Preparing for your SPECT Scan
Patient Instructions/Frequently Asked Questions
A. In general, our medical director recommends patients try to be off stimulants (Ritalin, Adderall, Concerta, etc.) at least four days before the first SPECT scan and remain off of them until the second SPECT scan (if one is ordered) is completed. It is the patient's responsibility to inform his/her primary care physician (or the prescribing doctor for the stimulant medication) of the recommended 4 day (96 hours) abstinence from such stimulants. Our doctors do NOT recommend going off other psychotropic medications. Be sure to ask your own doctor when and how to resume any stimulants you were asked to stop taking temporarily for this test. Feel free to have your physician or therapist call our RN/Tech with any questions.
B. Two days (48 hours) prior to the SPECT brain scan eliminate your caffeine and nicotine intake and try to not take cold medication (especially decongestants) or aspirin.(If you do, please write it down on the intake form.)
C. Arrive at least 15 minutes prior to your SPECT brain scan appointment time. Bring the signed order from your physician (if applicable) and any other paperwork necessary including current history and physical records.
D. The key to a successful nuclear medicine test is to remain as still as possible. The period time you will need to remain still is less than 16-26 minutes. Due to the sensitivity of the radioisotope, payment will be required if you are unable to remain still because another SPECT scan study will need to be rescheduled.
E. Be sure to dress comfortably so that you are relaxed. Also, dress warmly since our brain imaging room may be chilly.
F. Prepare yourself for a fairly lengthy visit.
-If you've been scheduled for one SPECT scan and the report, your one day visit will last approximately 1 1/2 hours.
-If you've been scheduled for two SPECT scans and a report, each visit will last approximately 1 1/2 hours (on two, separate days).
-If you've been scheduled for an evaluation, two SPECT brain scans and a report, there will be four appointments. The first appointment to review the history and intake information is 2 hours. The second appointment is for your first SPECT scan and lasts approximately 2 hours. The third appointment is for your second SPECT scan and lasts approximately 2 hours. The final appointment is for the Review Summary Session and lasts approximately 1 hour.
G. Relax. The staff at our clinic is friendly and professional, and will answer any questions you may have when you arrive.
Frequently Asked Questions:
Are there any side effects or risks to the SPECT brain scan study?
The study does not involve a dye and people do not tend to have allergic reactions to the study. Although adverse reactions to the radiopharmaceutical are very rare and when they do occur, usually involve only a mild, self-limited skin reaction such as a rash, please let your nurse/technician know if you experience any symptoms during or after the tracer injection. The total body radiation exposure is in the range of one to three times your annual exposure to natural background radiation (being in the sun, flying in an airplane, etc.).
Will I feel pain when the drug is injected?
You feel only a small prick from the needle as it is placed into the vein.There is a topical and/or a beneath-the-skin anesthetic that can be utilized.
How is the SPECT brain scanning procedure done?
You will be placed in a warm and comfortable quiet room and a small intravenous (IV) line is started. You remain quiet with no stimulation (including talking) for approximately 10 minutes with your eyes open to allow your mental state to acclimate to the environment. You will start a simple, concentration computer test and the imaging agent will be injected through your IV approximately 5 minutes into this computer test. This will provide a "snapshot" picture of what your brain is doing at concentration. After another period of time (approximately 45 minutes) the nurse will take you into the camera room and you will lie down on the padded, examination table.You will be positioned near the SPECT camera, which will image the areas of your brain where the radiopharmaceutical has accumulated. The closer the camera is to your head, the better the images of the blood flowing in the brain will be. If an "at rest" study is ordered, you will return at least 30 hours later (to allow the radioisotope to leave your system) for a second brain scan. The procedure is the same as the first scan except there is no computer concentration test.
Since the "snapshot" this time is of the brain at rest, it is important to allow your mind to wander, and remain quiet without talking until the radioisotope has been injected.After another period of time (approximately 45 minutes) the nurse will take you into the camera room and you will lie down on the padded, examination table for the second scan. After each SPECT scan has been completed, you will be free to move and interact as usual.
Will I be alone?
No. The nurse/technician and a parent (if applicable) will be with you throughout the examination.
Will the SPECT camera touch me?
No. The camera will rotate once around your head and may lightly brush against the tops of your shoulders.(You will not go through a tube.) Otherwise, no part of the machinery will touch your body.
Will I get a diagnosis from the SPECT scans?
No. Brain SPECT imaging will not provide a diagnosis by itself. It is a diagnostic tool that is used in conjunction with patient history, clinical interview and psychological testing to form diagnostic impressions and treatment recommendations.
After I've been injected with the radioisotope, should I avoid physical contact with others?
No. In general, the tracer you are given will remain in your body for a short period of time and is cleared through natural bodily functions. This is why drinking more fluids after your scan will help eliminate the tracer more quickly. If any special precautions are necessary, the RN/Tech will advise you.
What should I do after the exams?
Unless you were sedated, you can return to any activities of daily living (work, school, exercise, etc.).However, it will be necessary to increase fluid intake to encourage elimination of the radioisotope from your body. The goal is to urinate twice in the two hours following the injection. The nurse/technician will provide discharge instructions.
When will I get the results of my SPECT scan?
When the exam is completed, a nuclear medicine physician reviews your SPECT brain images, prepares a report and discusses your results with the clinical staff member. A final appointment is made (approximately 7-10 days after your last SPECT brain scan) for the clinical staff to review the test results with you and will discuss any treatment recommendations, if needed. You are welcome to include (in person or by conference call) family members, your therapist or treating physician in this brain scan evaluation session. You will be provided with the interpretation of the brain scans, the SPECT scans themselves and any educational materials and resources that may apply.
Are there alternatives to having a SPECT study?
In our opinion, SPECT is the most clinically useful study of brain function. There are other studies, such as electroencephalograms (EEGs), Positron Emission Tomography (PET) studies and functional MRIs (fMRIs).PET studies and fMRI are considerably more costly and they are performed mostly in research settings. EEGs, in our opinion, do not provide enough information about the deep structures of the brain to be as helpful as SPECT studies.
Does insurance cover the cost of SPECT studies?
Reimbursement by insurance companies varies according to your plan. It is often a good idea to check with your insurance company ahead of time to see if it is a covered benefit. Our office can assist you by providing specific diagnostic and procedure codes to help you determine the level of insurance benefit ahead of time. We will provide you with a "Super bill" for you to submit to your insurance company for possible reimbursement.
Is the use of brain SPECT imaging accepted in the medical community?
Brain SPECT studies are widely recognized as an effective tool for evaluating brain function in Alzheimer's, seizure, epilepsy, stroke, dementia and traumatic brain injury. Brain SPECT imaging is not considered an exact science for diagnosing psychiatric conditions.Close correlation with the patient's clinical examination is necessary. There are literally hundreds of research articles on all of these topics. If interested, please contact our clinical staff for further information.