SPECT V/Q with Kr81m gas and Tc99m MAA dual energy imaging
Lung SPECT V/Q has now superseded planar imaging as the standard modality. The benefits of SPECT over planar are clear, with sensitivity, specificity and accuracy matching that of computed tomography pulmonary angiography (CTPA).
SPECT V/Q can be carried out with Tc99m MAA for perfusion and Tc99m aerosol for ventilation. However, these two studies must be carried out separately, which involves two administrations and gamma camera acquisitions. The activity of the first part needs to be lower to avoid interference with the second part, which can compromise SPECT image quality. The two SPECT studies then need to be moved and aligned for comparison during reporting.
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