Diagnosis of Pulmonary Embolism

Thrombosis is the key factor in acute pulmonary embolism. Rapid diagnosis and treatment are crucial in reducing morbidity and mortality. Therefore, the ability to accurately assess and diagnose this condition with noninvasive imaging studies is desired. In nuclear medicine, ventilation and perfusion pulmonary scintigraphy (V/Q scintigraphy) fulfill this role with a noninvasive, minimal risk and accurate imaging exam. SPECT and SPECT/CT technologies have improved the V/Q scintigraphy accuracy. This chapter will discuss the workup of acute PE diagnosis, comparing the V/Q scintigraphy with the widely used computed tomography pulmonary angiography (CTPA), and will present the technical aspects of V/Q scintigraphy, including the diagnosis criteria. We will also discuss the new trends in nuclear medicine in PE diagnosis, with new PET tracers and artificial intelligence.