Ventilation/perfusion SPECT in children: Feasibility, impact on clinical decision-making and interrater agreement

儿童通气/灌注SPECT:可行性、对临床决策的影响及观察者间一致性

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Abstract

INTRODUCTION: It remains to be established whether it provides any clinical or diagnostic benefits to perform ventilation/perfusion (V/Q) scintigraphy as a single photon emission computed tomography in children. Here, we report our experience with this modality, evaluate its impact on clinical decision-making and assess its interrater agreement. METHODS: All V/Q scintigraphies performed in children over a 1-year period were identified, and patient files were reviewed. Two nuclear medicine physicians, blinded to patient data and each other's readings, interpreted all scintigraphies. RESULTS: A total of 20 planar and SPECT V/Q scintigraphies were identified. In 17/20 cases (85%), the results of the scan were found to directly inform clinical decision-making. SPECT mainly ruled out the presence of ventilation and perfusion defects that were suspected on planar scintigraphy. In terms of interrater agreement, Cohen's ϰ coefficients for planar ventilation and perfusion scintigraphy were 0.34 and 0.38 (fair agreement), respectively, while the corresponding values for SPECT were 0.42 and 0.61 (moderate to substantial agreement). CONCLUSION: It is both feasible and clinically meaningful to perform V/Q SPECT in children. In this patient group, V/Q SPECT furthermore seems to have better interrater agreement than planar scintigraphy.

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