Ventilation/perfusion lung scintigraphy. Multiple applications besides pulmonary embolism

Area of Science:

• Nuclear Medicine
• Pulmonary Medicine
• Diagnostic Imaging

Background:

• Ventilation/perfusion (V/Q) scintigraphy is the standard for pulmonary embolism (PE) diagnosis.
• Its utility for other lung pathologies is often overlooked or underestimated.
• Understanding V/Q scintigraphy requires integrating imaging findings with lung pathophysiology.

Purpose of the Study:

• To review the diagnostic value of V/Q scintigraphy for various lung diseases beyond PE.
• To describe the scintigraphic characteristics, interpretation, and artifacts associated with different pulmonary pathologies.
• To emphasize the underappreciated clinical potential of V/Q scintigraphy in a wider range of lung conditions.

Main Methods:

• Literature review focusing on V/Q scintigraphy in pulmonary diseases.
• Analysis of scintigraphic patterns for common and uncommon lung pathologies.
• Discussion of interpretation guidelines and potential imaging artifacts.

Main Results:

• V/Q scintigraphy reveals characteristic patterns for numerous lung diseases, not solely PE.
• Proper interpretation, considering lung pathophysiology, significantly enhances diagnostic yield.
• Artefacts can mimic or obscure true pathology, necessitating careful evaluation.

Conclusions:

• V/Q scintigraphy offers substantial diagnostic information for various lung diseases, often underestimated.
• Its application is underutilized in clinical practice for conditions other than PE.
• Further integration of V/Q scintigraphy into the diagnostic workup for diverse pulmonary conditions is warranted.