When facing a suspicion of pulmonary embolism in the current Covid-19 situation, patient management can be adapted.
Dr. Renaud Guignard,
nuclear medicine physician at Hôpital de La Tour in Switzerland, has accepted to share his procedures to avoid department, staff and other patient contamination during lung SPECT-CT scans.
His solution consists of modifying the patient workflow following these different steps:
Before the nuclear medicine examination,
initiate a CT diagnostic chest exam to diagnose potential Covid-19.
If patient is negative, ventilation/perfusion acquisitions can be performed as in normal conditions.
If patient is positive, the referring physician is immediately informed.
If still required, ventilation/perfusion scan is performed. Afterwards, the SPECT room is completely cleaned according to internal disinfection procedures for infectious diseases (room not available for at least 1 hour).
At the end, the patient is referred to the Covid-19 dedicated center.
In order to avoid cross contamination, patients addressed for a lung scan, whatever their Covid-19 status, are postponed at the very end of the exams slot.
Dr. Guignard comments:
CT diagnostic chest exams are not performed in pregnant women because ionizing radiation exposure is the most critical point in this very particular situation, according to the European guidelines. Only single perfusion SPECT scan with a very limited amount of radiopharmaceutical without any CT (diagnostic or for attenuation correction purposes) is performed.
Patient in her seventies with atypical chest pain. Referred for risk of pulmonary embolism.
Ventilation/perfusion mismatch seen in left inferior lobe indicating pulmonary embolism
Above clinical images acquired on the Discovery™ NM/CT 670 CZT have been processed through
Q. Lung, a quantitative SPECT/CT application to help diagnose pulmonary embolism*.