Access to Lung Scintigraphy / CT Pulmonary Angiography

Speed of performing and reporting lung scintigraphy / CT Pulmonary Angiography (CTPA).

- The rapid and accurate diagnosis of pulmonary embolism is clinically important for effective management 

- Prompt exclusion of pulmonary embolus reduces the likelihood of inappropriate treatment and an unnecessary in-patient stay 

The standard: 

In-patient requests for lung scans / CTPA should be performed and reported within one working day of receipt and acceptance of the request form.

Target: 

90%

Indicators: 

The percentage of in-patient requests for lung scans / CTPA performed and reported within one working day.

Data items to be collected: 

For each request, record:

• The date and time of receipt of the request form

• The date and time of the scan

• The date and time of issue of the report

Suggested number: 

All requests accepted over a 3-month period.

- In departments relatively reliant on lung scintigraphy, the availability may need to be increased, e.g. if it is performed only on certain days of the week

- Agree a protocol for investigating suspected pulmonary embolism to assist with the initiation of requests, in order to reduce unnecessary examinations and reduce the time taken for justification

- Scrutinise requests more carefully

- Scrutinise the organisational aspects of the nuclear medicine and CT service

• Prospective data recording

• No assistance required

• Radiologist (8 hours)

• Radiographer (24 hours)

1. Sostman HD, Stein PD, Gottschalk A, Matta F, Hull R, Goodman L. Acute pulmonary embolism: sensitivity and specificity of ventilation-perfusion scintigraphy in PIOPED II study. (2008) Radiology. 246 (3): 941-6  https://www.ncbi.nlm.nih.gov/pubmed/18195380

2. Miniati M, Pistolesi M, Marini C, Di Ricco G et al. Value of perfusion lung scan in the diagnosis of pulmonary embolism: results of the Prospective Investigative Study of Acute Pulmonary Embolism Diagnosis (PISA-PED). Am J Resp Crit Care Med 1996; 154: 1387-1393.

3. O'Neill JM, Wright L, Murchison JT.Helical CTPA in the investigation of pulmonary embolism: a 6-year review.Clin Radiol. 2004 Sep;59(9):819-25.

4. Mortensen J, Gutte H. SPECT/CT and pulmonary embolism. European Journal of Nuclear Medicine and Molecular Imaging. 2014;41(Suppl 1):81-90. doi:10.1007/s00259-013-2614-

Dr D Remedios and Ms J Ryder, updated by A Marzoug