brain patient spect dementia report

Brain perfusion SPECT

is highly useful for the diagnosis of the dementias, including Alzheimer’s disease, Frontotemporal Dementia and Lewy Body Disease. Studies of the accuracy of SPECT for diagnosing Alzheimer’s disease report sensitivities of 65%–85% and specificities (for other dementias) of 72%–87% (1).

Full Answer

Is SPECT useful in the workup of dementia?

SPECT provides useful positive information in dementia, particularly the differentiation of AD, FTD, and JCD. However, it does not distinguish PD from AD. SPECT provides useful positive information in dementia, particularly the differentiation of AD, FTD, and JCD. However, it does not distinguish PD from AD.

Can brain perfusion SPECT help diagnose dementia?

Guidelines of the European Association of Nuclear Medicine and the American College of Radiology endorse the clinical use of Brain Perfusion SPECT in the workup and diagnosis of dementia (4,5).

How accurate is SPECT for diagnosing Alzheimer’s?

Studies of the accuracy of SPECT for diagnosing Alzheimer’s disease report sensitivities of 65%–85% and specificities (for other dementias) of 72%–87% (1). In the largest study to date, both HMPAO SPECT and 18F-FDG PET were able to completely separate 26 AD cases from controls (2).

Can single photon emission tomography (SPECT) detect dementia?

Single photon emission tomography (SPECT) permits the assessment of the decrease of regional cerebral blood flow (rCBF). The aim of this study was to assess the relationship between the different types of dementia (Alzheimer's disease (AD), vascular dementia (VaD) and frontotemporal dementia (FTD)) and the rCBF in the SPECT examination.

Can a SPECT scan show dementia?

SPECT is currently one of the most widely available imaging techniques for the study of brain function. It has been used successfully for the diagnosis of dementias since the 1980's, while PET made its way to the clinic in the following decade.

What is a SPECT scan dementia?

Cerebral blood flow assessment performed by single-photon emission computed tomography (SPECT) of the brain is used to detect early neuronal dysfunction associated with degenerative dementia. Patterns of perfusion abnormalities are different across dementia syndromes.

What does a SPECT scan tell you?

A single photon emission computed tomography (SPECT) scan is an imaging test that shows how blood flows to tissues and organs. It may be used to help diagnose seizures, stroke, stress fractures, infections, and tumors in the spine.

What is the best scan to detect dementia?

MRI s are generally the preferred imaging test because MRI s can provide even more detail than CT scans about strokes, ministrokes and blood vessel abnormalities and is the test of choice for evaluating vascular dementia.

How accurate are SPECT scans?

The results of the study showed SPECT diagnoses were true-positive in 37, true-negative in eight, false-positive in three, and false-negative in six patients. Sensitivity was 86%; specificity, 73% and the positive predictive value was 92%, with an accuracy of 83%.

How is early dementia diagnosed?

Early symptoms of dementiamemory problems, particularly remembering recent events.increasing confusion.reduced concentration.personality or behaviour changes.apathy and withdrawal or depression.loss of ability to do everyday tasks.

How much does a brain SPECT cost?

SPECT scans are one of the more affordable ways to image the brain, but prices can fluctuate a lot based on location, the purpose of the scan, and what additional interpretation is involved. According to MDsave, brain SPECT scans range from $1,300 to over $3,500.

How long does it take to get SPECT scan results?

The wait could be as short as 20 minutes. In some cases, though, it could take hours or days for the absorption to happen. Your medical team will provide you with information on this process.

Can brain scans detect mental illness?

Brain scans alone cannot be used to diagnose a mental disorder, such as autism, anxiety, depression, schizophrenia, or bipolar disorder. In some cases, a brain scan might be used to rule out other medical illnesses, such as a tumor, that could cause symptoms similar to a mental disorder, such as depression.

How does a neurologist diagnose dementia?

The following procedures also may be used to diagnose dementia: Cognitive and neurological tests. These tests are used to assess thinking and physical functioning. These include assessments of memory, problem solving, language skills, and math skills, as well as balance, sensory response, and reflexes.

Can a brain MRI show dementia?

In Radiology, patients pose this question often. “Can MRI show if I have dementia?” In fact, we scan patients every day with a diagnosis of dementia, memory loss, Alzheimer's, and confusion, among a variety of other neurological disorders. The truth is that MRI is NOT the test to formally diagnose dementia.

Can a brain CT show dementia?

CT scans create x-ray images of structures within the brain and can show evidence of strokes and ischemia, brain atrophy, changes to the blood vessels and other problems that can bring about dementia. CT scans and MRI scans can show the loss of brain mass associated with Alzheimer's disease and other types of dementia.

What is functional brain imaging?

