Transition from Planar to SPECT V/Q Scintigraphy: Rationale, Practicalities, and Challenges

Compared with planar imaging, ventilation/perfusion scintigraphy performed with single-photon emission computed tomography (SPECT) has a greater sensitivity and specificity, greater accuracy, improved reproducibility, and a lower number of inconclusive reports in the detection of pulmonary embolism. Despite these improvements, there are several challenges that must be overcome for the transition from planar imaging to SPECT imaging to be successful, including a lack of familiarity with 3D imaging of the lungs by some reporting specialists, the selection of a ventilation agent appropriate for SPECT acquisitions, and a different approach in the image reporting. The transition to SPECT imaging can be facilitated by generating planar-like images from the SPECT data, with which many reporting specialists are more familiar. SPECT ventilation/perfusion acquisition times are generally equal to or shorter than conventional planar imaging, studies are easier for technologists to acquire, and modern computing provides several new approaches to image processing and display.