PE prior to Q-SPECT/CT), and noted ancillary imaging findings on CT. Results: Of the 33 patients imaged with Q-SPECT/CT, 6 patients (3 men, 3 women) had a laboratory confirmed diagnosis of COVID-19 (mean age, 55, ± 11.4 years, range 33–68). All patients had a current diagnosis of malignancy and had a moderate or high pre-test probability for PE (mean Wells score 2.8, range 2–4). Q-SPECT/CT was positive in 4/6 (67%) of patients. Distribution of pulmonary emboli was bilateral and segmental in 75% of patients. Ancillary acute findings on SPECT/CT included bilateral parenchymal ground glass opacities (n = 5), pleural effusions (n = 2), and pneumomediastinum (n = 1). Conclusion: Q-SPECT/CT has clinical utility for diagnosing PE in patients with COVID-19 where there is a contraindication for iodinated contrast media and a moderate or high pre-test probability for PE. © 2020, Springer-Verlag GmbH Germany, part of Springer Nature.
Keywords: adult; aged; middle aged; retrospective studies; tomography, x-ray computed; diagnostic imaging; retrospective study; lung embolism; pulmonary embolism; virus rna; probability; diagnosis; scintigraphy; rna, viral; tomography, emission-computed, single-photon; single photon emission computed tomography; procedures; coagulopathy; perfusion imaging; humans; human; male; female; x-ray computed tomography; covid-19; sars-cov-2; covid-19 testing; v/q spect/ct
Journal Title: European Journal of Nuclear Medicine and Molecular Imaging
Volume: 48
Issue: 3
ISSN: 1619-7070
Publisher: Springer  
Date Published: 2021-03-01
Start Page: 794
End Page: 799
Language: English
DOI: 10.1007/s00259-020-05043-y
PUBMED: 32959115
PROVIDER: scopus
PMCID: PMC7505736
DOI/URL:
Notes: Article -- Export Date: 1 June 2021 -- Source: Scopus
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MSK Authors
  1. Heiko Schoder
    418 Schoder
  2. Randy Yeh
    31 Yeh
  3. Jeeban Paul Das
    21 Das