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SPECT Scan
Overview

A Single-photon emission computed tomography (SPECT) scan is
a specialized imaging test that produces detailed,
three-dimensional images of blood flow to tissues and
organs. This advanced diagnostic technique is a key
component of nuclear medicine, which uses small amounts of
radioactive substances to evaluate organ function and detect
abnormalities. SPECT imaging is widely utilized to diagnose
and manage conditions affecting the brain, heart, and other
vital organs.
First introduced in the 1960s, SPECT scans have evolved
significantly over the decades, becoming a cornerstone of
modern medical imaging. By integrating nuclear medicine with
computed tomography (CT), SPECT scans offer unique insights
into both the structure and function of tissues, making them
invaluable for identifying diseases at an early stage.
What is a SPECT scan?
Single-photon emission computerized tomography (SPECT) scans
use radioactive materials and a specially designed camera to
produce three-dimensional images of your organs and tissues.
This type of imaging provides a non-invasive way for
healthcare providers to evaluate the health of certain parts
of your body, most commonly the heart, brain, and bones.
What makes SPECT scans different from other methods of
imaging is that it can show how well certain organs are
functioning. For example, the images made by the SPECT scan
can help pinpoint the location of seizures in people with
epilepsy and assess whether there's sufficient blood flow to
different areas of the brain.
Read on to learn why your healthcare provider may order
this, who shouldn't have a SPECT scan, what to expect if you
get one done, and how the results are interpreted.
Understanding the Basics of Nuclear Imaging
Nuclear imaging, like SPECT, uses radioactive tracers
injected into the bloodstream. These tracers emit gamma rays
that a camera detects. This allows doctors to see blood flow
in the brain and other organs. The data is then processed to
create detailed images.
The most common radioisotopes in SPECT scans are:
Radioisotope |
Half-life |
Gamma Energy (keV) |
Technetium-99m |
6 hours |
140 |
Thallium-201 |
73 hours |
69-83 |
Iodine-123 |
13 hours |
159 |
How SPECT Differs from Other Neuroimaging Techniques
SPECT scans offer insights into brain function but are
different from other imaging methods. Unlike MRI, which
shows brain structure, SPECT focuses on blood flow and
physiological processes. PET scans also image brain function
but use different tracers and have higher resolution than
SPECT.
Despite these differences, SPECT is a key tool in
neuroimaging. It’s affordable, widely available, and shows
brain activity over time. By combining SPECT with MRI or CT
scans, doctors can fully understand brain health and
disease.
The Science Behind SPECT Scanning
SPECT scanning combines nuclear medicine and advanced
imaging to show the brain’s inner workings. It uses special
radioactive tracers, or radioisotopes,
injected into the blood. These tracers are taken up by
different brain areas based on their unique properties.
As these tracers decay, they emit gamma rays. These rays are
caught by cameras around the patient’s head. This allows
SPECT scanners to create detailed 3D images of the brain’s radiotracer
uptake.
Radioisotopes and Gamma Ray Detection
The type of radioisotope used is key in SPECT scanning. For
example, technetium-99m (Tc-99m) compounds help measure
blood flow in the brain. Iodine-123 (I-123) labeled tracers,
like ioflupane (DaTscan), help see dopamine transporters in Parkinson’s
disease.
The detectors in SPECT scanners use scintillation crystals
and photomultiplier tubes. When a gamma ray hits the
crystal, it creates light. This light is turned into an
electrical signal. Then, computers turn these signals into
SPECT images.
Visualizing Blood Flow and Metabolic Activity in the Brain
SPECT scans show how blood flow and metabolism vary in the
brain. Areas with more blood flow or activity show up
brighter on the images.
This helps spot problems like reduced blood flow or activity
in the brain. For example, Alzheimer’s
disease shows up as reduced activity in certain brain
areas. This helps doctors understand the disease better.
SPECT imaging also helps see how brain lesions affect the
brain. It shows changes in blood flow and activity around
lesions. This helps plan treatments like surgery or
radiation therapy.
What does a SPECT scan show?
In addition to showing what the structures inside your body look like, a
SPECT scan shows how blood flows through your arteries and veins to
your organs and tissues.
