Ventilation/Perfusion PET/CT With Galligas and 68Ga-MAA for Regional Lung Function Assessment After Pulmonary Embolism

Inclusion criteria

• Patient included in the RAMBO study, whose inclusion criteria are: Age ≥ 18 years; Patient treated with at least 3 months and up to 8 months of anticoagulation for an acute symptomatic PE diagnosed according the ESC and ACCP guidelines; Patients who have a PembQol score ≥ 10% and whose total scores for the subgroups Q1 (dyspnea) and Q4 (impact of daily life) are ≥ 10%.
• Patients planned to be randomized
• Abnormal conventional V/Q scan at V1
• Give consent to participate to the EOLE study

Exclusion criteria

• Non inclusion criteria of the RAMBO trial:
• Previsible inability to perform the effort test and/or PR
• Presence of CTEPH according to international guidelines
• Patients treated for acute PE with anticoagulants for more than 8 months
• Active cancer or in remission for less than two years
• Dyspnea post - COVID due to parenchymal injuries
• Post-COVID hyperventilation syndrome without pulmonary vascular perfusion sequelae
• Physical or psychological inability to undertake PR
• Isolated or more distal segmental PE
• Neuro-muscular disease with PR contraindication.
• Cardiac insufficiency (unstable coronary artery disease)
• Severe respiratory failure (long-term oxygen therapy, pulmonary hypertension)
• Chronic dyspnea MMRC ≥ 2 before PE
• Cardiac or respiratory rehabilitation in the previous year
• Indication to urgent PR within 6 months at the time of inclusion
• Life expectancy of less than 12 months
• Inability to give consent
• Patient under guardianship or curatorship
• Patient deprived of liberty by an administrative or judicial decision
• Patient has not social security affiliation or who don't beneficiary of such social security

After initial PR work up, patients with following criteria cannot be included:

• Incapacity to perform the effort test
• Effort test stopped because of hemodynamic intolerance
• Cardiac failure discovered after PR work up