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01-05-2010 | Original Article

Lung ventilation–perfusion imbalance in pulmonary emphysema: assessment with automated V/Q quotient SPECT

Authors: Kazuyoshi Suga, Yasuhiko Kawakami, Hiroaki Koike, Hideyuki Iwanaga, Osamu Tokuda, Munemasa Okada, Naofumi Matsunaga

Published in: Annals of Nuclear Medicine | Issue 4/2010

Abstract

Purpose

Tc-99m-Technegas–MAA single photon emission computed tomography (SPECT)-derived ventilation (V)/perfusion (Q) quotient SPECT was used to assess lung V–Q imbalance in patients with pulmonary emphysema.

Methods

V/Q quotient SPECT and V/Q profile were automatically built in 38 patients with pulmonary emphysema and 12 controls, and V/Q distribution and V/Q profile parameters were compared. V/Q distribution on V/Q quotient SPECT was correlated with low attenuation areas (LAA) on density-mask computed tomography (CT). Parameters of V/Q profile such as the median, standard deviation (SD), kurtosis and skewness were proposed to objectively evaluate the severity of lung V–Q imbalance.

Results

In contrast to uniform V/Q distribution on V/Q quotient SPECT and a sharp peak with symmetrical V/Q distribution on V/Q profile in controls, lung areas showing heterogeneously high or low V/Q and flattened peaks with broadened V/Q distribution were frequently seen in patients with emphysema, including lung areas with only slight LAA. V/Q distribution was also often asymmetric regardless of symmetric LAA. All the proposed parameters of V/Q profile in entire lungs of patients with emphysema showed large variations compared with controls; SD and kurtosis were significantly different from controls (P < 0.0001 and P < 0.001, respectively), and a significant correlation was found between SD and A-aDO2 (P < 0.0001).

Conclusions

V/Q quotient SPECT appears to be more sensitive to detect emphysematous lungs compared with morphologic CT in patients with emphysema. SD and kurtosis of V/Q profile can be adequate parameters to assess the severity of lung V–Q imbalance causing gas-exchange impairment in patients with emphysema.

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Title: Lung ventilation–perfusion imbalance in pulmonary emphysema: assessment with automated V/Q quotient SPECT
Authors: Kazuyoshi Suga
Yasuhiko Kawakami
Hiroaki Koike
Hideyuki Iwanaga
Osamu Tokuda
Munemasa Okada
Naofumi Matsunaga
Publication date: 01-05-2010
Publisher: Springer Japan
Published in: Annals of Nuclear Medicine / Issue 4/2010
Print ISSN: 0914-7187
Electronic ISSN: 1864-6433
DOI: https://doi.org/10.1007/s12149-010-0369-7

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Springer Medicine

Lung ventilation–perfusion imbalance in pulmonary emphysema: assessment with automated V/Q quotient SPECT

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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