1Department of Nuclear Medicine, Kasra Hospital, Tehran, Iran
2Department of Neurology, Bushehr Medical University Hospital, Bushehr University of Medical Sciences, Bushehr, Iran
3The Persian Gulf Nuclear Medicine Research Center, The Persian Gulf Biomedical Sciences Institute, Bushehr University of Medical Sciences, Bushehr, Iran
4The Persian Gulf Marine Biotechnology Research center, The Persian Gulf Biomedical Sciences Institute, Bushehr University of Medical Sciences, Bushehr, Iran
Brain single-photon emission computerized tomography (SPECT), in particular, with perfusion agents or with neuroreceptor imaging radiopharmaceuticals, is rapidly becoming a clinical tool in many neurologic and psychiatric conditions. This imaging modality has been used for diagnosis, prognosis assessment, evaluation of response to therapy, risk stratification, detection of benign vs. malignant viable tissue, and the choice of medical or surgical therapy. We will present our institutional experience in this area, formatting a pictorial review of brain perfusion SPECT on more than 20 types of different neurologic and psychiatric diseases, such as dementia, epilepsy, cerebral palsy, head injury, brain tumor, herpes encephalitis, hypoxic brain damage, vacuities, depression, carbon monoxide (CO) poisoning, and cocaine abuse. This is a demanding procedure as far as the need for trained and experienced physicians and personnel as well as advanced equipment are concerned. However, extraordinary useful clinical information achieved by this technology outweighs the existing challenge. More routine use of this procedure which is unfortunately underutilized in many countries including ours should be encouraged.
Camargo EE. Brain SPECT in neurology and psychiatry. J Nucl Med. 2001 Apr;42(4):611-23.
Ozgur HT, Kent Walsh T, Masaryk A, Seeger JF, Williams W, Krupinski E, Melgar M, Labadie E. Correlation of cerebrovascular reserve as measured by acetazolamide-challenged SPECT with angiographic flow patterns and intra- or extracranial arterial stenosis. AJNR Am J Neuroradiol. 2001 May;22(5):928-36.
Tomura N, Otani T, Koga M, Ishiyama K. Correlation between severity of carotid stenosis and vascular reserve measured by acetazolamide brain perfusion single photon emission computed tomography. J Stroke Cerebrovasc Dis. 2013 Feb;22(2):166-70.
Goffin K, Dedeurwaerdere S, Van Laere K, Van Paesschen W. Neuronuclear assessment of patients with epilepsy. Semin Nucl Med. 2008 Jul;38(4):227-39.
Nemati R, Nabipour I, Javadi H, Chabi N, Assadi M. Regional Cerebral Blood-Flow with 99mTc-ECD Brain Perfusion SPECT in Landau-Kleffner Syndrome: Report of Two Cases. Case Rep Radiol. 2014;2014:617343.
Devous MD Sr. Functional brain imaging in the dementias: role in early detection, differential diagnosis, and longitudinal studies. Eur J Nucl Med Mol Imaging. 2002 Dec;29(12):1685-96.
Brockhuis B, Sławek J, Wieczorek D, Ussorowska D, Derejko M, Romanowicz G, Marks W, Dubaniewicz M. Cerebral blood flow changes in patients with dementia with Lewy bodies (DLB). A study of 6 cases. Nucl Med Rev Cent East Eur. 2006;9(2):114-8.
Gabryelewicz T, Pawłowska-Detko A, Miśko J, Cwikła JB, Pfeffer A, Barczak A, Wasiak B, Łuczywek E, Królicki L, Walecki J, Barcikowska M. Prediction of deterioration of mild cognitive impairment with CT and SPECT. Med Sci Monit. 2007 May;13 Suppl 1:31-7.
Nobili F, Frisoni GB, Portet F, Verhey F, Rodriguez G, Caroli A, Touchon J, Calvini P, Morbelli S, De Carli F, Guerra UP, Van de Pol LA, Visser PJ. Brain SPECT in subtypes of mild cognitive impairment. Findings from the DESCRIPA multicenter study. J Neurol. 2008 Sep;255(9):1344-53.
