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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 15 of 15. This is the beginning of the thread.
Posted by Chris O on March 2, 2005, at 17:22:35
I'm just curious if anyone here has had a SPECT scan made of their brain, and if they found the information from the scan useful. I have seen two different psychiatrists who are of opposite opinions on the subject. One says they make "pretty pictures" but provide little valid information. The other thinks they are "right on" and helps facilitate the correct meds and treatment of mental illness. I live in southern California, near one of the Amen Clinics (Daniel Aman--guy who popularized SPECT scans). Has anyone had a SPECT scan with Dr. Aman and if so, what did you think?
Gracias,
Cristobal
Posted by SadDoggie on March 4, 2005, at 17:28:03
In reply to Are brain SPECT scans useful?, posted by Chris O on March 2, 2005, at 17:22:35
How much do one of these SPECT scans cost? I doubt they're covered by insurance.
SadDoggie> I'm just curious if anyone here has had a SPECT scan made of their brain, and if they found the information from the scan useful. I have seen two different psychiatrists who are of opposite opinions on the subject. One says they make "pretty pictures" but provide little valid information. The other thinks they are "right on" and helps facilitate the correct meds and treatment of mental illness. I live in southern California, near one of the Amen Clinics (Daniel Aman--guy who popularized SPECT scans). Has anyone had a SPECT scan with Dr. Aman and if so, what did you think?
>
> Gracias,
> Cristobal
Posted by Chris O on March 4, 2005, at 17:42:29
In reply to Re: Are brain SPECT scans useful?, posted by SadDoggie on March 4, 2005, at 17:28:03
Not covered by my insurance, which is good (Pacificare). Believe they are around $2,000. The therapist I am seeing swears by them, saying they have been accurate in helping one hundred percent of her patients. She sent me to a psychiatrist who also believes strongly in them. I'm more of the mind that I can just experiment with meds on my own
rather than pay the money and inject myself with a radioactive isotope to get the brain pics. I don't know though. I just wanted to know if anyone here had gotten a positive diagnosis via a SPECT scan.Chris
Posted by alohashirt on March 6, 2005, at 19:20:30
In reply to Re: Are brain SPECT scans useful? » SadDoggie, posted by Chris O on March 4, 2005, at 17:42:29
My pdoc, who is part of a multidisciplinary team that specializes in ADHD said he thought the results were uncompelling so far - too early to be very useful. He related one experience of a patient who's diagnosis was missed. One part of the problem may be that Amen himself isn't involved in the day to day interpretations of the scans.
Do you expect that the results fo the test would change the likely treatment regime? Do you have an ADHD diagnosis already?
> Not covered by my insurance, which is good (Pacificare). Believe they are around $2,000. The therapist I am seeing swears by them, saying they have been accurate in helping one hundred percent of her patients. She sent me to a psychiatrist who also believes strongly in them. I'm more of the mind that I can just experiment with meds on my own
> rather than pay the money and inject myself with a radioactive isotope to get the brain pics. I don't know though. I just wanted to know if anyone here had gotten a positive diagnosis via a SPECT scan.
>
> Chris
Posted by Chris O on March 6, 2005, at 23:43:10
In reply to Re: Are brain SPECT scans useful?, posted by alohashirt on March 6, 2005, at 19:20:30
Alohashirt:
Thanks for the feedback. As I think I said in the first post (or maybe I did not), I have not gotten a scan so far because I figure that I can just experiment with meds on my own. In addition, being as that they are not accepted by many psychiatrists, I just kind of decided against it. My diagnosis is not ADHD, but the exact opposite: GAD, OCD, panic--all the things in that direction.
If anything, my insides are way "overactive," not "underactive," as they would be in ADHD. Anyway, I was just interested in finding out if any others on this board had had the scans and how they felt about them.Muchos gracias again,
ChrisMy pdoc, who is part of a multidisciplinary team that specializes in ADHD said he thought the results were uncompelling so far - too early to be very useful. He related one experience of a patient who's diagnosis was missed. One part of the problem may be that Amen himself isn't involved in the day to day interpretations of the scans.
Do you expect that the results fo the test would change the likely treatment regime? Do you have an ADHD diagnosis already?