The most common types of SPECT scans include:
-
SPECT brain scan.
This helps assess and diagnose neurological disorders
such as epilepsy, dementia, Parkinson’s disease, strokes
and brain injuries. It can also show which brain areas
have more or less activity and how much blood is flowing
to them.
-
SPECT heart scan.
Conditions that may be revealed with a heart scan
include ineffective circulation, scar tissue on the
heart (such as from a heart attack), clogged or narrowed
arteries and other heart abnormalities. It can also
assess how well a patient is healing from heart
surgeries and procedures.
-
SPECT bone scan.
Conditions that may be revealed with a bone scan include
bone infections, cancer that has spread to the bones or
bone fractures.
Depending on your situation, your provider may do a regular SPECT scan
or a SPECT/CT scan. A SPECT/CT scan combines two types of scans (single
photon emission computed tomography and computed tomography).
SPECT brain scan
A SPECT test creates a detailed, 3D map of the blood flow
activity in the brain,
It can tell your provider which areas of your brain are most active and
least active.
SPECT brain scans help diagnose neurological conditions like:
- Seizure disorders. A SPECT scan can help diagnose and
treat seizure disorders, such as epilepsy. It does this
by pinpointing the area of seizure activity in the brain
- Clogged blood vessels. SPECT scanning can find issues
with blood flow in the brain. It can help diagnose or
check on vascular brain disorders, such as moyamoya
disease, a condition in which the arteries in the brain
become blocked or narrowed.
- Parkinson’s disease.
Parkinson’s disease is a movement disorder caused by the
degeneration of dopamine-producing neurons in the brain.
Symptoms include tremors, muscle rigidity, and slowed
movement. SPECT imaging, particularly dopamine
transporter (DaT) scans, detects abnormalities in
dopamine activity, aiding in the diagnosis of
Parkinson’s disease. This test is especially valuable
for differentiating Parkinson’s from other movement
disorders. With a PPV of around 88% and an NPV of 92%,
SPECT scans provide critical insights into disease
progression and help guide treatment decisions.
- Epilepsy.
Epilepsy is a neurological condition characterized by
recurrent seizures. Identifying the specific brain
regions responsible for seizure activity is crucial for
effective treatment planning, particularly for patients
considering surgery. A SPECT scan for epilepsy employs a
technique called ictal SPECT, which captures images
during or immediately after a seizure. This approach
helps pinpoint areas of abnormal blood flow in the
brain. SPECT imaging has a PPV of 80-90% and an NPV of
85% in localizing seizure foci, making it an
indispensable tool for pre-surgical evaluation.
- Alzheimer’s disease.
Alzheimer’s disease is a progressive neurological
disorder that leads to memory loss, cognitive decline,
and behavioral changes. Early and accurate diagnosis is
essential for managing symptoms and planning care. A
SPECT scan for Alzheimer’s diagnosis detects areas of
reduced blood flow in specific brain regions, such as
the parietal and temporal lobes, which are commonly
affected by the disease. Research indicates that SPECT
imaging has a PPV of approximately 85% and an NPV of 90%
for Alzheimer’s, making it a reliable tool for
distinguishing Alzheimer’s from other forms of dementia.
- Traumatic brain injuries (TBIs).
- Dementia
SPECT heart scan
Because the radioactive tracer highlights areas of blood
flow, this type of SPECT scan can show your provider how well your heart works.
It can help diagnose a wide range of conditions, including:
- Scar tissue, which can indicate a heart
attack.
-
Coronary artery disease (narrowed arteries).
- Atherosclerosis (clogged arteries).
If the arteries that feed the heart muscle become
narrowed or clogged, the parts of the heart muscle
served by these arteries can become damaged or even die.
- Poor circulation.
SPECT can show how completely your heart chambers empty
during contractions.
- Whether surgical procedures, such as bypass surgeries or
other surgeries, were successful
A SPECT heart scan can also tell your provider how well you recover
after triple
bypass surgery or other heart procedures.
SPECT bone scan
Areas of bone healing usually light up on SPECT scans, so
this type of test is being used more often to help diagnose
hidden bone fractures. SPECT scans also can diagnose and
track cancer that has spread to the bones. It also can help
find sites for bone biopsy.
