(Perfusion Lung Scan, Lung Perfusion Scintigraphy, Radionuclide Pulmonary Scan, Ventilation-Perfusion Scan, V/Q Scan)
What is a lung scan?
A lung scan is an imaging test to look at your lungs and help diagnose certain lung problems. A lung scan may also be used to see how well treatment is working.
A lung scan is a type of nuclear imaging test. This means that a tiny amount of a radioactive matter is used during the scan. The radioactive matter called tracer sends out gamma rays. These rays are picked up by the scanner to make a picture of your lungs.
A lung scan can be a ventilation scan or a perfusion scan. A ventilation scan looks at how air moves in and out of your lungs. In particular, it looks at how air moves through the bronchi and bronchioles within your lungs. A perfusion scan looks at how blood is flowing within your lungs.
In a perfusion scan, the radioactive tracer is absorbed evenly where blood flow is normal. Areas that are not getting blood do not absorb the tracer. In a ventilation scan, the tracer will fill the lungs unless you have an area where the air cannot move.
The areas of the lungs where the radioactive tracer collects in greater amounts are called “hot spots.” The areas that do not absorb the tracer and appear less bright on the scan image are referred to as “cold spots.”
Lung scans are most often used to diagnose and find blood clots or other small masses called emboli in the lungs. But your healthcare provider may also use the scan to help diagnose other lung conditions.
Other related procedures that may be used to diagnose problems of the lungs and respiratory tract include bronchoscopy, computed tomography (CT scan) of the chest, chest fluoroscopy, chest X-ray, chest ultrasound, lung biopsy, bronchography, mediastinoscopy, oximetry, peak flow measurement, positron emission tomography (PET) scan, pleural biopsy, pulmonary angiography, pulmonary function tests, and thoracentesis.
Why might I need a lung scan?
You may need a lung scan if you have symptoms of a blood clot in your lung. Symptoms include:
If your healthcare provider thinks you may have a blood clot, you will have a ventilation scan and a perfusion scan. They will be done one right after the other. If the ventilation scan is normal, but the perfusion scan is not, it is called a mismatch. A mismatch often means that you have a blood clot.
You may also need a lung scan if your healthcare provider thinks you may have:
You may also have a lung scan before lung surgery. This is done to see how blood is flowing in your lungs and to see how well they are working.
Your healthcare provider may have other reasons to recommend a lung scan.
What are the risks of a lung scan?
The risk from the radioactive tracer is very low. The amount used in the test is very small. You may feel some slight discomfort when the tracer is injected. Allergic reactions to the tracer are rare, but they may happen.
Lying on the scanning table during the procedure may cause some discomfort or pain for certain people.
Tell your healthcare provider if you:
Are allergic to or sensitive to medicines, contrast dyes, or latex
Are pregnant or think that you might be pregnant since the scan may not be safe for the unborn baby
Are breastfeeding since the tracer may contaminate your breast milk
You may have other risks that are unique to you. Let your healthcare provider know about all your medical conditions.
Make a list of questions you have about the procedure. Be sure to discuss these questions and any concerns with your healthcare provider prior to the procedure. Consider bringing a family member or trusted friend to the medical appointment to help you remember your questions and concerns.
Certain things can make a lung scan less accurate. These include:
Having radioactive tracer in your body from another recent nuclear medicine test
Pneumonia or obstructive lung disease
Structural problem in your chest
Ventilation scan mask that is loose or does not fit well
How do I prepare for a lung scan?
PRECAUTIONS: If you are pregnant or think you may be pregnant, please check with your doctor before scheduling the exam. We will discuss other options with you and your doctor.
BREASTFEEDING: If you are breastfeeding, you should notify your health care provider due to the risk of contaminating breast milk with the tracer.
CLOTHING: You may be asked to change into a patient gown. A gown will be provided for you. Lockers are provided to secure your personal belongings. Please remove all piercings and leave all jewelry and valuables at home.
EAT/DRINK: Generally, no prior preparation, such as fasting or sedation, is required prior to a lung scan.
ALLERGIES: Notify the radiologist or technologist if you are allergic to or sensitive to medications, contrast dyes or iodine. The injection of the radiotracer may cause some slight discomfort. Allergic reactions to the radiotracer are rare, but may occur.
CHEST X-RAY: A chest X-ray may be performed prior to the procedure if one has not already been obtained in the previous 24 to 48 hours.
Based on your medical condition, your doctor may request other specific preparation.
What happens during a lung scan?
You may have a lung scan as an outpatient or as part of your stay in a hospital. The way the test is done may vary depending on your condition and your healthcare provider’s practices.
You may have either a perfusion scan or a ventilation scan. Or you may have both scans. If you have both scans, one will be done right after the other.
Generally, a lung scan follows this process:
You will be asked to remove any clothing, jewelry, or other objects that may get in the way of the scan.
You may be asked to remove clothing. If so, you will be given a gown to wear.
For a perfusion lung scan, an IV line will be started in a hand or arm so that you can be given the radioactive tracer.
The radiologist will slowly inject the tracer into your vein while you are lying flat on the test table.
The tracer will collect in the blood vessels of your lungs. The radiologist will use the scanner to take images of the lungs. You will be helped into several different positions during the test. This will let the radiologist take images of the lungs from different angles.
For a ventilation scan, you will breathe in a gas with the tracer in it through a face mask or a tracer may be injected.
You will then be asked to hold your breath for a short time. The radiologist will use the scanner to take images of your lungs while you are holding your breath. He or she will continue to take images while you breathe in the tracer for a few more minutes. Be careful not to swallow the tracer. Swallowing the tracer could affect the quality of the images.
After the tracer gas has collected in your lungs, the radiologist will remove the face mask. As you breathe normally, the tracer will gradually leave your lungs.
Once the scan is done, the IV line will be removed.
The lung scan is not painful. But you may have some discomfort or pain from lying still during the test. This may because of recent surgery or a joint injury. The technologist will use all possible comfort measures and do the scan as quickly as possible to minimize any discomfort or pain.
What happens after a lung scan?
You may be watched for a short while after the test for any signs that mean you are allergic to the tracer.
You should move slowly when getting up from the scanner table to avoid any dizziness or lightheadedness.
You may be told to drink plenty of fluids and empty your bladder often for 1 to 2 days after the scan. This will help flush the radioactive tracer from your body.
The medical staff will check the IV site for any signs of redness or swelling. Tell your healthcare provider if you see any pain, redness, or swelling at the IV site after you go home. These may be signs of infection or another type of reaction.
You should not have any other nuclear medicine tests for the next 24 to 48 hours after your lung scan.
You may go back to your usual diet and activities as directed by your healthcare provider.
Your healthcare provider may give you other instructions, depending on your situation.