Posted by Sarah T. on March 8, 2005, at 19:47:32
In reply to Are brain SPECT scans useful?, posted by Chris O on March 2, 2005, at 17:22:35
Hi Chris. I think SPECT scans are useful, but PET scans are probably more useful. If you live near the Amen Clinic, then at least you don't have to hassle with traveling a long distance for the appointments. Sometimes SPECT scans will just confirm what has been clinically evident. If you have limited resources or insurance problems and have to make a choice, I'd opt for the PET scan.
Posted by Chris O on March 8, 2005, at 20:40:27
In reply to Re: Are brain SPECT scans useful? » Chris O, posted by Sarah T. on March 8, 2005, at 19:47:32
Sarah:
I've seen some people post on here regarding their PET scans. But what is the difference in terms of what they reveal about the brain? Have you (or anyone you know) had either a PET or a SPECT scan yourself? What did it tell you? I'm just curious about people's specific experiences with these brain imaging studies. And yeah, I think if I got a SPECT, it would just confirm that I'm the anxious freakazoid that I am. That's why I probably won't do it.
Thanks for the feedback,
Chris> Hi Chris. I think SPECT scans are useful, but PET scans are probably more useful. If you live near the Amen Clinic, then at least you don't have to hassle with traveling a long distance for the appointments. Sometimes SPECT scans will just confirm what has been clinically evident. If you have limited resources or insurance problems and have to make a choice, I'd opt for the PET scan.
Posted by SLS on March 9, 2005, at 7:14:13
In reply to What's the difference: PET vs. SPECT? » Sarah T., posted by Chris O on March 8, 2005, at 20:40:27
> Sarah:
>
> I've seen some people post on here regarding their PET scans. But what is the difference in terms of what they reveal about the brain? Have you (or anyone you know) had either a PET or a SPECT scan yourself? What did it tell you? I'm just curious about people's specific experiences with these brain imaging studies. And yeah, I think if I got a SPECT, it would just confirm that I'm the anxious freakazoid that I am. That's why I probably won't do it.
>
> Thanks for the feedback,
> Chris
>
> > Hi Chris. I think SPECT scans are useful, but PET scans are probably more useful. If you live near the Amen Clinic, then at least you don't have to hassle with traveling a long distance for the appointments. Sometimes SPECT scans will just confirm what has been clinically evident. If you have limited resources or insurance problems and have to make a choice, I'd opt for the PET scan.
>
>
-------------------------------------------From an imaging website:
-------------------------------------------
Types of brain imaging
[edit]
PET
Positron Emission Tomography (PET) measures emissions from radioactively labeled chemicals that have been injected into the bloodstream and uses the data to produce two or three-dimensional images of the distribution of the chemicals throughout the brain (Nilsson 57). PET scans involve the use of a machine called a cyclotron to label chemicals with small amounts of radioactivity. The labeled compound, called radiotracer, is injected into the bloodstream and eventually makes its way to the brain. Sensors in the PET scanner detect the radioactivity as the compound accumulates in different regions of the brain. A computer uses the data gathered by the sensors to create multicolored two or three-dimensional images that show where the compound acts in the brain.The greatest benefit of PET scanning is that different compounds can show blood flow and oxygen and glucose metabolism in the tissues of the working brain. These measurements reflect the amount of brain activity in the various regions of the brain and allow us to learn more about how the brain works. PET scans were superior in terms of resolution and speed of completion (as little as 30 seconds) when they first came online. The improved resolution permitted better judgments to be made as to the area of the brain activated by a particular task. The biggest drawback of PET scanning is that because the radioactivity decays rapidly, it is limited to monitoring short tasks (Nilsson 60). Before fMRI technology came online, PET scanning was the preferred method of brain imaging, and it still continues to make large contributions to neuroscience.
