Indian Journal of Nuclear Medicine
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Year : 2013  |  Volume : 28  |  Issue : 4  |  Page : 221-225

Correlation between the clinical pretest probability score and the lung ventilation and perfusion scan probability

1 Department of Nuclear Medicine, King's College Hospital NHS Foundation Trust, Denmark Hill, London, United Kingdom
2 Department of Medical Imaging, Canterbury Christ Church University, Canterbury, Kent, United Kingdom

Correspondence Address:
Shanmugasundaram Bhoobalan
Department of Nuclear Medicine, King Fahad Hospital, KAMC, National Guard Health Affairs, Dept Post Code 1422, P O Box: 22490, Riyadh 11426
United Kingdom
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0972-3919.121967

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Purpose: Aim of the study was to determine the accuracy of the clinical pretest probability (PTP) score and its association with lung ventilation and perfusion (VQ) scan. Materials and Methods: A retrospective analysis of 510 patients who had a lung VQ scan between 2008 and 2010 were included in the study. Out of 510 studies, the number of normal, low, and high probability VQ scans were 155 (30%), 289 (57%), and 55 (11%), respectively. Results: A total of 103 patients underwent computed tomography pulmonary angiography (CTPA) scan in which 21 (20%) had a positive scan, 81 (79%) had a negative scan and one (1%) had an equivocal result. The rate of PE in the normal, low-probability, and high-probability scan categories were: 2 (9.5%), 10 (47.5%), and 9 (43%) respectively. A very low correlation (Pearson correlation coefficient r = 0.20) between the clinical PTP score and lung VQ scan. The area under the curve (AUC) of the clinical PTP score was 52% when compared with the CTPA results. However, the accuracy of lung VQ scan was better (AUC = 74%) when compared with CTPA scan. Conclusion: The clinical PTP score is unreliable on its own; however, it may still aid in the interpretation of lung VQ scan. The accuracy of the lung VQ scan was better in the assessment of underlying pulmonary embolism (PE).

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