V/Q Scanning Using SPECT and SPECT/CT

P. J. Roach, G. P. Schembri, D. L. Bailey
2013 Journal of Nuclear Medicine  
Learning Objectives: On successful completion of this activity, participants should be able to describe (1) advantages and shortcomings of planar versus SPECT V/Q scanning, (2) advantages and disadvantages of CT pulmonary angiography versus V/Q SPECT in the investigation of pulmonary embolism, and (3) an overview of image acquisition, processing, display, and reporting of V/Q SPECT studies. Financial Disclosure: The authors of this article have indicated no relevant relationships that could be
more » ... erceived as a real or apparent conflict of interest. CME Credit: SNMMI is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to sponsor continuing education for physicians. SNMMI designates each JNM continuing education article for a maximum of 2.0 AMA PRA Category 1 Credits. Physicians should claim only credit commensurate with the extent of their participation in the activity. For CE credit, participants can access this activity through the SNMMI Web site (http:// www.snmmi.org/ce_online) through September 2016. Planar ventilation-perfusion ( V/Q) scanning is often used to investigate pulmonary embolism; however, it has well-recognized limitations. SPECT overcomes many of these through its ability to generate 3-dimensional imaging data. V/Q SPECT has higher sensitivity, specificity, and accuracy than planar imaging and a lower indeterminate rate. SPECT allows for new ways to display and analyze data, such as parametric V/Q ratio images. Compared with CT pulmonary angiography, SPECT has higher sensitivity, a lower radiation dose, fewer technically suboptimal studies, and no contrast-related complications. Any nuclear medicine department equipped with a modern hybrid scanner can now perform combined V/Q SPECT with CT (using low-dose protocols) to further enhance diagnostic accuracy. V/Q SPECT (with or without CT) has application in other pulmonary conditions and in research.
doi:10.2967/jnumed.113.124602 pmid:23907760 fatcat:kch3zukogjaklns4pzub3ljjqa