A SPECT bone scan can find issues that other imaging tests can’t detect,
like:
- Stress fractures.
- Bone infections.
- Bone cancer or cancer that’s spread to your bone.
Test Details
How does a SPECT scan work?
A SPECT scan involves two main steps. Your provider will:
-
Give you a radiotracer. A radiotracer is a
radioactive substance that helps highlight certain areas
in your body on an imaging test. Providers usually
inject radiotracers into a vein. But in some cases, you
may need to swallow or inhale the substance. As the
radiotracer moves through your body, it accumulates in
certain areas. This gives your provider information
about how your organs and tissues function. Radiotracers
are safe. They contain very minimal amounts of radiation
— about the same amount you get from a regular X-ray.
They don’t contain dyes or cause side effects and they
leave your body within 24 hours.
-
Take pictures with a gamma camera. A gamma
camera (nuclear camera) uses specialized imaging
techniques to look for the radiotracers in your body.
You can think of a gamma camera as a radiation detector.
It doesn’t emit radiation, but it finds radioactive
energy (in this case, the radiotracer) inside your body.
The gamma camera takes pictures of your organs, bones
and tissues, and tells your provider how well they’re
working.
How do I prepare for a SPECT scan?
Your provider will give you specific instructions for your
situation. In general, you should wear comfortable clothing
and leave jewelry, watches and other metal items at home.
You'll receive a radioactive substance through an
intravenous (IV) infusion into a vein in your arm. The
tracer dose is very small, and you may feel a cold sensation
as it enters your body. You may be asked to lie quietly in a
room for 20 minutes or more before your scan while your body
absorbs the radioactive tracer. In some cases, you may need
to wait several hours or, rarely, several days between the
injection and your SPECT scan.
Your body's more active tissues will absorb more of the
radioactive substance. For instance, during a seizure, the
area of your brain causing the seizure may hold on to more
of the radioactive tracer. This can pinpoint the area of the
brain causing your seizures.
What to expect during a SPECT scan
Once your body absorbs the radiotracer, your provider will
walk you to a room with a SPECT machine. You’ll lie down on
a table (usually on your back) while the scanner rotates
around you. The SPECT machine will take pictures of the
structures inside your body. Then, it’ll send the
information to a computer, which will create detailed 3D
images.
A SPECT
scan usually takes about 30 minutes to complete. It may take
longer if your provider needs to take pictures of other
areas, can take up to 3 hours.
What to expect after the test
Most of the radioactive tracer leaves your body through your
urine within a few hours after your SPECT scan.
You may be told to drink more fluids, such as juice or
water, after your SPECT scan.
This helps flush the tracer from your body. Your body breaks
down the remaining tracer over the next few days. Once the
scan is completed, you can usually leave and resume your
daily activities right away.
What are the advantages of a SPECT scan?
SPECT scans:
- Are safe for people with pacemakers and
other cardiovascular implantable electronic devices
(CIEDs).
- Can find issues that other imaging methods can’t detect.
- Can tell your provider how well your organs function.
Interpreting SPECT Scan Results
After a SPECT
scan, experts analyze the images. Radiologists and nuclear medicine
specialists are trained to do this. They look for brain
perfusion patterns that show normal or abnormal brain function.
Normal vs. Abnormal Findings
In a normal scan, the brain’s blood flow and activity are balanced. But,
abnormal patterns can mean reduced or increased activity. This might
point to certain conditions.
Condition |
SPECT Scan Findings |
Alzheimer’s disease |
Reduced perfusion in the temporal and parietal lobes |
Parkinson’s disease |
Decreased uptake in the basal ganglia |
Traumatic brain injury |
Focal areas of reduced perfusion |
Stroke |
Absent or diminished uptake in the affected brain region |
The Role of Radiologists and Nuclear Medicine Specialists
Experts are needed to understand SPECT scan results. Radiologists and
nuclear medicine specialists find abnormal patterns. They also consider
the patient’s history and symptoms.
For complex cases, a team of doctors might be needed. This team includes
neurologists and psychiatrists. They work together to understand the
scan results and plan the best treatment.
