Provider FAQ

What is brain SPECT imaging?
SPECT stands for single photon emission computed tomography. It is a nuclear medicine procedure that is widely used to study heart, liver, thyroid, bone, and brain problems. Brain SPECT imaging provides important information about the blood flow and activity patterns of each patient’s brain.

What is the purpose of the brain SPECT imaging procedure?
Brain SPECT imaging is a proven and reliable measure of cerebral blood flow and activity patterns in the brain; therefore, it is used as a tool in the evaluation and treatment process at Amen Clinics. It lets our physicians look inside the brain to observe three things: areas of the brain that work well; areas of the brain that are overactive; and areas of the brain that are underactive.

Will the SPECT study give a diagnosis?
No. A SPECT study by itself will not give a diagnosis. In fact, no imaging study by itself is a “doctor in a box” that can give accurate diagnoses on individual patients. SPECT imaging helps the physician understand more about the specific function of the brain. Each person’s brain is unique which may lead to unique responses to treatment. At Amen Clinics, diagnoses about specific conditions are made through a combination of clinical history, personal interview, information from family members, questionnaires and checklists, SPECT studies and neuropsychological tests.

Why are SPECT studies ordered?
Some of the common reasons include:

  1. Evaluating suspected seizure activity
  2. Evaluating suspected cerebral vascular disease (such as stroke)
  3. Evaluating cognitive decline and suspected dementia or other memory problems
  4. Evaluating the effects of mild, moderate and severe head trauma
  5. Evaluating the presence of a suspected underlying organic brain condition that contributes to behavioral or emotional disturbances
  6. Evaluating aggressive or suicidal behavior
  7. Evaluating the extent of brain impairment caused by drug or alcohol abuse or other toxic exposure
  8. Subtyping the physiology of underlying mood disorders, anxiety disorders, or attention deficit disorders
  9. Evaluating atypical, unresponsive or mixed psychiatric conditions
  10. Following up to evaluate the physiological effectiveness of treatment
  11. General brain health check-up

Do patients need to be off medication before the study?
We know some people worry they may not get accurate scans while on medication, but many of our patients are scanned on their medications and the scans are still very valuable. Medication or nutritional supplements necessary for the patient’s physical health should NOT be discontinued for the SPECT scans. These include, but are not limited to, blood pressure medications, blood thinners, diabetes or thyroid medications, and medications that treat heart or lung problems. If a patient wants to be scanned off all medications and supplements, they MUST do so under the guidance of their healthcare provider.
In general we recommend patients:

  • Discontinue stimulants four days prior to the first scan appointment and stay off of them until the scan appointment(s) are completed.
  • For other psychiatric medications, it depends on the particular half-life of each medication. Patients must always check with their doctor before reducing or discontinuing any medication, and reduce or stop medication only under the doctor’s supervision.
  • If helpful, a phone consultation with one of our physicians can be arranged with the patient’s personal doctor to answer any questions about discontinuing medication and supplements prior to the scans.

What should patients do on the day of the scan?
On the day of the scan, caffeine intake must be eliminated as well as cold medication or aspirin (if taken, this information needs to be noted on the intake form). Food intake should be the same as it normally is.

Are there any side effects or risks to the study?
Since a SPECT scan is a nuclear medicine procedure, it requires the injection of a very small amount of a radioisotope through a small needle into a vein in the arm. The medicine we inject is not an iodine-based
dye; therefore, people typically do not have allergic responses to it. The average radiation exposure for one SPECT scan is 0.7 rem. This exposure is similar to the amount from a nuclear bone scan or brain CT scan—both of which are routinely ordered for many common medical conditions (i.e. bone fractures or head trauma).

How is the SPECT procedure done?
When the scan begins, the patient will be placed in a quiet room and a small IV line will be inserted into the arm. For those who have sensitive skin or are afraid of needles, Emla (lidocaine) cream can be applied to numb the area of the arm where the injection is administered.
During the concentration scan, the patient will take a 15-20 minute computerized test that measures attention and focus. For the baseline scan, the patient will be instructed to sit quietly and relax. During this period of time (whether taking the computer test or relaxing), the imaging solution is injected through the small IV and travels to the brain. Once the imaging solution has been given time to be absorbed, the patient will be taken to the scan machine. The machine has three cameras that will rotate around the patient’s head. The imaging process is typically 20-25 minutes and requires the patient to be completely still.

Are there alternatives to having a SPECT study?
In our opinion, SPECT is the most clinically useful study of brain function for the indications listed above. There are other studies, such as positron emission tomography (PET) and functional MRI (fMRI); however, they are considerably more costly and are performed mostly in research settings.

Does insurance cover the cost of SPECT studies?
Reimbursement by insurance companies varies according to the patient’s plan. It is often a good idea to check with the insurance company to see if it is a covered benefit.

Is the use of brain SPECT imaging accepted in the medical community?
Science has repeatedly recognized the value of brain SPECT imaging for assessing brain function. There is a robust amount of scientific data that support the utility of SPECT for revealing the blood flow patterns underlying many different types of brain problems. Dr. Daniel Amen has authored or co-authored more than 70 peer-reviewed published research studies on brain SPECT imaging. In addition, our website has a collection of more than 2,700 abstracts on SPECT from researchers around the world.