The role of SPECT scanning in a neuropsychiatry unit.
OBJECTIVE
Single photon emission computerised tomography (SPECT) studies allow the assessment of cerebral blood flow and have been increasingly used as a clinical tool in neurology and neuropsychiatry. This paper examines the contribution of SPECT to the clinical management of patients with neuropsychiatric disorders, in particular patients with atypical or early onset dementia.


METHODS
All patients admitted to an eight-bed neuropsychiatry unit in a general hospital setting who had undergone SPECT scanning over a 15-month period were reviewed. Information was collected on clinical diagnosis, neuropsychological testing, structural neuroimaging and SPECT.


RESULTS
SPECT abnormalities were present in 88% of patients. The pattern of SPECT abnormality was concordant with structural neuroimaging in 65% of patients and concordant with neuropsychological testing in 82% of patients. The sensitivity and specificity of SPECT was 89%/79% for Alzheimer's disease and 56%/79% for frontotemporal dementias.


CONCLUSIONS
SPECT results must be interpreted in the context of other clinical and diagnostic assessments. In no single case was the clinical diagnosis made solely on the basis of a SPECT result. SPECT was of maximum clinical use in the diagnosis of frontotemporal dementias and in confirming the diagnosis of Alzheimer's dementia. SPECT was valuable in Lewy body dementia, vascular dementia and head injury. Its clinical utility in other psychiatric disorders remains unclear.
Neuropsychiatry Unit, Royal Melbourne Hospital, Parkville, Victoria, Australia.
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D
Velakoulis
J H
JH
Lloyd
D000328:Adult; D000368:Aged; D000544:Alzheimer Disease / Q000000981:diagnostic imaging / Q000503:physiopathology; D001479:Basal Ganglia / Q000098:blood supply / Q000000981:diagnostic imaging / Q000503:physiopathology; D001921:Brain / Q000098:blood supply / Q000000981:diagnostic imaging* / Q000473:pathology / Q000503:physiopathology; D002560:Cerebrovascular Circulation / Q000502:physiology*; D003937:Diagnosis, Differential; D005625:Frontal Lobe / Q000098:blood supply / Q000000981:diagnostic imaging / Q000503:physiopathology; D006757:Hospital Units / Q000706:statistics & numerical data; D006801:Humans; D008279:Magnetic Resonance Imaging; D001523:Mental Disorders / Q000175:diagnosis; D008875:Middle Aged; D019965:Neurocognitive Disorders / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000503:physiopathology; D009483:Neuropsychological Tests; D012680:Sensitivity and Specificity; D013702:Temporal Lobe / Q000098:blood supply / Q000000981:diagnostic imaging / Q000503:physiopathology; D015899:Tomography, Emission-Computed, Single-Photon / Q000592:standards*; D014057:Tomography, X-Ray Computed