Objectives: COVID-19 has created difficulties for everyone, especially in the medical field. Within Nuclear Medicine, lung ventilation and perfusion (VQ) studies used to rule out pulmonary embolism (PE) have become a challenge with COVID positive patients. SPECT/CT technology provides a potential deeper look into not only physiological but anatomical information. The purpose of this study is to review a SPECT/CT perfusion lung case study and evaluate the effectiveness in identifying the possibility of pulmonary embolism.

Methods: Lung perfusion studies were observed and reviewed from an institution that does not perform ventilation. The protocol utilized is as follows: 5 mCi Tc99m MAA, followed by 8 standard spot views taken in a supine position: anterior, posterior, oblique, and lateral views. The SPECT/CT portion is completed immediately after the perfusion.

Results: In one case, a 76-year-old female with history of asthma, DVT and shortness of breath was evaluated using SPECT/CT perfusion study to rule out PE. The patient received 5.5mCi of Tc99m MAA and subsequent planar images were taken in the anterior, posterior, and 4 oblique views, followed by SPECT/CT. Images revealed bilateral segmental perfusion defects which were concerning for pulmonary embolism.

Conclusion: Continued research is required to decide if SPECT/CT can decrease the need for a ventilation in a VQ scan; however, this hybrid scanner provides an opportunity to perform an alternative perfusion only study with added anatomical information. Another consideration would be the difference in radiation dose from a SPECT/CT lung perfusion study compared to planar VQ.

Both Crystal Botkin and Sarah Frye were very influential in the development of Jake Whipple's abstract. They kept him motivated and assisted in the production of the paper.