[edit]
SPECT
Similar to PET, single photon emission computed tomography (SPECT) uses radioactive tracers and a scanner to record data that a computer uses to construct two- or three-dimensional images of active brain regions (Ball). SPECT tracers are considered to be more limited than PET scanners in the kinds of brain activity they have the ability to monitor. The tracers of SPECT are longer lasting than those of PET, which allows for different, longer lasting brain functions to be examined, but this also requires more time for the SPECT to be completed. The resolution of a SPECT is poor (about 1 cm) compared to that of PET. SPECT is often chosen over PET simply as a cost issue, for less equipment is involved and fewer staff is required to perform the tests.[edit]
EEG
Electroencephalography (EEG) is the oldest of the modern brain imaging techniques and uses electrodes placed on the scalp to detect and measure patterns of electrical activity coming from the brain. There have been many recent developments regarding EEG's ability to read brain activity data from the entire head simultaneously (Thompson, Bioinformatics). Using scale electrodes, EEG can determine the relative strengths and positions of electrical activity in different brain regions by measuring electrical activity on the outside of the brain. EEG records timing of activity very precisely but resolution is poor and does not directly record interior brain activity. As a result, researchers often use EEG images of brain electrical activity in combination with MRI scans to better pinpoint the location of the activity in the brain.[edit]
MRI
Magnetic Resonance Imaging (MRI) uses magnetic fields and radio waves to produce high quality two- or three-dimensional images of brain structures without injecting radioactive tracers. During an MRI, a large cylindrical magnet creates a magnetic field around the head of the patient through which radio waves are sent. When the magnetic field is imposed, each point in space has a unique radio frequency at which the signal is received and transmitted (Preuss). Sensors read the frequencies and a computer uses the information to construct an image. The detection mechanisms are so precise that changes in structures over time can be detected. Using MRI, scientists can create images of both surface and subsurface structures with a high degree of anatomical detail. MRI scans can produce cross sectional images in any direction from top to bottom, side to side, or front to back. The problem with original MRI technology was that while it provides a detailed assessment of the physical appearance of the brain, it fails to provide information about how well the brain is working at the time of imaging. The distinction is now made between MRI imaging and functional imaging since the brain's function rather than the brain's structure is of interest.[edit]
fMRI
Functional MRI (fMRI) relies on the magnetic properties of blood to enable scientists to see images of blood flow in the brain as it occurs. This mapping of blood flow allows for dynamic brain mapping to take place (Shorey). During the test, the subject is normally asked to perform a repetitive motion like tapping a finger or tapping a foot. FMRI has taken the place of PET scanning as the king of brain imaging because fMRI can produce images of the brain every second, and scientists can determine with great precision when brain regions become active and for how long. Also, fMRI has such high resolution that it can distinguish structures less than a millimeter apart. This allows scientists to know exactly which areas of the brain are being activated. PET, however, retains the significant advantage of being able to identify which brain receptors are being activated by neurotransmitters, abused drugs, and potential treatment compounds.Drawbacks of fMRI are few but substantial at this point. First, it takes quite a bit of time to perform the procedure and the patient needs to be completely still for often more than twenty minutes at a time. Second, and more importantly, interpretations of fMRI results are still vague. It is difficult to determine if the subject was thinking about something that caused certain parts of the brain to activate, if the scanner picked up real data or noise, and so on (Shorey). For these and other reasons, fMRI technology has begun to be combined with EEG technology.
[edit]
CAT
Computed axial tomography (CT or CAT) scanning uses a series of x-rays of the head taken from many different directions. Typically used for quickly viewing brain injuries, CT scanning has a computer program that uses a set of algebraic equations to estimate how much x-ray is absorbed in a small area within a cross section of the brain (Jeeves 21). In the final analysis, the harder a material is, the whiter it will appear on the scan. CT scans are primarily used for evaluating swelling from tissue damage in the brain and in assessment of ventricle size. Modern CT scanning exposes the subject to about as much radiation as a single x-ray and can provide reasonably good images in a matter of minutes.
Posted by Chris O on March 9, 2005, at 13:08:27
In reply to Re: What's the difference: PET vs. SPECT?, posted by SLS on March 9, 2005, at 7:14:13
Posted by KaraS on March 10, 2005, at 19:55:53
In reply to Re: What's the difference: PET vs. SPECT?, posted by SLS on March 9, 2005, at 7:14:13
> > Sarah:
> >
> > I've seen some people post on here regarding their PET scans. But what is the difference in terms of what they reveal about the brain? Have you (or anyone you know) had either a PET or a SPECT scan yourself? What did it tell you? I'm just curious about people's specific experiences with these brain imaging studies. And yeah, I think if I got a SPECT, it would just confirm that I'm the anxious freakazoid that I am. That's why I probably won't do it.
> >
> > Thanks for the feedback,
> > Chris
> >
> > > Hi Chris. I think SPECT scans are useful, but PET scans are probably more useful. If you live near the Amen Clinic, then at least you don't have to hassle with traveling a long distance for the appointments. Sometimes SPECT scans will just confirm what has been clinically evident. If you have limited resources or insurance problems and have to make a choice, I'd opt for the PET scan.
