A reduced role of V/Q scintigraphy in the diagnosis of acute pulmonary embolism.

Ventilation/perfusion (V/Q) lung scintigraphy, when used for the clinical determination of the presence or absence of pulmonary embolism, has been much studied by medical imagers. Inherent to a ‘‘cold-spot’’ scan targeting the normal pulmonary tissue, the deck has always been stacked against us and our specialty frequently maligned by the referring physicians as practicing ‘‘unclear’’ and not nuclear medicine. The nonspecificity and, at times reputed, nonsensitivity of the V/Q scan for embolism as imaging protocols evolved led to a probability scheme (1) of reporting positive or negative findings in shades of gray rather than as