Imran MB, Kawashima R, Awata S, Sato K, Kinomura S, Ono S, Sato M, Fukuda H. Tc-99m HMPAO SPECT in the evaluation of Alzheimer's disease: correlation between neuropsychiatric evaluation and CBF images. J Neurol Neurosurg Psychiatry. 1999 Feb;66(2):228-32.
Miller BL, Cummings JL, Villanueva-Meyer J, Boone K, Mehringer CM, Lesser IM, Mena I. Frontal lobe degeneration: clinical, neuropsychological, and SPECT characteristics. Neurology. 1991 Sep;41(9):1374-82.
Shyu WC, Lin JC, Shen CC, Hsu YD, Lee CC, Shiah IS, Tsao WL. Vascular dementia of Binswanger's type: clinical, neuroradiological and 99mTc-HMPAO SPET study. Eur J Nucl Med. 1996 Oct;23(10):1338-44.
Lycke J, Wikkelsö C, Bergh AC, Jacobsson L, Andersen O. Regional cerebral blood flow in multiple sclerosis measured by single photon emission tomography with technetium-99m hexamethylpropyleneamine oxime. Eur Neurol. 1993;33(2):163-7.
Assadi M, Salimipour H, Seyedabadi M, Saberifard J, Javadi H, Nabipour I, Nemati R. Brain single photon emission computed tomography with Tc-99m MIBI or Tc-99m ECD in comparison to MRI in multiple sclerosis. Clin Nucl Med. 2010 Sep;35(9):682-6.
Taghizadeh Asl M, Nemati R, Chabi N, Salimipour H, Nabipour I, Assadi M. Brain perfusion imaging with voxel-based analysis in secondary progressive multiple sclerosis patients with a moderate to severe stage of disease: a boon for the workforce. BMC Neurol. 2016 May 26;16:79.
Lass P, Koseda M, Lyczak P. Technetium-99m-HMPAO brain SPECT in systemic lupus erythematosus with central nervous system involvement. J Nucl Med. 1998 May;39(5):930-1.
Broich K, Horwich D, Alavi A. HMPAO-SPECT and MRI in acute disseminated encephalomyelitis. J Nucl Med. 1991 Oct;32(10):1897-900.
Langleben DD, Austin G, Krikorian G, Ridlehuber HW, Goris ML, Strauss HW. Interhemispheric asymmetry of regional cerebral blood flow in prepubescent boys with attention deficit hyperactivity disorder. Nucl Med Commun. 2001 Dec;22(12):1333-40.
George MS, Ketter TA, Post RM. SPECT and PET imaging in mood disorders. J Clin Psychiatry. 1993 Nov;54 Suppl:6-13.
Tutus A, Kibar M, Sofuoglu S, Basturk M, Gönül AS. A technetium-99m hexamethylpropylene amine oxime brain single-photon emission tomography study in adolescent patients with major depressive disorder. Eur J Nucl Med. 1998 Jun;25(6):601-6.
Alptekin K, Degirmenci B, Kivircik B, Durak H, Yemez B, Derebek E, Tunca Z. Tc-99m HMPAO brain perfusion SPECT in drug-free obsessive-compulsive patients without depression. Psychiatry Res. 2001 Jul 1;107(1):51-6.
Lu YY, Tsai SC, Kao CH, Lin WY. Regional cerebral blood flow in patients with carbon monoxide intoxication. Ann Nucl Med. 2012 Dec;26(10):771-6.
Choi IS, Kim SK, Lee SS, Choi YC. Evaluation of outcome of delayed neurologic sequelae after carbon monoxide poisoning by technetium-99m hexamethylpropylene amine oxime brain single photon emission computed tomography. Eur Neurol. 1995;35(3):137-42.
Adinoff B, Devous MD, Best SE, Harris TS, Chandler P, Frock SD, Williams MJ. Regional cerebral blood flow in female cocaine-addicted subjects following limbic activation. Drug Alcohol Depend. 2003 Sep 10;71(3):255-68.