> >
> >
>
>
> -------------------------------------------
>
> From an imaging website:
>
> -------------------------------------------
>
> Types of brain imaging
> [edit]
> PET
> Positron Emission Tomography (PET) measures emissions from radioactively labeled chemicals that have been injected into the bloodstream and uses the data to produce two or three-dimensional images of the distribution of the chemicals throughout the brain (Nilsson 57). PET scans involve the use of a machine called a cyclotron to label chemicals with small amounts of radioactivity. The labeled compound, called radiotracer, is injected into the bloodstream and eventually makes its way to the brain. Sensors in the PET scanner detect the radioactivity as the compound accumulates in different regions of the brain. A computer uses the data gathered by the sensors to create multicolored two or three-dimensional images that show where the compound acts in the brain.
>
> The greatest benefit of PET scanning is that different compounds can show blood flow and oxygen and glucose metabolism in the tissues of the working brain. These measurements reflect the amount of brain activity in the various regions of the brain and allow us to learn more about how the brain works. PET scans were superior in terms of resolution and speed of completion (as little as 30 seconds) when they first came online. The improved resolution permitted better judgments to be made as to the area of the brain activated by a particular task. The biggest drawback of PET scanning is that because the radioactivity decays rapidly, it is limited to monitoring short tasks (Nilsson 60). Before fMRI technology came online, PET scanning was the preferred method of brain imaging, and it still continues to make large contributions to neuroscience.
>
> [edit]
> SPECT
> Similar to PET, single photon emission computed tomography (SPECT) uses radioactive tracers and a scanner to record data that a computer uses to construct two- or three-dimensional images of active brain regions (Ball). SPECT tracers are considered to be more limited than PET scanners in the kinds of brain activity they have the ability to monitor. The tracers of SPECT are longer lasting than those of PET, which allows for different, longer lasting brain functions to be examined, but this also requires more time for the SPECT to be completed. The resolution of a SPECT is poor (about 1 cm) compared to that of PET. SPECT is often chosen over PET simply as a cost issue, for less equipment is involved and fewer staff is required to perform the tests.
>
> [edit]
> EEG
> Electroencephalography (EEG) is the oldest of the modern brain imaging techniques and uses electrodes placed on the scalp to detect and measure patterns of electrical activity coming from the brain. There have been many recent developments regarding EEG's ability to read brain activity data from the entire head simultaneously (Thompson, Bioinformatics). Using scale electrodes, EEG can determine the relative strengths and positions of electrical activity in different brain regions by measuring electrical activity on the outside of the brain. EEG records timing of activity very precisely but resolution is poor and does not directly record interior brain activity. As a result, researchers often use EEG images of brain electrical activity in combination with MRI scans to better pinpoint the location of the activity in the brain.
>
> [edit]
> MRI
> Magnetic Resonance Imaging (MRI) uses magnetic fields and radio waves to produce high quality two- or three-dimensional images of brain structures without injecting radioactive tracers. During an MRI, a large cylindrical magnet creates a magnetic field around the head of the patient through which radio waves are sent. When the magnetic field is imposed, each point in space has a unique radio frequency at which the signal is received and transmitted (Preuss). Sensors read the frequencies and a computer uses the information to construct an image. The detection mechanisms are so precise that changes in structures over time can be detected. Using MRI, scientists can create images of both surface and subsurface structures with a high degree of anatomical detail. MRI scans can produce cross sectional images in any direction from top to bottom, side to side, or front to back. The problem with original MRI technology was that while it provides a detailed assessment of the physical appearance of the brain, it fails to provide information about how well the brain is working at the time of imaging. The distinction is now made between MRI imaging and functional imaging since the brain's function rather than the brain's structure is of interest.
>
> [edit]
> fMRI
> Functional MRI (fMRI) relies on the magnetic properties of blood to enable scientists to see images of blood flow in the brain as it occurs. This mapping of blood flow allows for dynamic brain mapping to take place (Shorey). During the test, the subject is normally asked to perform a repetitive motion like tapping a finger or tapping a foot. FMRI has taken the place of PET scanning as the king of brain imaging because fMRI can produce images of the brain every second, and scientists can determine with great precision when brain regions become active and for how long. Also, fMRI has such high resolution that it can distinguish structures less than a millimeter apart. This allows scientists to know exactly which areas of the brain are being activated. PET, however, retains the significant advantage of being able to identify which brain receptors are being activated by neurotransmitters, abused drugs, and potential treatment compounds.
