Brain SPECT Frequently Ask Questions
1. WHAT IS SPECT?
SPECT is Single Photon Computerized Tomography. It is a technique that utilizes special medications called Radiopharmaceuticals that bind to the cells in the brain to provide a three dimensional representation of the blood flow to the different regions of the brain. Utilizing this technology allows the physician to see the blood flow patterns of the internal and external structures of the brain, which indicates the activity level of the different regions of the brain. This information is an essential tool to aid with the evaluation, diagnosis and treatment of psychiatric conditions.
2. WHY ARE SPECT SCANS ORDERED?
Our clinic and other clinics around the country have correlated neurological, psychiatric, and behavioral states with specific brain SPECT patterns. Information from your scan will help your doctor understand your unique brain pattern and treatment needs. Some of the most common reasons SPECT is ordered include: obtaining baseline physiological data, analyzing the physiology of underlying mood disorders, evaluating unusual or unresponsive neuropsychiatric conditions, evaluating and subtyping ADD, evaluating violence, aggression or suicidal behaviors, evaluating substance abuse or toxic exposure, looking for causes of deteriorating mental functioning (after head trauma, stroke or suspected dementia) and performing before and after treatment studies. For example, it is often asked if SPECT scans will show learning disabilities. Yes, in general. It will show if there is decreased activity in the left temporal lobe (that is where learning skills show up) but it won’t specifically tell what kind of learning disability is there.
3. WHY ARE TWO SPECT SCANS NECESSARY?
In order to fully evaluate brain function we usually order two studies: a baseline study done while at rest and a concentration study done while a patient performs a concentration task. This series allows us to see the brain at work and have a baseline study for comparison.
4. WILL THE SPECT STUDY GIVE ME AN ACCURATE DIAGNOSIS?
No. A SPECT study by itself will not give a diagnosis. SPECT studies help the clinician understand more about the specific function of your brain. Each person’s brain is unique, which may lead to unique responses to medicine or therapy. SPECT is a powerful tool in combination with clinical history, personal interview, information from families, checklists, and other neuropsychological tests.
5. HOW IS THE SPECT PROCEDURE DONE?
You will be placed in a quiet room to receive the radiopharmaceutical agent by quick injection into the arm. Immediately following, for the concentration study, you will take a 15 minute computerized test of attention and focus. For the baseline study you will be instructed to rest quietly for 20-30 minutes. Then you will lie on the imaging table and the SPECT camera will slowly rotate around your head taking images of brain blood flow. You are not placed inside a tube. The time on the table is approximately 16-18 minutes. Your study will be interpreted by Dr. Klindt and the test results will be made available to you and your treatment professionals.
6. DO I HAVE TO BE OFF MEDICATION BEFORE THE SPECT STUDY?
This question must be answered individually between you and your doctor. In general it is better to be off medications until they are out of your system, but this is not always practical or advisable. If the study is done while on medication, let the technician know. Usually, we recommend patients be off stimulant medications at least 24 hours or more before each scan. It may be impractical to stop antidepressant medications so check with the doctor who prescribed your medication at least two weeks before your scan for a recommendation.
7. ARE THERE ANY SIDE EFFECTS OR RISK INVOLVED IN THE SPECT STUDY?
The study does NOT involve a dye and people do NOT have allergic reactions to the isotope used in the study. The possibility exists, although, in a very SMALL percentage of patients, of a mild rash, facial redness, fever or brief increase in blood pressure. The amount of radiation exposure from a brain scan is approximately the same as one abdominal xray. You should not have a SPECT scan done if you are pregnant.
8. CAN A PARENT ACCOMPANY THEIR CHILD DURING THE SPECT SCAN PROCEDURE?
Yes. It is safe for the parent to stand next to the child and/or hold the child’s hand during the brain imaging procedure. The patient will, however need to remain still. No headphones are allowed during the procedure but you may read to your child if that will help them lay still.
9. IF THE PATIENT IS UNABLE TO KEEP STILL CAN THEY BE SEDATED FOR THE INJECTION AND SCAN?
No, the patient needs to be off all sedating type medications to get a good scan reading. To make it easier to cope with the injection part of the process, a staff member can apply EMLA cream to the injection site (arm) to numb the first few layers of skin. Once the injection is completed it is possible to give the patient Benedryl to calm them enough to lay still for the picture taking process. Extra time for the scan process must be allowed and this must be arranged with the staff in advance.
10. HOW EXPERIENCED ARE THE TECHNICIANS PERFORMING THE SPECT SCAN PROCEDURE?
The fully licensed technicians working at Silicon Valley Brain SPECT Imaging have numerous years of experience in all aspects of nuclear medicine as well as Brain SPECT imaging.
11. WHAT SHOULD I DO ON THE DAY OF THE SPECT SCAN?
On the day of the scan you should not consume caffeine, nicotine or alcohol. Caffeine is found in things such as coffee, tea, soda, chocolate, cold medicines and aspirin. Nicotine is found in cigarettes and chewing tobacco. If you do consume caffeine or nicotine please record it on the first page of your intake forms or tell the technician performing the SPECT scan. You may eat and consume other beverages as you normally would. You may dress normally.
12. ARE THERE ALTERNATIVES TO HAVING A SPECT SCAN STUDY?
In our opinion, SPECT is the most clinically useful study of brain function. There are other studies; such as electroencephalogram (EEG), Positron Emission Tomography (PET) studies, and functional MRI’s (fMRI). PET studies and fMRI’s are considerably more costly and they are performed mostly in research settings.
13. DO I HAVE TO HAVE THE SPECT SCAN STUDY PERFORMED AT SILICON VALLEY BRAIN SPECT IMAGING?
No. SPECT studies may be performed at other clinics. The patient may choose any other facility for this study. However, many doctors and patients utilize our services because Dr. Klindt has experience performing and interpreting thousands of SPECT studies. Dr. Klindt is one of only a handful of psychiatrists licensed to perform Brain SPECT imaging in the United States.
14. DOES INSURANCE COVER THE COST OF SPECT SCAN STUDIES?
Reimbursement by insurance companies varies according to your plan. It is often a good idea to check with your insurance company ahead of time to see if it is a covered benefit. A fee and code schedule can be obtained from our office staff. Dr. Klindt does not bill insurance companies direct. The patient will need to pay for the scans and bill their insurance company themselves for reimbursement.
15. HOW CAN I RESEARCH SPECT SCAN TECHNOLOGY?
There are several websites where information can be obtained regarding SPECT scan technology, such as www.brainplace.com. There are also other patients of our clinic who would be glad to share their experiences with you. You may call our office for more details.