Holman BL, Carvalho PA, Mendelson J, Teoh SK, Nardin R, Hallgring E, Hebben N, Johnson KA. Brain perfusion is abnormal in cocaine-dependent polydrug users: a study using technetium-99m-HMPAO and ASPECT. J Nucl Med. 1991 Jun;32(6):1206-10.
Peskind ER, Petrie EC, Cross DJ, Pagulayan K, McCraw K, Hoff D, Hart K, Yu CE, Raskind MA, Cook DG, Minoshima S. Cerebrocerebellar hypometabolism associated with repetitive blast exposure mild traumatic brain injury in 12 Iraq war Veterans with persistent post-concussive symptoms. Neuroimage. 2011 Jan;54 Suppl 1:S76-82.
Denays R, Tondeur M, Toppet V, Ham H, Piepsz A, Spehl M, Rubinstein M, Noel P. Cerebral palsy: initial experience with Tc-99m HMPAO SPECT of the brain. Radiology. 1990 Apr;175(1):111-6.
Asl MT, Yousefi F, Nemati R, Assadi M. 99mTc-ECD brain perfusion SPECT imaging for the assessment of brain perfusion in cerebral palsy (CP) patients with evaluation of the effect of hyperbaric oxygen therapy. Int J Clin Exp Med. 2015 Jan 15;8(1):1101-7.
Rieck H, Adelwöhrer C, Lungenschmid K, Deisenhammer E. Discordance of technetium-99m-HMPAO and technetium-99m-ECD SPECT in herpes simplex encephalitis. J Nucl Med. 1998 Sep;39(9):1508-10.
Launes J, Nikkinen P, Lindroth L, Brownell AL, Liewendahl K, Iivanainen M. Diagnosis of acute herpes simplex encephalitis by brain perfusion single photon emission computed tomography.Lancet. 1988 May 28;1(8596):1188-91.
Alexiou G, Tsiouris S, Fotopoulos A. Single-photon emission computed tomography in the evaluation of brain tumors and the diagnosis of relapse vs radiation necrosis. Hell J Nucl Med. 2007 Sep-Dec;10(3):205-8.
Birbilis T, Boussios N, Papatheodossiou L, Matis G, Zissimopoulos A. Is there a role for SPECT with (99m)Tc-Tetrofosmin in the diagnostic work up of a brain tumor? Maedica (Buchar). 2013 Sep;8(4):347-50.
Shih WJ, Lee JK, Milan P. Discordant technetium-99m-MIBI and technetium-99m-HMPAO uptake of recurrent occipital meningioma on brain SPECT images. J Nucl Med. 1996 Jul;37(7):1183-5.
Masdeu JC, Abdel-Dayem H, Van Heertum RL. Head trauma: use of SPECT. J Neuroimaging. 1995 Jul;5 Suppl 1:S53-7.
Raji CA, Tarzwell R, Pavel D, Schneider H, Uszler M, Thornton J, van Lierop M, Cohen P, Amen DG, Henderson T. Clinical utility of SPECT neuroimaging in the diagnosis and treatment of traumatic brain injury: a systematic review. PLoS One. 2014 Mar 19;9(3):e91088.
Assadi M, Eftekhari M, Gholamrezanezhad A. SPET brain scan with (99m)Tc-ECD and CT, MRI in traumatic brain injury with chronic symptoms. Hell J Nucl Med. 2007 Sep-Dec;10(3):183.
Eftekhari M, Assadi M, Kazemi M, Saghari M, Mojtahedi A, Fard-Esfahani A, Sichani BF, Beiki D. Brain perfusion single photon emission computed tomography findings in patients with posttraumatic anosmia and comparison with radiological imaging. Am J Rhinol. 2006 Nov-Dec;20(6):577-81.
Rupright J, Woods EA, Singh A. Hypoxic brain injury: evaluation by single photon emission computed tomography. Arch Phys Med Rehabil. 1996 Nov;77(11):1205-8.