Are there any risks or possible complications?
SPECT scans offer valuable insights into brain function. Yet, it’s key
to know their limits and risks. A major SPECT
scan limitation is the exposure to ionizing radiation. This
radiation, though low, can worry some patients, mainly those needing
many scans.
Another issue is the chance of getting false results. Things like
patient movement, medication, or health conditions can mess with the
scan’s accuracy. False positives can cause unnecessary stress or more
tests. False negatives might delay finding and treating the real
problem.
When looking at SPECT scan results, it’s important to think about the
patient’s history and other tests. SPECT scans should be part of a
bigger picture, not the only thing considered. Relying too much on SPECT
scans without looking at other factors can lead to wrong diagnoses or
treatments.
Radiation exposure is a big worry for those getting SPECT scans,
like kids and pregnant women. While one scan’s risks are small, many
scans can raise the danger. It’s smart for patients to talk to their
doctors about the scan’s benefits and risks to see if it’s right for
them.
Lastly, remember that SPECT scans, like any test, can’t be perfect. False-positive
results can happen for many reasons, like technical problems or
misreading the scan. These false positives can cause extra stress, more
tests, or wrong treatments. So, it’s vital to have experts interpret
SPECT scan results and look at all the patient’s information for the
best care.
When should I know the results of my SPECT scan?
A radiologist or healthcare specialist with advanced
training in nuclear medicine will study the results of your
SPECT scan and send them to your healthcare team. Pictures
from your scan may show colors that tell your team what
areas of your body absorbed more of the radioactive tracer
and which areas absorbed less. For instance, a brain SPECT
image might show a lighter color where brain cells are less
active and darker colors where brains cells are more active.
Some SPECT images show shades of gray, rather than colors.
Ask your healthcare team how long to expect to wait for your
results. You should get the results of your SPECT scan back in about
one week. After your appointment, a radiologist will
interpret the images captured during your scan. Then they’ll
create a report of their findings to share with the provider
who ordered the test. Your provider will talk with you about
your results and determine any appropriate next steps.
Advances in SPECT Scan Technology
Recent tech advancements have changed SPECT scanning a lot.
They’ve made images clearer and helped doctors diagnose
better. Now, SPECT scans can show more about brain function
and problems.
Improvements in Spatial Resolution and Sensitivity
One big step forward is better spatial resolution and
sensitivity. High-resolution
SPECT systems can now show more detail. This means
doctors can find brain activity and issues more accurately.
Detector design, collimation, and algorithms have all played
a part in these upgrades.
The table below compares the spatial resolution of
conventional and high-resolution
SPECT systems:
SPECT System |
Spatial Resolution |
Conventional SPECT |
8-12 mm |
High-resolution SPECT |
3-5 mm |
Another key area is sensitivity
enhancement. New materials and designs in detectors have
made gamma
ray detection better. This means scans are shorter and
use less radiation. It also helps spot small brain issues
that were hard to see before.
Hybrid Imaging: Combining SPECT with CT or MRI
Hybrid imaging combines SPECT with CT or MRI. These methods
give more information by mixing SPECT’s function data with
CT or MRI’s detailed images.
SPECT/CT and SPECT/MRI systems have many benefits. They help
doctors know exactly where problems are and how big they
are. This makes diagnosis more accurate and treatment plans
better.
Hybrid SPECT imaging brings together the best of different
imaging types. It helps doctors understand the brain better,
leading to better care for patients.
What is the difference between a SPECT and CT scan?
A CT
(computed tomography) scan uses radiation to take detailed pictures
of the structures inside your body. The main goal of a CT scan is to
look at your anatomy.
It shows the size and location of organs, bones and tissues.
A SPECT scan involves injecting, ingesting or inhaling a radiotracer
before taking images. The main goal of a SPECT scan is to look at your physiology —
how the radiotracer behaves once it’s inside your body. This is helpful
for determining how your organs and tissues function.
In some cases, a healthcare provider may combine CT and SPECT technology
to get even more detailed information. Some scanners can take both types
of images at the same time.
What is the difference between a SPECT scan and an MRI?
