VQ Scan

Author: Dr Ian Jong*

What is a Nuclear Medicine VQ Scan?

A ventilation–perfusion (VQ) scan is a nuclear medicine scan that uses radioactive material (radiopharmaceutical) to examine airflow (ventilation) and blood flow (perfusion) in the lungs.

The aim of the scan is to look for evidence of any blood clot in the lungs, called pulmonary embolism (PE).

A VQ scan is carried out in two parts. In the first part, radioactive material is breathed in and pictures or images are taken to look at the airflow in the lungs. In the second part, a different radioactive material is injected into a vein in the arm, and more images taken to see the blood flow in the lungs.
(See Nuclear Medicine for further general information).

Why would my doctor refer me to have this procedure?

Your doctor would refer you for this scan if the doctor suspects you might have a blood clot in your lung. A blood clot in the lung can sometimes be fatal, particularly if left untreated. The most common early symptoms are shortness of breath and a sharp pain when you breathe in.

Blood clots in the lungs often come from a clot in the leg called a deep vein thrombosis. A VQ scan will determine if a blood clot has travelled from your leg to your lung.

How do I prepare for a VQ Scan?

There is no preparation for a VQ scan other than having a recent chest X-ray examination. Your referring doctor will discuss this with you. You should continue to take your normal medications.
You will need to keep still while the images are being taken, so they are not blurred. If you feel you will not be able to stay still for approximately 3–15 minutes (this is the time of each scan and depends on the type of scan), please advise your doctor or the nuclear medicine staff where you are having the scan.

If you are severely claustrophobic, please advise the department when you make your appointment. The gamma camera is to be placed close to you to acquire the images.

If you are or think you might be pregnant, and/or breast-feeding, you must inform the doctor who is referring you for the VQ scan and also the radiology staff where you are having the VQ scan.

Women who are breast-feeding need to make special preparations for after the scan. This will involve stopping breast-feeding for approximately 24 hours. This is due to the radioactivity in your breast milk after the scan injection. You should discuss this with your referring doctor or with the nuclear medicine practice where you will be having the test. You might need to have bottles of formula or previously expressed breast milk available.

The Australian Radiation Protection and Nuclear Safety Agency (ARPANSA) has recommendations about breast-feeding and close contact with children after nuclear medicine tests.

VQ scans can be carried out if you are pregnant. Usually only the injected radiopharmaceutical is used and the dose of radioactivity is reduced to minimise the radiation to the developing foetus (unborn baby).

What happens during a VQ Scan?

The scan is carried out in two parts:

Part 1
You will be given a small dose of radioactive material (radiopharmaceutical) to breathe in through a nebuliser for a few minutes, with guidance from the nuclear medicine technologist who is carrying out the scan. A nebuliser is a small machine that changes liquid into an aerosol (or mist), which is breathed in, usually through a tube-like mouthpiece or a special mask that fits over your nose and mouth.

You will then lie down on a table and images of your lungs will be taken at several different angles by a gamma camera. This is a special nuclear medicine camera that identifies where the radioactive material has gone to in the lungs.

Part 2
The nuclear medicine technologist will then inject a different radiopharmaceutical into a vein in your arm. A second set of images of your lungs will be taken.

The entire imaging process will take 30–60 minutes. While the images are taken, you will be asked to breathe gently and to keep still, otherwise the images will be blurry and might need to be repeated. The medical radiation technologist will ensure that you are comfortable throughout the whole process.
The radiopharmaceuticals you received will be eliminated from your body within 24 hours of the scan. Part of the radioactive material will pass out of your body through your urine and the rest of the radioactive material will completely decay away (or disappear).

Are there any after effects of a VQ Scan?

There are no after effects from a VQ scan. The radioactive material used in a VQ scan is not known to interfere with any food or medications you might be taking.

If you are breast-feeding, see the ‘How do I prepare’ section for more information about special precautions you need to take.

How long does a VQ Scan take?

A VQ scan takes approximately 30 minutes – 1 hour to complete.

What are the risks of a VQ Scan?

There are minimal risks involved in the VQ scan.
Allergic reactions to the radiopharmaceuticals are rare and will be treated as needed.

The test involves exposure to ionising radiation (see Radiation Risk of Medical Imaging in Adults and Children).

If you are pregnant, the test can still be carried out after consultation with the nuclear medicine specialist. A reduced dose of radioactive material will be given, so that it will not affect your foetus (your unborn baby).

If you are breast-feeding, it is advised that you stop breast-feeding for the 24 hours after the scan. This is so that your baby is not unnecessarily exposed to radiation. During this time, your milk can be expressed, but it need not be discarded. It can be stored in the fridge and can be used to feed your baby 24 hours after the VQ scan.

What are the benefits of a VQ Scan?

The benefits of a VQ scan are:

• The scan is readily available, with minimal risks involved.
• It is a relatively good test to look for or exclude blood clots in your lungs if your medical history and current symptoms suggest that you might have a pulmonary embolism. The scan result will provide information your doctor needs to diagnose or treat your problem.

Who does the VQ Scan?

The VQ scan is carried out by a nuclear medicine technologist. The images taken by the technologist are reviewed by a nuclear medicine specialist doctor who provides a written report to the doctor who referred you for the VQ scan.

Where is a VQ Scan done?

Most large public and private hospitals and private radiology or nuclear medicine practices have nuclear medicine facilities where VQ scans are carried out.

When can I expect the results of my VQ Scan?

The time that it takes your doctor to receive a written report on the test you have had will vary, depending on:

• the urgency with which the result is needed;
• the complexity of the examination;
• whether more information is needed from your doctor before the examination can be interpreted by the nuclear medicine specialist doctor;
• whether you have had previous X-rays or other medical imaging that needs to be compared with this new test (this is commonly the case if you have a disease or condition that is being followed to assess your progress);
• how the report is conveyed from the practice or hospital to your doctor (i.e. phone, email, fax or mail).

Please feel free to ask the private practice, clinic or hospital where you are having your test or procedure when your doctor is likely to have the written report.

It is important that you discuss the results with the doctor who referred you, either in person or on the telephone, so that they can explain what the results mean for you.

*The author has no conflict of interest with this topic.

Page last modified on 24/8/2018.