Comparative analysis and clinical application of imaging methods for diagnosis of pulmonary embolism

<bold>Introduction:</bold>Contemporary diagnostic strategy to establish pulmonary embolism(PE) is assessing clinical probability, measuring D-dimer levels, followed by imaging tests including compuded tomography pulmonary angiography (CTPA), ventilation-perfusion scintigraphy, or single-photon emission tomography combined with computed tomography(SPECT/CT). <bold>Aim:</bold> This study compares CTPA and the hybrid method of perfusion SPECT/CT (pSPECT/CT) in terms of sensitivity, specifity and accuracy for diagnosing of PE and to determine the degree of comparability between CTPA and pSPECT/CT. One hundred eighty four individuals with clinical data for PE have been examined. The study was conducted during the period of September 2016 to February 2020 at the Pulmonary Department of the Clinic of Propaedeutics of Internal Diseases at the University Hospital "Alexandrovska" <bold>Results:</bold> From the calculations and data analysis of the patients who underwent CTPA is observed that the method has high specifity(90%), low sensitivity(58.2%), and an accuracy of 61.8%. The negative predictive value is low 21.4%, while the possitive predictive value is very high, reaching 97.9%. Respectively for pSPECT/CT it is found that the method has a relatively high sensitivity(82.9%), specifity of 64.7%, and accuracy(80.8%). The negative predictive value is low(33.3%), while the positive predictive value is very high reaching 94.7%. Assessment of the copmparability between the two tests was obtained by Cohen`s Kappa coefficient wiht value 0.41. <bold>Conclusion:</bold> Perfusion SPECT/CT can be considered a first choice method when suspecting PE in scheduled patients. There is a moderate level of agreement between CTPA and perfusion SPECT/CT.