Ventilation-perfusion (V/Q) scans: trends from medicare part B (2013-2023)

Ventilation-Perfusion (V/Q) scan has been established as a nuclear imaging modality for diagnosis of pulmonary embolism (PE), especially in patients with contraindications computed tomography pulmonary angiography (CTPA). However, its use in United States is declining. We analyzed national Medicare data (2013-2023) to assess V/Q and Q scan utilization and physician procedure volumes. Our analysis shows that annual V/Q scans have been declining over the period from 2013 to 2023, with a marked drop occurring between 2019 and 2020 (COVID-19 era). Most of the V/Q scans have been read by low volume readers (< 11/ year). Low-volume readers percentage increased from 20.3% in 2013 to 43.4% in 2023. These trends may impact diagnostic quality and highlight the need to reassess training, competency, and access to V/Q imaging for patients contraindicated for CTPA.