Key result
Semiautomated V/Q SPECT PE quantification correlates strongly with manual delineation at R² ~0.96.
Why the study?
Conventional pulmonary embolism imaging is reported in a binary manner, with no generally accepted graduated quantification systems available to guide management or predict acute or long-term complications.
Does a semiautomated volumetric V/Q SPECT quantification technique accurately measure %PE compared to manual delineation in patients with pulmonary embolism?
Observational (n=100)
No
Does a semiautomated volumetric V/Q SPECT quantification technique accurately measure %PE compared to manual delineation in patients with pulmonary embolism?
A semiautomated V/Q SPECT %PE quantification method using phantom-derived optimization parameters accurately and rapidly measures pulmonary embolism clot burden compared to manual delineation.
Answers are grounded in this paper and cite their sources.
May support automated PE quantification in V/Q SPECT; leaves open prospective outcome validation before clinical adoption.
BACKGROUND: Pulmonary embolism (PE) remains an important cause of cardiovascular death and morbidity worldwide. Conventionally, PE imaging is reported in a binary manner, with reports stating the presence or absence of a thrombus. No generally accepted graduated quantification systems are available to guide management or predict the development of acute or long-term complications. V/Q SPECT is a well-established method for diagnosing PE in acute and chronic settings. The use of volumetric perfusion and ventilation functional images could potentially calculate the volumetric PE burden. This project aimed to develop and optimise a volumetric V/Q SPECT PE quantification technique, utilising V/Q SPECT phantoms, 100 consecutive clinical V/Q SPECT studies, and advanced V/Q SPECT image analysis with semiautomated %PE quantification methods. RESULTS: Lung phantoms with PE defects of known volume demonstrated that the choice of acquisition, reconstruction parameters, and the volumetric cutoff threshold influences %PE results. The V/Q quotient image utilised a semiautomated technique with phantom-derived optimisation parameters, which was found to be the most accurate quantification method. CONCLUSION: This study, combining phantom and clinical study analysis, developed a successful method for semiautomated V/Q SPECT %PE quantification, which has the potential utility of guiding patient management and outcome prediction.
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Fernando et al. (2026) conducted an observational in Pulmonary embolism (n=100). Semiautomated V/Q SPECT %PE quantification (POR/QID method) vs. Manual gold standard delineation was evaluated on Correlation of %PE quantification with manual gold standard (R2=0.96). A semiautomated V/Q SPECT quantification method utilizing phantom-derived optimization parameters and quotient image data accurately quantified pulmonary embolism burden, showing high correlation (R2=0.96) with manual delineation.
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