Residual pulmonary vascular obstruction computed with ventilation/perfusion single photon emission computed tomography/computed tomography to predict the risk of venous thromboembolism recurrence in patients with pulmonary embolism: protocol for a cohort study (PRONOSPECT)
Background: In patients with pulmonary embolism (PE), identifying predictors of recurrence is important to risk-stratify patients and tailor anticoagulation duration. After PE, a significant proportion of patients demonstrate residual pulmonary vascular obstruction (RPVO) on lung imaging. However, t...
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Elsevier
2025-03-01
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| Series: | Research and Practice in Thrombosis and Haemostasis |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2475037925001918 |
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| author | Pierre–Yves Le Roux Philippe Robin Romain Le Pennec Cécile Tromeur Francis Couturaud Julien Asselineau Grégoire Le Gal Pierre–Yves Salaun |
| author_facet | Pierre–Yves Le Roux Philippe Robin Romain Le Pennec Cécile Tromeur Francis Couturaud Julien Asselineau Grégoire Le Gal Pierre–Yves Salaun |
| author_sort | Pierre–Yves Le Roux |
| collection | DOAJ |
| description | Background: In patients with pulmonary embolism (PE), identifying predictors of recurrence is important to risk-stratify patients and tailor anticoagulation duration. After PE, a significant proportion of patients demonstrate residual pulmonary vascular obstruction (RPVO) on lung imaging. However, the exact prognostic significance of RPVO for venous thromboembolism recurrence remains unclear. Objectives: The primary objective is to assess whether RPVO on ventilation/perfusion (V/Q) single photon emission computed tomography (SPECT)/CT imaging after completion of 3 to 6 months of anticoagulation is an independent predictor of venous thromboembolism recurrence in patients with PE. Methods: The PRONOSPECT trial is a prospective multicenter cohort study. Participants are patients who experienced an objectively proven PE, provoked by a minor transient risk factor or unprovoked; who have been treated with anticoagulant therapy for 3 to 6 uninterrupted months; and for whom anticoagulation will not be prolonged. A standardized baseline patient assessment will be conducted including V/Q SPECT/CT imaging, collection of other potential predictor variables, and a functional evaluation. Anticoagulants will be withdrawn at the 3- or 6-month points from diagnosis and patients will be followed up for up to 2 years. Conclusion: The PRONOSPECT cohort study has the potential to determine whether the presence of RPVO on V/Q SPECT/CT imaging predicts the risk of recurrence in patients with PE in whom there remains a doubt on duration of anticoagulation. |
| format | Article |
| id | doaj-art-ffc7c5e465854a79a53e66cbce0aa6c0 |
| institution | OA Journals |
| issn | 2475-0379 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | Elsevier |
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| series | Research and Practice in Thrombosis and Haemostasis |
| spelling | doaj-art-ffc7c5e465854a79a53e66cbce0aa6c02025-08-20T02:31:05ZengElsevierResearch and Practice in Thrombosis and Haemostasis2475-03792025-03-019310286710.1016/j.rpth.2025.102867Residual pulmonary vascular obstruction computed with ventilation/perfusion single photon emission computed tomography/computed tomography to predict the risk of venous thromboembolism recurrence in patients with pulmonary embolism: protocol for a cohort study (PRONOSPECT)Pierre–Yves Le Roux0Philippe Robin1Romain Le Pennec2Cécile Tromeur3Francis Couturaud4Julien Asselineau5Grégoire Le Gal6Pierre–Yves Salaun7Médecine nucléaire, Université de Brest, Centre Hospitalier Universitaire de Brest (CHU Brest), Groupe d’Études Tumeurs et Biothérapies Oncologiques (GETBO), Unité Mixte de Recherche (UMR) 1304, Brest, France; Correspondence Pierre–Yves Le Roux, Médecine nucléaire, Centre Hospitalier Universitaire de Brest, 29609 Brest Cedex, France.Médecine nucléaire, Université de Brest, Centre Hospitalier Universitaire de Brest (CHU Brest), Groupe d’Études Tumeurs et Biothérapies Oncologiques (GETBO), Unité Mixte de Recherche (UMR) 1304, Brest, FranceMédecine nucléaire, Université de Brest, Centre Hospitalier Universitaire de Brest (CHU Brest), Groupe d’Études Tumeurs et Biothérapies Oncologiques (GETBO), Unité Mixte de Recherche (UMR) 1304, Brest, FrancePneumologie, Université de Brest, CHU Brest, Pneumologie, GETBO, UMR 1304, Brest, FrancePneumologie, Université de Brest, CHU Brest, Pneumologie, GETBO, UMR 1304, Brest, FranceDirection de la recherche clinique et de l’innovation, Université de Brest, CHU