EANM guidelines for ventilation/perfusion scintigraphy – Part 1

Bajc M, et al. Eur J Nul Med Mol Imaging 2009; 36: 1356-1370

EANM guidelines for ventilation/perfusion scintigraphy – Part 2

Bajc M, et al. Eur J Nul Med Mol Imaging 2009; 36: 1528-1538


Clinical References

Ventilation defect typical for COPD is frequent among patients suspected for pulmonary embolism but does not prevent the diagnosis of PE by V/P SPECT 01/07/2017
First Author: Nasr A, Last Author: Bajc M

"The introduction of the tomographic technique and the implementation of Technegas as a novel ventilation agent facilitated imaging of pulmonary embolism in comparison with planar imaging and particularly in COPD patients together with the new interpretation criteria."

EC Pulmonology and Respiratory Medicine. 2017; 4(3): 85-91

Peripheral ventilation heterogeneity determines the extent of bronchoconstriction in asthma 01/11/2017
First Author: Farrow CE, Last Author: King GG

"Ventilation SPECT imaging with Technegas was used as an estimation of regional ventilation [...] In asthma, bronchostriction causes topographically heterogeneous airway narrowing as measured by 3-dimensional ventilation imaging."

J Appl Physiol (1985). 2017; 123(5): 1188-1194

Radionuclide diagnosis of pulmonary embolism 01/01/2017
First Author: Hess S, Last Author: Madsen PH

"Among the traditional imaging modalities for diagnosing pulmonary embolism (PE), the choice has narrowed to V/Q scan and CTPA. However, V/Q scan is preferred over CTPA for follow-up of PE particularly in young women in order to avoid the excessive breast radiation exposure associated with CTPA."

Adv Exp Med Biol 2017; 906: 49-65

State-of-the-Art Imaging in pulmonary embolism: ventilation-perfusion single photon emission computed tomography versus computed tomography angiography – Controversies, Results, and Recommendations from a Systematic Review 01/10/2016
First Author: Hess S, Last Author: Madsen PH

"V/Q SPECT-CT should be considered the first-line modality in most clinical setting based on overall better diagnositic performance. The use of V/Q SPECT-CT also allows differential diagnosis of other lung diseases than pulmonary embolism or chronic thromboembolic pulmonary hypertension (CTEPH)."

Semin Thromb Hemost 2016; 42(8): 833-845

SPECT-CT/VQ versus CTPA for diagnosing pulmonary embolus and other lung pathology: Pre-existing lung disease should not be a contraindication 01/08/2016
First Author: Bhatia KD, Last Author: Emmett L

"Pre-existing lung disease should not be a relative contraindication to the use of V/Q SPECT-CT. This modality has a sensitivity of 100% and specificity of 94% with lower radiation doses compared to CTPA."

J Med Imaging Radiat Oncol 2016; 60(4): 492-497

Reproducibility of lobar perfusion and ventilation quantification using a SPECT/CT segmentation software in lung cancer patients 01/04/2017
First Author: Provost K, Last Author: Lord M

"We recommend that SPECT/CT based quantification be used for all lung cancer patients undergoing pre-therapy evaluation of regional lung function."

J Nucl Med Technol. 2017; 45(3): 185-192

The benefit of personalized hybrid SPECT/CT pulmonary imaging 01/08/2016
First Author: Simanek M, Last Author: Koranda P

"Hybrid SPECT/CT increases tools and approaches for imaging complex diseases. V/Q SPECT-CT enables identification of other lung diseases with perfusion abnormalities and sucessfully demonstrates to diagnose pulmonary embolism among the target patient group."

Am J Nucl Med Mol Imaging 2016; 6(4): 215-222

Appropriate use Criteria for Ventilation-Perfusion imaging in Pulmonary embolism : Summary and Excerpts 01/05/2017
First Author: Waxman, AD, Last Author: Donohoe, K

"V/Q SPECT allows quantification of pulmonary embolism, valuable for therapeutic decision making, follow-up and research. In patients with suspected pulmonary embolism who have complex situations including comorbidities, V/Q SPECT retains its diagnostic utility."

J Nucl Med 2017; 58(5): 13N-15N

A review of imaging modalities in pulmonary hypertension 01/04/2017
First Author: Ascha, ML, Last Author: Tonelli, AR

"V/Q scan is the imaging modality of choice for screening patients with suspected chronich tromboembolic pulmonary hypertension (CTEPH) due to its high sensitivity. Imaging in CTEPH reveals perfusion defects with normal ventilation. A normal or low-probability V/Q effectively excludes CTEPH with a sensitivity of 90-100% compared to CTPA yielding a sensitivity of 50-98%. Despite the high sensitivity and experts recommendations, V/Q scan for detecting CTEPH patients is still underutilized. Efforts should be tailored to increase its use in clinical setup as V/Q do not require iodine contrast and have less radiation exposure compared to CTPA."

Ann Thorac Med 2017; 12(2): 61-73

Current status of ventilation-perfusion scintigraphy for suspected pulmonary embolism 01/03/2017
First Author: Metter DF, Last Author: Freeman LM

"Ventilation imaging is most often performed in conjunction with lung perfusion to characterize perfusion defects as a matched, mismatched or reverse mismatched. The optimal tracer for ventilation studies is Technegas, an ultra fine dispersion of 99mTc-labeled carbon. Despite that Technegas is not approved for use in the United States, it is used in 79% of ventilation imaging studies performed in Canada and is also commonly used in Europe. Its main advantage is greater percentage deposition in the alveolar spaces and less undesirable adherence to the central airways, compared with droplet radioaerosols."

AJR Am J Roentgenol 2017; 208(3): 489-494