Magnetic resonance imaging (MRI) uses a large magnet and radio waves
to take pictures of the structures inside your body. Like a CT scan, MRI
can tell you a lot about your physical anatomy — but it can’t tell you
how your anatomy functions.
A SPECT scan, on the other hand, shows how your organs and tissues work.
After your provider injects the radiotracer, the substance moves through
your body and accumulates in certain areas. How the radiotracer behaves
can tell your provider whether your organs, bones and tissues function
as they should.
Food and Drink
Your healthcare team will let you know if the scan requires
you to avoid certain foods or drinks.
For example, if you have a SPECT scan for cardiac reasons,
you may need to avoid caffeine for several hours before the
test.
Cost and Health Insurance
Your insurance may require prior authorization in order to
cover your SPECT scan. Be sure to check with the company on
whether and to what extent the scan is covered so you'll
know what, if any, costs you'll need to cover.
SPECT scans, without insurance coverage, can cost over
$1,300 to $4,000 or more.
The Future of SPECT Scanning in Neuroimaging
Advances in SPECT scanning are opening up new possibilities. Researchers
and doctors are finding more ways to use this tool. This could lead to
better understanding of the brain and more tailored treatments for brain
and mental health issues.
Potential New Applications and Research Directions
One exciting area is studying how new treatments affect the brain. By
comparing SPECT scans before and after treatment, scientists can see how
therapies change brain activity. This could help make treatments more
effective and find the best therapy for each patient.
Integration with Other Imaging Modalities and Biomarkers
Another area to watch is combining SPECT with other imaging and
biomarkers. This mix can give a fuller view of brain health. Adding
blood tests or genetic markers to SPECT data could make diagnoses more
accurate and predict how well patients will do. This approach could lead
to better treatments for complex brain conditions.
As research advances, SPECT scanning will become even more vital in
brain health. By using SPECT with other advanced technologies, we can
improve diagnosis and treatment. This could even help prevent some brain
disorders in the future.
FAQ's
Q: What is a SPECT scan, and how does it work?
A: A SPECT scan uses radioactive tracers and gamma rays to
create 3D images of the brain. These tracers are injected
into the blood and taken up by brain tissues. This lets the
scanner see blood flow and metabolic activity in the brain.
Q: How does a SPECT scan differ from other neuroimaging techniques
like MRI and PET?
A: A SPECT scan looks at blood flow and neurotransmitter
activity. MRI shows brain structure, and PET scans measure
glucose metabolism. SPECT is great for studying brain
disorders like Alzheimer’s and depression. Q: What can I expect during a SPECT scan procedure?
A: During a SPECT scan, a radiotracer is injected into your
blood. You’ll wait for it to spread through your brain,
which takes 30-60 minutes. Then, you’ll lie down while a
camera takes images from all sides. The whole process takes
1-2 hours. Q: Are there any risks or side effects associated with SPECT scans?
A: SPECT scans use a small amount of radiation. But the dose
is safe, like other medical scans. You might feel a bit
uncomfortable from lying down or the injection. Rarely, you
could have an allergic reaction to the tracer. Q: How are SPECT scan results interpreted, and what can they reveal
about brain function?
A: Radiologists and specialists look at the scan results to
see how the brain is working. Normal scans show even blood
flow. Abnormal scans might show changes in activity. These
changes help diagnose and monitor brain disorders. Q: What are some common clinical applications of SPECT scans in
neurology and psychiatry?
A: SPECT scans help diagnose and manage many brain and
mental health issues. This includes Alzheimer’s,
Parkinson’s, epilepsy, and depression. They help doctors
find the right treatment by showing how the brain is
working. Q: Are there any recent advances or future directions in SPECT scan
technology and applications?
A: New SPECT technology offers better images and accuracy.
Hybrid scans that combine SPECT with CT or MRI are being
tested. Future research will explore more uses for SPECT and
how it can work with other tests for better diagnosis and
treatment.
One Final Note..
Providers can use SPECT scans to evaluate any area of your body. But
this type of imaging is most common for detecting heart, brain and
bone conditions. Talk to your healthcare provider to learn more
about SPECT scans and whether you need one.
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