Table of Contents
Hull University Teaching Hospitals NHS Trust - Nuclear Medicine
Uncontrolled if printed
| SOP Code | Title | Review Date |
|---|---|---|
| REF005 | Lung Ventilation/Perfusion Referral Criteria | 2027-06-18 |
| Authorised By | Authorising Role | Authorisation Signature (only on master paper copy) | Date Authorised |
|---|---|---|---|
| Prof G Avery | ARSAC Licence Holder | 2024-06-18 |
REF005 - Lung Ventilation/Perfusion Imaging
See REF000 - Referring to Nuclear Medicine (HUTH) for details of how to refer.
Description
Lung ventilation can be assessed by imaging deposition of a radioactive aerosol (Tc99m DTPA) inhaled by the patient. Lung perfusion can be assessed by imaging of the distribution of Technetium-99m labelled macro-aggregates of albumin (MAA) following intravenous injection. Mismatches in ventilation and perfusion can be used to diagnose pulmonary emboli.
Three dimensional images are usually acquired combined with low dose CT (SPECT/CT).
| ARSAC Licence Holders | Indication |
|---|---|
| Prof Stephen Richard Underwood | lung ventilation imaging |
| Prof Stephen Richard Underwood | lung perfusion imaging |
| Prof Ged Avery | lung ventilation imaging |
| Prof Ged Avery | lung perfusion imaging |
| Dr Najeeb Ahmed | lung ventilation imaging |
| Dr Najeeb Ahmed | lung perfusion imaging |
| Radiopharmaceutical | CT component of SPECT/CT | |
|---|---|---|
| Typical Radiation Dose (mSv) | 2.3 | 1.7 |
Staff Entitled to Refer
All UK registered medical practitioners
Supplementary Drugs
Sodium chloride for parenteral use (0.9% w/v).
Contraindications
Patients with right to left cardiac shunt must be discussed with an ARSAC licence holder.
If the patient has pulmonary hypertension, this must be indicated on the request because the technique needs to be modified in these patients.
Clinical Indications
| Suspected pulmonary embolism [1][2] A contemporaneous high quality erect chest radiograph must be available so that other clinical conditions that can causes ventilation/perfusion defects are not overlooked. |
| Document the degree of resolution of pulmonary embolism[1] |
| Pre-operative assessment eg: lung volume reduction, bronchial carcinoma[1] |
| Evaluate the cause of pulmonary hypertension[1] |
| Lung transplant evaluation[1] |
| Evaluate chronic pulmonary parenchymal disorders such as cystic fibrosis[1] |
| Confirm the presence of bronchopleural fistula[1] |
| Evaluate congenital heart or lung disease such as cardiac shunts, pulmonary arterial stenoses, and arteriovenous fistulae and their treatment[1] |
| Hepatopulmonary syndrome[3] |
