Safe practice ventilation technique in lung scanning for pulmonary embolism.

Ventilation/Perfusion scanning for suspected pulmonary embolism is undergoing a renaissance due to the advent of single-photon emission computed tomography (SPECT). The scan protocol demands the inhalation of a radioactive gas or vapour for the ventilation scan. The purpose of this article is to report the radioactive environmental contamination that can occur when Tc Technegas vapours are administered to patients for the ventilation SPECT scan. This contamination can concentrate within gamma camera heads to degrade images and is also a radiation hazard to staff. A method for sequestrating this airborne contamination was investigated using an ultra-low particulate air filter. The prevalence of radioactive contamination and the levels of contamination captured were quantified and only 36% of patients were found to have undergone the ventilation procedure without producing significant airborne contamination. Advice is given on best practice that will minimize airborne contamination and minimize the risks to staff working in the Nuclear Medicine department. The use of an extraction/filtration device may be seen as an effective additional control measure against airborne radioactive contamination for health professionals.

It's a small world after all: A Canadian resident's perspective on COVID-19.

COVID-19 has infected millions of people, with an estimated total dead in the hundreds of thousands. This has significantly impacted health care, including who is delivering it, how it is delivered, and how it is taught. This article describes challenges of the COVID-19 pandemic from the perspective of a Canadian nuclear medicine resident, including new risks with nuclear imaging, navigating new and sometimes challenging guidelines, as well as working and living within the confines of social distancing.

Lung Ventilation/Perfusion Single Photon Emission Computed Tomography (SPECT) in Infants and Children with Nonembolic Chronic Pulmonary Disorders.

Single photon emission computed tomography (SPECT) provides high contrast three dimensional images of the regional distribution of a radiotracer. SPECT is a widely used technique in pulmonary investigations of the ventilation (V) and perfusion (Q) in the adult patient, mainly in the diagnosis of pulmonary embolism. However, safety concerns among practitioners due to radiation exposure and the use of macroaggregate albumin for the perfusion scan have historically precluded the use of SPECT in pediatric patients with nonembolic pulmonary disorders. Additionally, patient cooperation at ventilation tracer administration and image artifacts from patient movements due the long acquisition times, have further limited the application of SPECT in pediatric patients. With the introduction of technegas aerosol for ventilation studies and the use of high sensitive multihead gamma cameras, both the total amount of administered activity and acquisition time have drastically been reduced allowing the application of SPECT in pediatric patients. Modern hybrid gamma camera/computed tomography systems (SPECT/CT) also brings the possibility of adding a fully diagnostic CT to the SPECT images, incrementing the clinical value of the investigation. Besides pulmonary embolism, there is now some clinical evidence that lung SPECT has diagnostic value in several pulmonary pathologies causing V/Q mismatching, which are specific to the pediatric age group. In this work, we will exemplify and briefly discuss some of these applications based on the literature and our routine clinical experience. Consideration to the risks and safety aspects associated to performing pediatric V/Q SPECT are also discussed.