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Citation:
Deng F, Bell D, PISAPED criteria for diagnosis of pulmonary embolus. Reference article, Radiopaedia.org (Accessed on 23 Jan 2025) https://doi.org/10.53347/rID-71359
The PISAPED criteria for the diagnosis of pulmonary embolus indicate the presence or absence of pulmonary emboli based on findings on perfusion scintigraphy (only the Q portion of the V/Q scan) in combination with chest radiography. The criteria were validated in the Prospective Investigative Study of Acute Pulmonary Embolism Diagnosis, abbreviated to PISAPED 1. Compared to perfusion-only modified PIOPED II interpretation criteria, PISAPED is simpler, eliminates non-diagnostic readings, and may have higher interobserver agreement 2.
Criteria
Pulmonary embolism present
- one or more wedge-shaped perfusion defects
Pulmonary embolism absent
- no perfusion defects of any kind
- perfusion defects other than wedge-shaped
- perfusion defects smaller or equal in size and shape to the following radiographic abnormalities:
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1. Miniati M, Pistolesi M, Marini C, Di Ricco G, Formichi B, Prediletto R, Allescia G, Tonelli L, Sostman HD, Giuntini C. Value of perfusion lung scan in the diagnosis of pulmonary embolism: results of the Prospective Investigative Study of Acute Pulmonary Embolism Diagnosis (PISA-PED). (1996) American journal of respiratory and critical care medicine. 154 (5): 1387-93. doi:10.1164/ajrccm.154.5.8912753 - Pubmed
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2. Sostman HD, Miniati M, Gottschalk A, Matta F, Stein PD, Pistolesi M. Sensitivity and specificity of perfusion scintigraphy combined with chest radiography for acute pulmonary embolism in PIOPED II. (2008) Journal of nuclear medicine : official publication, Society of Nuclear Medicine. 49 (11): 1741-8. doi:10.2967/jnumed.108.052217 - Pubmed
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3. Parker JA, Coleman RE, Grady E, Royal HD, Siegel BA, Stabin MG, Sostman HD, Hilson AJ. SNM practice guideline for lung scintigraphy 4.0. (2012) Journal of nuclear medicine technology. 40 (1): 57-65. doi:10.2967/jnmt.111.101386 - Pubmed
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