Ugeskr Læger 2018;180:V05170391
The choice of diagnostic modality for acute pulmonary embolism
The diagnosis of pulmonary embolism (PE) relies on clinical assessment, D-dimer test and diagnostic imaging. Modern CT pulmonary angiography (CTPA), ventilation/perfusion single-photon emission computed tomography (SPECT) and SPECT/CT are rather equal in terms of sensitivity, specificity and inconclusive results for the diagnosis of PE, outperforming planar lung scintigraphy. Furthermore, SPECT/CT and CTPA can both provide important information regarding differential diagnoses. Thus, the choice of primary diagnostic modality relies on local expertise, availability and special circumstances like radiation dose, contraindications and the clinical urgency.