Functional brain imaging includes a set of techniques that reveal biochemical, physiological, or electrical properties of the central nervous system. The most developed of these techniques are single photon emission tomography (SPECT), positron emission tomography (PET) and functional magnetic resonance imaging (fMRI). Of them, the first two are the most widely used and validated techniques in clinical practice, while the third is still limited to scientific research in dementia, and is the most appropriate modality for brain activation or connectivity studies. Magnetic resonance spectroscopy (MRS) is another functional technique that has clinical utility mostly in the evaluation of brain tumors, although it does not have yet defined clinical applications in dementia. SPECT and PET are nuclear medicine techniques that use radiopharmaceuticals for the evaluation of different functional phenomena (classically brain perfusion for SPECT or metabolism for PET), although today there is a plethora of tracers that allow the study of many molecular events in the brain.

What is the clinical use of magnetic resonance spectroscopy?

Magnetic resonance spectroscopy (MRS) is another functional technique that has clinical utility mostly in the evaluation of brain tumors, although it does not have yet defined clinical applications in dementia.

Is SPECT a biomarker for dementia?

Although amyloid and tau biomarkers have gained ground in recent years and are the current focus of research, neuro degeneration biomarkers continue to play a key role in the diagnosis of dementia. Despite the trend to use PET instead of SPECT in high-income countries, the differences in diagnostic performance between both techniques are subtle, particularly in patients in the clinical stage of dementia, and SPECT has the advantage of wider availability and significantly lower cost. We conclude that SPECT should still be considered an important tool in clinical practice and research in dementia in low- and middle-income countries.

Is functional imaging effective for dementia?

The study of cost-effectiveness for the introduction of functional imaging to dementia diagnostic algorithms have showed contra dictory results, main ly due to the scarcity of effective treatments to date. McMahon et al. ( 88, 89) argue against the inclusion of functional imaging, based on the estimation of quality-adjusted life years and the limited efficacy of cholinesterase inhibitors. According to the authors, any diagnostic test, no matter how perfect, would be incapable of reaching adequate cost-effectiveness thresholds using this methodology unless it has a very low cost. Other authors such as Silverman et al. argue in favor of including functional imaging considering that PET can introduce an increase in diagnostic accuracy of 15% with respect to clinical evaluation, resulting in savings per patient that exceed the cost of a PET study in the United States ( 90 ). In their study, the authors consider other costs caused by the disease, such as care expenses, which far exceed those of drug therapy. However, it is important to notice that the exclusion of AD in a patient with dementia does not necessarily imply a reduction in the costs of hospitalization and nursing care, which is fundamentally determined by the functional situation of the patient beyond the etiological diagnosis, since the vast majority of causes of dementia are irreversible. Moulin-Romsee et al. endorsed Silverman's results for the European population. Using the same arguments, they postulate that the diagnostic performance of SPECT in comparison with neuropathological confirmation results in a possible reduction in false diagnoses with respect to conventional algorithms, which is also estimated at 15%, with eventual savings for the health system far superior to the use of PET due to its significantly lower cost ( 91 ).

Is Alzheimer's disease atypical?

Although many patients with Alzheimer's disease (AD) have a characteristic clinical presentation, some forms of the disease may present with atypical symptoms. Diagnostic difficulties may rise in early disease stages, in atypical presentations or in clinical scenarios in which the differential diagnosis with other forms of dementia is challenging ( 14, 15 ). Murray et al. published a series of 889 cases of AD with histopathological confirmation, describing three well-defined subtypes with different clinical characteristics, of which the hippocampal-sparing subtype (11% of cases) was associated with atypical clinical presentation and previous diagnostic errors with higher frequency in comparison with the typical and predominantly limbic subtypes ( 16 ). Up to 25% of AD cases may show an atypical clinical presentation, supporting the use of functional neuroimaging biomarkers in diagnosis. Moreover, the hippocampal-sparing subtype represents a challenge for structural MRI, which usually relies on the identification of hippocampal atrophy as a hallmark for the diagnosis of AD ( 16 ).

Can you detect beta amyloid in vivo?

Research carried out in the last two decades has made possible to detect beta-amyloid deposits in vivo by PET . The first radiopharmaceutical used in patients to reveal amyloid, 11 C-PIB, give the way to several 18 F-labeled analogs such as florbetapir, florbetaben, and flutemetamol, with considerable advantages in terms of cost and availability due to the longer half-life of 18 F ( 12, 92 ). These 18 F-labeled radiopharmaceuticals have shown a very good correlation with 11 C-PIB with high correspondence in visual interpretation ( 93 ). High correspondence between 11 C-PIB uptake and beta-amyloid deposits in neuropathology has been demonstrated in various studies, and there are also similar reports for 18 F radiopharmaceuticals ( 93, 94 ).