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Is the lung scan alive and well? Facts and controversies in defining the role of lung scintigraphy for the diagnosis of pulmonary embolism in the era of MDCT

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Abstract

Purpose

The last decade has seen a changing pattern of utilization of multidetector CT (MDCT) versus lung perfusion scintigraphy in the investigation of pulmonary venous thromboembolism (VTE). In response to this the International Atomic Energy Agency (IAEA) determined that the subject required an overview.

Method

The IAEA has invited a group of five specialists in the relevant fields to review the current status and optimum role of scintigraphy, to explore some of the facts and controversies surrounding the use of both modalities and to make recommendations about the continued role of nuclear medicine for the investigation of pulmonary embolism. This paper identifies the relative merits of each technique, highlights benefits, focuses on complementary roles and seeks a nonadversarial symbiosis.

Conclusion

The consultants reached a consensus that the continued use of scintigraphy for diagnosis of thromboembolic disease is recommended, particularly in scenarios where scintigraphy confers specific benefits and is complementary to MDCT.

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The use of particular designations of countries or territories does not imply any judgment by the IAEA as to the legal status of such countries or territories, of their authorities and institutions or of the delineation of their boundaries. The mention of names of specific companies or products (whether or not indicated as registered) does not imply any intention to infringe their proprietary rights, nor should it be construed as an endorsement or recommendation on the part of the IAEA. The IAEA Consultants group would like to acknowledge helpful advice from Prof. Carlo Giuntini, emeritus Professor of Respiratory Pathophysiology, University of Pisa Medical School and Prof. Massimo Pistolesi, Professor of Respiratory Diseases at the University of Florence Medical School. The Group would also like to thank Ms Libby McBride for her secretarial assistance.

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Correspondence to John H. Reid.

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An Editorial Commentary to this paper is available at http://dx.doi.org/10.1007/s00259-008-1068-2.

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Reid, J.H., Coche, E.E., Inoue, T. et al. Is the lung scan alive and well? Facts and controversies in defining the role of lung scintigraphy for the diagnosis of pulmonary embolism in the era of MDCT. Eur J Nucl Med Mol Imaging 36, 505–521 (2009). https://doi.org/10.1007/s00259-008-1014-8

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