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CUDURADA FAAFA

Lung Scan (V/Q)

 

 

 

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• Name of the procedure                                                                                              

• Indications

• Contraindications

• Patient Prep

• Radiopharmaceuticals

• Adjunct pharmaceuticals

• Acquisition parameters

• Computer processing  parameters

• Normal results

• Abnormal result

 

1. Name of the Procedure:  Lung Scan ( Ventilation/Perfusion)

2. Indications:

   • Ventilation: Assesses the air supply going to the lungs.

   • Perfusion:  determine how much blood is flowing to lungs. And to determine the likelihood of pulmonary embolism.

   • After/before surgery: To asses how the lung is functioning after surgery. Lung transplantation, preoperative evaluation, right to left shunt evolution.

3. Contraindications: Sever pulmonary arterial hypertension, Pregnancy, Right to left intracardiac shunt.

4. Patient Preparation: Chest radiograph (24 hrs) should be obtained before lung scan imaging for pulmonary embolism. The patient should be in the supine position during injection.  

5. Radiopharmaceuticals:

   • Aerosol: Tc-99m DTPA is used; Administered activity is 25-35 mCi in the nebulizer. Ventilation is usually performed before Perfusion because it is more difficult to deliver a larger dose of the Tc-99m DTPA than it is to deliver a larger dose of Tc-99m MAA.

   • Perfusion: Tc-99m MAA is used for perfusion imaging. With a biological half-life of 1.5 to 3 hrs. Administered activity for adult is 5 mCi. For pediatric administered activity is 0.02-0.08 mCi/kg.

              Radio-pharmaceutica    Activity               Root of Injection       T/1/2                      Photopeak (keV)

Tc-99m MAA	1-5mCi	I.V	6hrs	140
Tc-99m DTPA	20-40 mCi	Inhalation	6hrs	140

6-        Adjunct Pharmaceutical:  None.

7-        Acquisition Parameters:

·        Gamma Camera: Set peak at Tc-99m at 20% window. Low energy All Purpose Collimator (LEAP). Preset Count is 300.000. Views 6 (Anterior. Posterior, RAO, LAO, R-Lt, L-Lt, RPO, and LPO). Matrix: 128 x 128.

8-        Computer Processing: Go Multi static display, choose the patient’s name and choose ventilation first; type VENTILATION on the bottom first picture; type the amount the type of the radiopharmaceutical, and the root of administration on the bottom of the third picture; then print. After ventilation pictures printed, open the perfusion test, and much perfusion images with the ventilation images; type the word “PERFUSION” on the bottom of the first picture; then type the amount, the radiopharmaceutical, and the root of administration on the bottom of the third picture, and then print the perfusion pictures.

9-    Normal result:  On the normal scan there is uniform distribution of aerosol in both lungs. A normal perfusion lung scan excludes clinically significant pulmonary emboli. Normal result shows in both tests an even distribution of radioactive material in all parts of the lungs.

10- Abnormal result: In the lung ventilation scan, an absence of the radioactivity distribution when the lung perfusion scan for the area is normal suggests lung disease.  In the lung perfusion scan, an absence of the marker material suggests decreased blood flow to that part of the lung. Possibly that is pulmonary embolism.    

 

 

 

 

 

 

 

 

www.gammaquality.com

 

A/Razaq H.Nuurre

Nuclear Medicine

Ohio, USA