SNMMI released a statement in March of 2020 about concerns that had risen over COVID-19 spread to patients and staff through the ventilation portion of ventilation perfusion (V/Q) scans. V/Q scans are important for accurate diagnoses of various illnesses. SNMMI updated that statement with steps to perform lung ventilation scans safely.

As COVID-19 spreads throughout the US, infections to healthcare workers and patients are a serious concern. In the spring of 2020 SNMMI issued a safety statement¹ which recommended to not do the ventilation portion of standard V/Q studies until more was known about risks. Some hospitals and organizations chose to follow this recommendation even though it meant important information about airway physiology would be lost.²

At the time of SNMMI’s initial statement, access to personal protective equipment (PPE) and accurate COVID-19 testing was limited, it was believed that following a perfusion-only V/Q protocol would be safer for all involved. If the images showed no abnormalities, officials were confident there were no pulmonary emoli present.² But perfusion-only scans removed important information which was needed to accurately diagnose patients.


SNMMI Updates Safety Statement on V/Q Scans

SNMMI issued an update to their original statement³ in September of 2020 in which it was noted that perfusion-only images are not a definitive answer and a V/Q study is necessary. In fact, ventilation images give information about airway obstructions and lung diseases that may help to explain symptoms.

SNMMI also states that while the risks are unknown about potential COVID-19 transmission through use of ventilation systems, a ventilation study may still be performed when deemed necessary, provided there is adequate access to COVID-19 testing and other safety measures are put in place.

SNMMI issued these six safety items to consider prior to ventilation studies being performed:

  1. Patients should have a negative COVID-19 test.
  2. Technologists should use proper PPE.
  3. Airflow in the rooms in which these tests are performed should be evaluated.
  4. The availability and possibility of administering ventilation agents should be considered.
  5. Local infection groups should be contacted to help evaluate facilities and their safety.
  6. Performing ventilation scans in relation to a perfusion scan should be approached on a case-by-case basis.

Full details on recommendations are on SNMMI’s website.


Growing Support for V/Q Scans

The pandemic has brought challenges to the practice of administering ventilation scans, but the benefits of these scans may outweigh the risks. Many medical institutions by now have precautions in place to treat patients while limiting risk of viral transmission.

Studies have shown V/Q scintigraphy to be preferred over CT angiography for potentially fatal thromboembolic pulmonary hypertension². There is also possibility of permanent pulmonary fibrotic damage and the component of post-thrombotic sequelae in patients who have gotten over COVID.

For survivors of COVID, analysis of lung health is vital. Imaging departments and nuclear medicine are advised to manage and adapt to these risks in order to serve COVID-19 survivors.4


The Source for Lung Ventilation Supplies

Regional and local health care facility guidelines should always be followed in patient care related to COVID-19, but it is recently recommended that V/Q scans are vital and potentially life-saving, and can be performed safely.

If your department is currently performing lung ventilation studies, Sirona Complete care is ready to assist you with options for lung ventilation systems and accessories. Please contact Sirona Complete Care for more information.

1 COVID-19 and Ventilation/Perfusion (V/Q) Lung Studies. March 19, 2020.
2 J. Anthony Parker, MD, PhD, and Kevin J. Donohoe, MD. Lung Scintigraphy in the Era of COVID-19 and Chronic Thromboembolic Pulmonary Hypertension. SNMMI Uptake. May 2020.
3 Updated Statement: COVID-19 and Ventilation/Perfusion (V/Q) Lung Studies. September 3, 2020.
4 Ranju T. Dhawan, et al. Beyond the clot: perfusion imaging of the pulmonary vasculature after COVID-19. The Lancet Respiratory Medicine. Available online 17 November 2020.