Enhancement of Xe-133 ventilation lung scan image acquired after Tc-99m perfusion scan

In nuclear medicine, the match and mismatch between the images of lung perfusion and ventilation provide an important criterion to diagnose pulmonary embolism. Usually, for imaging clarity, the ventilation scan using 133Xe is performed before the perfusion scan using 99mTc. But the inverse order is preferred clinically, since (i) if the perfusion image is normal, there is no need to do the ventilation scan, and (ii) if the perfusion image is abnormal, the ventilation image can be obtained by focusing on the perfusion abnormalities. However, the quality of the ventilation image is reduced if the ventilation scan is performed after the perfusion scan, because the 140 keV photons emitted from 99mTc will scatter into the acquisition window of 133Xe (81 keV). The purpose of this study is to apply image processing techniques to reduce the scattering effect of 99mTc to get a better 133Xe ventilation image. First, an image sequence in the preferred inverse order is simulated using the images acquired in the normal order. Image processing techniques are used to find an optimized way to reduce the scattering background in the ventilation image. Second, a real image sequence is acquired in the inverse order. An improved ventilation image is then obtained by applying image processing techniques to this image sequence.