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Brain SPECT Imaging

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SPECT stands for Single Photon Emission Computed Tomography. It is a nuclear medicine study that measures the cerebral blood flow and activity patterns of your brain. It utilizes a radiopharmaceutical to create images of actual brain function by identifying blood flow patterns throughout the brain. The study is performed by injecting a very small dose of a radioactively tagged compound (Ceretec) that is taken up by the brain. Once in the brain the Ceretec emits energy for the next few hours. The cameras in the SPECT scanner slowly rotate around your head and detect this energy in the form of light. The most active brain cells will emit the most energy and the least active cells will emit the least energy.

SPECT imaging is a very useful tool in research. It is often used to elucidate how the brain is functioning when it is concentrating and when it is in its baseline state. Recently, some clinics have used SPECT studies widely to treat many common psychiatric illnesses.

In my experience, seeing clients who have undergone brain SPECT imaging, many of them undergo the procedure with the false perception the SPECT studies will finally give them the diagnosis that their psychiatrists has not been able to treat appropriately or adequately over the years.

A SPECT study by itself will not give a diagnosis. Again the SPECT studies simply measures blood flow to the brain, under two conditions, the resting state and the concentration state.  These studies may help your psychiatrist understand more about the specific function of your brain, during these two specific states.

The psychiatric/medical diagnoses about specific conditions are made through a combination of: complete clinical history, physical examination by a psychiatrist, information from families, and the appropriate lab work.  Although it is typical to see some conditions that are seen on the SPECT scans that pathognomonic for certain diseases processes, such as certain types of dementias, head trauma, attention deficit disorder, etc., the diagnosis are still made clinically and not by the SPECT scan.

The SPECT scan, if read appropriately and taken into context with a complete history and physical examination by a psychiatrist, and any necessary lab work, can confirm any diagnostic dilemma and can elucidate for the clinician a way forward in treatment.  When done correctly by a skilled psychiatrist, who is trained and experienced, not just reading the SPECT scans, but understanding and treating patients, it can be, and is a valuable tool.  If not, it can be an expensive waste of time.

After going through the SPECT scan, I am sure to communicate to my clients that I believe in treating the person, not the scan, and I believe in treating the person, not the diagnosis.  Overall, at the end of the day, taking in all of the information and the examination, the main goal is to find the best treatment plan to the patient’s problem, and/or anything that may inhibit the patient from being productive, and living up to their full potential of daily living.

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