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Rong-Zheng Ma,1 Ping-Ping Han,1 Xin-Cao Tao,2 Huan Li,1 Ling Wang,1 Zhen-Guo Zhai,2 Li-Ping Fu1 1Department of Nuclear Medicine, China-Japan Friendship Hospital, Beijing, 100029, People’s Republic of China; 2Department of Pulmonary and Critical Care Medicine, China-Japan Friendship Hospital, National Center for Respiratory Medicine, Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, National Clinical Research Center for Respiratory Diseases, Beijing, 100029, People’s Republic of ChinaCorrespondence: Li-Ping FuDepartment of Nuclear Medicine, China-Japan Friendship Hospital, No. 2 of Yinghuayuan Road, Chaoyang District, Beijing, 100029, People’s Republic of ChinaTel +86 10 84205389Fax +86 10-84205389Email fulipjh@126.comZhen-Guo ZhaiDepartment of Pulmonary and Critical Care Medicine, China-Japan Friendship Hospital, No. 2 of Yinghuayuan Road, Chaoyang District, Beijing, 100029, People’s Republic of ChinaTel +86 10 84206269Fax +86 10 84206269Email zhaizhguo235@outlook.comObjective: The study is designed to evaluate the diagnostic ability of single-photon emission computed tomography (SPECT) pulmonary ventilation/perfusion (V/Q) imaging in patients with chronic thromboembolic pulmonary hypertension (CTEPH) and investigate its feasibility in assessing patient risk.Methods: A total of 83 patients suspected of having CTEPH who received V/Q tomography were retrospectively analyzed. The consistency between SPECT V/Q imaging and pulmonary angiography was compared to investigate the correlation between the percentage of pulmonary perfusion defect score (PPDs%) and the hemodynamic indices. Patients were grouped according to the pulmonary arterial hypertension risk stratification, and the V/Q imaging results were compared between different groups.Results: For the 1494 pulmonary segments of the 83 patients, the sensitivity, specificity, and accuracy of identifying pulmonary segments with defects using V/Q imaging was 87.05%, 82.78% (668/807), and 84.7