Brest, Brest, FranceDirection de la recherche clinique et de l’innovation, Université de Brest, CHU Brest, Brest, France; Department of Medicine, Ottawa Hospital Research Institute, Ottawa, Ontario, CanadaMédecine nucléaire, Université de Brest, Centre Hospitalier Universitaire de Brest (CHU Brest), Groupe d’Études Tumeurs et Biothérapies Oncologiques (GETBO), Unité Mixte de Recherche (UMR) 1304, Brest, FranceBackground: In patients with pulmonary embolism (PE), identifying predictors of recurrence is important to risk-stratify patients and tailor anticoagulation duration. After PE, a significant proportion of patients demonstrate residual pulmonary vascular obstruction (RPVO) on lung imaging. However, the exact prognostic significance of RPVO for venous thromboembolism recurrence remains unclear. Objectives: The primary objective is to assess whether RPVO on ventilation/perfusion (V/Q) single photon emission computed tomography (SPECT)/CT imaging after completion of 3 to 6 months of anticoagulation is an independent predictor of venous thromboembolism recurrence in patients with PE. Methods: The PRONOSPECT trial is a prospective multicenter cohort study. Participants are patients who experienced an objectively proven PE, provoked by a minor transient risk factor or unprovoked; who have been treated with anticoagulant therapy for 3 to 6 uninterrupted months; and for whom anticoagulation will not be prolonged. A standardized baseline patient assessment will be conducted including V/Q SPECT/CT imaging, collection of other potential predictor variables, and a functional evaluation. Anticoagulants will be withdrawn at the 3- or 6-month points from diagnosis and patients will be followed up for up to 2 years. Conclusion: The PRONOSPECT cohort study has the potential to determine whether the presence of RPVO on V/Q SPECT/CT imaging predicts the risk of recurrence in patients with PE in whom there remains a doubt on duration of anticoagulation.http://www.sciencedirect.com/science/article/pii/S2475037925001918lung scintigraphypulmonary embolismrecurrenceresidual pulmonary vascular obstructionventilation/perfusion SPECT/CT |
| spellingShingle | Pierre–Yves Le Roux Philippe Robin Romain Le Pennec Cécile Tromeur Francis Couturaud Julien Asselineau Grégoire Le Gal Pierre–Yves Salaun Residual pulmonary vascular obstruction computed with ventilation/perfusion single photon emission computed tomography/computed tomography to predict the risk of venous thromboembolism recurrence in patients with pulmonary embolism: protocol for a cohort study (PRONOSPECT) Research and Practice in Thrombosis and Haemostasis lung scintigraphy pulmonary embolism recurrence residual pulmonary vascular obstruction ventilation/perfusion SPECT/CT |
| title | Residual pulmonary vascular obstruction computed with ventilation/perfusion single photon emission computed tomography/computed tomography to predict the risk of venous thromboembolism recurrence in patients with pulmonary embolism: protocol for a cohort study (PRONOSPECT) |
| title_full | Residual pulmonary vascular obstruction computed with ventilation/perfusion single photon emission computed tomography/computed tomography to predict the risk of venous thromboembolism recurrence in patients with pulmonary embolism: protocol for a cohort study (PRONOSPECT) |
| title_fullStr | Residual pulmonary vascular obstruction computed with ventilation/perfusion single photon emission computed tomography/computed tomography to predict the risk of venous thromboembolism recurrence in patients with pulmonary embolism: protocol for a cohort study (PRONOSPECT) |
| title_full_unstemmed | Residual pulmonary vascular obstruction computed with ventilation/perfusion single photon emission computed tomography/computed tomography to predict the risk of venous thromboembolism recurrence in patients with pulmonary embolism: protocol for a cohort study (PRONOSPECT) |
| title_short | Residual pulmonary vascular obstruction computed with ventilation/perfusion single photon emission computed tomography/computed tomography to predict the risk of venous thromboembolism recurrence in patients with pulmonary embolism: protocol for a cohort study (PRONOSPECT) |
| title_sort | residual pulmonary vascular obstruction computed with ventilation perfusion single photon emission computed tomography computed tomography to predict the risk of venous thromboembolism recurrence in patients with pulmonary embolism protocol for a cohort study pronospect |
| topic | lung scintigraphy pulmonary embolism recurrence residual pulmonary vascular obstruction ventilation/perfusion SPECT/CT |
| url | http://www.sciencedirect.com/science/article/pii/S2475037925001918 |
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