Pulmonary Embolism, Ventilation Perfusion Mismatch
Conditions
Keywords
Ga-68-MAA, Galligas, Tc-99m-MAA, Technegas, PET/CT, SPECT/CT
Brief summary
Lung perfusion scintigraphy with 99mTc-MAA and ventilation scintigraphy with Technegas (V/Q SPECT/CT) has been the cornerstone for the detection of pulmonary embolisms (PE) for many decades. In last two decades after the introduction of pulmonary CTA, general PE detection has shifted towards CTA and V/Q SPECT/CT has become the modality of choice for specific patient populations (iodine contrast allergy, poor kidney function, pregnancy, etc.) or indications (pre-operative risk stratification, chronic embolism detection, pulmonary hypertension). V/Q SPECT/CT acquisition is performed on a gamma camera, but this technique has distinct challenges and/or disadvantages. A potential alternative is the nowadays broadly available. 68Ga as a positron emitter allows PET/CT imaging. Replacing 99mTc with 68Ga in both MAA and aerosol suspension is easy and requires no modifications. However, 68Ga-V/Q with PET/CT will resolve many of the disadvantages of V/Q SPECT/CT. International studies have proven safety and feasibility of replacing 99mTc with 68Ga and preliminary work by international colleagues and our institute have shown validated preparations of the radiopharmaceuticals. However, in our institution, clinical translation is hampered by lack of data on technical acquisition parameters for our scanners. The aim of this small study is to get more insights into technical parameters for image acquisition, logistical feasibility of V/Q PET/CT, and confirm preliminary non-inferiority of this new technique over the current clinical standard (V/Q SPECT/CT).
Interventions
DIAGNOSTIC_TESTGa-68 V/Q PET/CT
Head-to-head comparison of Ga-68 V/Q PET/CT vs Tc-99m V/Q SPECT/CT
Sponsors
UMC Utrecht
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
DIAGNOSTIC
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Adult ≥18 years and declared competent * Provided written informed consent * Referred to the Nuclear Medicine Department for a conventional V/Q-SPECT/CT * Indication for conventional V/Q-SPECT/CT includes known or suspected pulmonary embolism
Exclusion criteria
\- Pregnancy
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Qualitative assessment of V/Q-PET/CT | Study participation is maximum 1 week. | Qualitative assessment of different image acquisition parameters for V/Q PET/CT, as determined by blinded assessment by experienced nuclear medicine physicians in a 5-point Likert scale of V/Q PET (compared to the clinical reference standard V/Q SPECT). |
| Quantitative assessment of V/Q PET/CT | Study participation is maximum 1 week. | Quantitative assessment of different image acquisition parameters for V/Q PET/CT, by comparison semi-quantitative measurements of V/Q PET (e.g. signal-noise ratio's, etc.). |
Countries
Netherlands
Contacts
Primary ContactArthur J.A.T. Braat, M.D. Ph.D.
Backup ContactRadiology Desk
Outcome results
None listed