The risk of pulmonary embolism is increased in pregnancy and can be life-threatening in rare cases. Both CTPA and VQ SPECT can be performed in pregnancy with very low radiation dose to the foetus.
CTPA diagnostic quality can be compromised in pregnant patients due to the hyperdynamic circulation affecting the timing of the contrast bolus1. In cases where CTPA is considered suboptimal, a VQ SPECT can be performed for further investigation. Conversely, if a patient undergoes VQ SPECT and it is equivocal, CTPA can be performed subsequently.