Computer processing of perfusion, ventilation, and V/Q images to highlight pulmonary embolism

A method is described for generating regional ventilation/perfusion (V/Q) images of the lung to aid assessment of suspected pulmonary embolism, especially in patients with obstructive airways disease. The radionuclide scans used for this are stored on a computer and comprise; lung perfusion (P) with Tc-99 m MAA, lung ventilation at equilibrium (E) with Xe-127, and the sum of the Xe-127 washout images (W). A functional ventilation image is calculated as V=E/W and a functional perfusion image as Q=P/E. Finally a ventilation perfusion ratio image is obtained by taking V/Q. This is normalised by a factor determined from the cumulative frequency distributions of the counts per pixel in the Q and V images so that areas which are well ventilated and perfused are given a V/Q value of 1.10. Areas with normalised V/Q values greater than 1.5 suggest pulmonary embolism. In 100 studies on patients with pulmonary embolism. In 100 studies on patients with abnormal perfusion scans this method proved very helpful by assisting the recognition or exclusion of areas with abnormally high V/Q values.