>
> Drawbacks of fMRI are few but substantial at this point. First, it takes quite a bit of time to perform the procedure and the patient needs to be completely still for often more than twenty minutes at a time. Second, and more importantly, interpretations of fMRI results are still vague. It is difficult to determine if the subject was thinking about something that caused certain parts of the brain to activate, if the scanner picked up real data or noise, and so on (Shorey). For these and other reasons, fMRI technology has begun to be combined with EEG technology.
>
> [edit]
> CAT
> Computed axial tomography (CT or CAT) scanning uses a series of x-rays of the head taken from many different directions. Typically used for quickly viewing brain injuries, CT scanning has a computer program that uses a set of algebraic equations to estimate how much x-ray is absorbed in a small area within a cross section of the brain (Jeeves 21). In the final analysis, the harder a material is, the whiter it will appear on the scan. CT scans are primarily used for evaluating swelling from tissue damage in the brain and in assessment of ventricle size. Modern CT scanning exposes the subject to about as much radiation as a single x-ray and can provide reasonably good images in a matter of minutes.
>
>
Yes, excellent info! One more question: where does BEAM fit into all of this?
Posted by SLS on March 10, 2005, at 21:18:35
In reply to Re: What's the difference: PET vs. SPECT? » SLS, posted by KaraS on March 10, 2005, at 19:55:53
Hi Kara.
> Yes, excellent info! One more question: where does BEAM fit into all of this?
I have no idea. I thought it was dropped for lack of utility. It was very popular and considered cutting-edge in 1990 when it was performed on me. A search on Google reveals that BEAM still has its advocates.
- Scott
Posted by Larry Hoover on March 10, 2005, at 22:06:58
In reply to Re: What's the difference: PET vs. SPECT? » KaraS, posted by SLS on March 10, 2005, at 21:18:35
> > Yes, excellent info! One more question: where does BEAM fit into all of this?
>
> I have no idea. I thought it was dropped for lack of utility. It was very popular and considered cutting-edge in 1990 when it was performed on me. A search on Google reveals that BEAM still has its advocates.
>
>
> - ScottAhhh, Scott, we finally have the true origin of "BEAM me up, Scotty". 'Twas you, eh?
Lar
Posted by KaraS on March 11, 2005, at 1:42:33
In reply to Re: What's the difference: PET vs. SPECT? » KaraS, posted by SLS on March 10, 2005, at 21:18:35
Posted by CK1 on March 11, 2005, at 12:48:22
In reply to Re: Thanks. (nm) » SLS, posted by KaraS on March 11, 2005, at 1:42:33
SPECT scans are supposedly outdated. PET scans are considered to provide "more information" than SPECT. However, even if you have one of these tests and something does show up, then what....You have to go through the same process everyone else goes through trying to find the correct dose/drug for you. So, it's basically like spending $2,000 to simply find out something is wrong (and you already know something is wrong!). The only way I'm jumping into the PET/SPECT scan boat is if doctors can (someday) read these scans and prescribe medicine based on the results. We're not there yet though. Until then, it's trial and error .
Posted by KaraS on March 11, 2005, at 14:28:37
In reply to Re: Thanks., posted by CK1 on March 11, 2005, at 12:48:22
> SPECT scans are supposedly outdated. PET scans are considered to provide "more information" than SPECT. However, even if you have one of these tests and something does show up, then what....You have to go through the same process everyone else goes through trying to find the correct dose/drug for you. So, it's basically like spending $2,000 to simply find out something is wrong (and you already know something is wrong!). The only way I'm jumping into the PET/SPECT scan boat is if doctors can (someday) read these scans and prescribe medicine based on the results. We're not there yet though. Until then, it's trial and error .
Have you read the fairly recent posts here on rEEG or QEEG? Supposedly this is allowing some doctors to eliminate a lot of the guess work. They review the results of the QEEG and compare them to other people's results. Then they recommend medications (or combinations of medications) that have helped those other people.
http://www.dr-bob.org/babble/20050207/msgs/455823.html
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