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The Use and Applications of Single-Photon Emission Computerised Tomography in Dementia

Published online by Cambridge University Press:  06 August 2018

D. P. Geaney*
Affiliation:
University of Oxford Department of Psychiatry, Warneford Hospital, Oxford OX3 7JX
M. T. Abou-Saleh
Affiliation:
University Department of Psychiatry, Royal Liverpool Hospital, Liverpool L69 3BX
*
Correspondence

Extract

The introduction of single-photon emission computerised tomography (SPECT) has markedly enhanced the study of brain function. The development of SPECT was the culmination of a series of investigations of cerebral blood flow (CBF) pioneered by Kety and Schmidt in the late 1940s combined with the introduction of transmission computerised tomography (CT) in the early 1960s, in which three-dimensional images are derived from two-dimensional data. Positron-emission tomography (PET), in addition to providing information on cerebral blood flow, also allows the evaluation of brain metabolism and neurotransmitter receptor function. However, the technology required for PET is expensive and sophisticated, with little prospect for general clinical application. Fortunately, SPECT is relatively cheap and is widely available for clinical use. We aim to review the principles and basic techniques of SPECT, its present utility and application to clinical practice, and its future potential in the investigation of brain function.

Type
Research Article
Copyright
Copyright © Royal College of Psychiatrists, 1990 

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References

Bartlett, E., Brodie, J., Wolf, A., et al (1988) Reproducibility of cerebral glucose metabolic measurements in resting human subjects. Journal of Cerebral Blood Flow and Metabolism, 8, 502512.CrossRefGoogle ScholarPubMed
Battistin, L., Pizzolato, G., Dam, M., et al (1989) Single photon emission computed tomography studies with 99mTc-hexamethylpropyleneamine oxime in dementia: effects of acute administration of L-acetylcarnitine. European Neurology, 29, 261265.CrossRefGoogle ScholarPubMed
Benson, D., Kuhl, D., Hawkins, R., et al (1983) The fluorodeoxyglucose 18F scan in Alzheimer's disease and multi-infarct dementia. Archives of Neurology, 40, 711714.Google Scholar
Bonte, F., Ross, E., Chehabi, H., et al (1986) SPECT study of regional cerebral blood flow in Alzheimer's disease. Journal of Computer Assisted Tomography, 10, 579583.Google Scholar
Burns, A., Philpot, M., Costa, D., et al (1989a) The investigation of Alzheimer's disease with single photon emission tomography. Journal of Neurology, Neurosurgery and Psychiatry, 52, 248253.CrossRefGoogle ScholarPubMed
Burns, A., Tune, L., Steele, C., et al (1989b) Positron emission tomography in dementia: a clinical review. International Journal of Geriatric Psychiatry, 4, 6772.CrossRefGoogle Scholar
Burns, A., Jacoby, R. & Levy, R. (1990) Psychiatric phenomena in Alzheimer's disease. IV: disorders of behaviour. British Journal of Psychiatry, 157, 8694.CrossRefGoogle ScholarPubMed
Chase, T., Foster, N., Fedio, P., et al (1984) Regional cortical dysfunction in Alzheimer's disease as determined by positron emission tomography. Annals of Neurology, 15 (suppl), S170–S174.Google Scholar
Cohen, M., Graham, S., Lake, R., et al (1986) Diagnosis of Alzheimer's disease and multiple infarct dementia by tomographic imaging of iodine-123 IMP. Journal of Nuclear Medicine, 27, 769774.Google Scholar
Creutzig, H., Schober, O., Gielow, P., et al (1986) Cerebral dynamics of N-isopropyl- (123I) p-iodamphetamine. Journal of Nuclear Medicine, 27, 178183.Google Scholar
Cutler, N., Haxby, J., Duara, R., et al (1985) Clinical history, brain metabolism and neuropsychological function in Alzheimer's disease. Annals of Neurology, 18, 298309.Google Scholar
Dastur, D. (1985) Cerebral blood flow and metabolism in normal human ageing, pathological ageing, and senile dementia. Journal of Cerebral Blood Flow and Metabolism, 5, 19.Google Scholar
Dastur, D., Lane, M., Hansen, D., et al (1963) Effects of ageing on cerebral circulation and metabolism in man. In Human Ageing: A Biological and Behavioural Study (eds Birren, J., Butler, R., Greenhouse, S., et al). Washington, DC: US Government Printing Office.Google Scholar
De Leon, M., Ferris, S., George, A., et al (1983) Computed tomography and positron emission transaxial tomography evaluations of normal ageing and Alzheimer's disease. Journal of Cerebral Blood Flow and Metabolism, 3, 391394.Google Scholar
Devous, M. (1989) Imaging brain function by single-photon emission computer tomography. In Brain Imaging: Applications in Psychiatry (ed. Andreasen, N.), pp. 147234. Washington DC: American Psychiatric Press.Google Scholar
Devous, M., Stokely, E., Chehabi, H., et al (1986) Normal distribution of regional cerebral blood flow measured by dynamic single-photon emission tomography. Journal of Cerebral Blood Flow and Metabolism, 6, 95104.Google Scholar
Duara, R., Grady, C., Haxby, J., et al (1984) Human brain glucose utilization and cognitive function in relation to age. Annals of Neurology, 16, 702713.Google Scholar
Duara, R., Grady, C., Haxby, J., et al (1986) Positron emission tomography in Alzheimer's disease. Neurology, 36, 879887.Google Scholar
Ebmeier, K., Besson, J., Crawford, J., et al (1987) Nuclear magnetic resonance imaging and single photon emission tomography with radio-iodine labelled compounds in the diagnosis of dementia. Acta Psychiatrica Scandinavica, 75, 549556.Google Scholar
Foster, N., Chase, T., Fedio, P., et al (1983) Alzheimer's disease: focal cortical changes shown by positron emission tomography. Neurology, 33, 961965.Google Scholar
Foster, N., Chase, T., Mansi, L., et al (1984) Cortical abnormalities in Alzheimer's disease. Annals of Neurology, 16, 649654.Google Scholar
Fox, P., Raichle, M., Mintun, M., et al (1988) Nonoxidative glucose consumption during focal physiologic neural activity. Science, 241, 462464.CrossRefGoogle ScholarPubMed
Frackowiak, R., Lenzi, G. L., Jones, T., et al (1980) Quantitative measurement of regional cerebral blood flow and oxygen metabolism in man using 15O and positron emission tomography: theory, procedure, and normal values. Journal of Computer Assisted Tomography, 4, 727736.Google Scholar
Frackowiak, R., Pozzilli, C., Legg, N., et al (1981) Regional cerebral oxygen supply and utilization in dementia: a clinical and physiological study with oxygen-15 and positron tomography. Brain, 104, 753778.Google Scholar
Frackowiak, R., Wise, R., Gibbs, J., et al (1984) Positron emission tomographic studies in ageing and cerebrovascular diasease at Hammersmith Hospital. Annals of Neurology, 15 (suppl.), S112–S118.CrossRefGoogle Scholar
Friedland, R., Budinger, T., Ganz, E., et al (1983) Regional cerebral metabolic alterations in dementia of the Alzheimer type: positron emission tomography with (18F) fluorodeoxyglucose. Journal of Computer Assisted Tomography, 7, 590598.Google Scholar
Geaney, D., Soper, N., Shepstone, B., et al (1990) Effect of central cholinergic stimulation on regional cerebral blood flow in Alzheimer disease. Lancet, 335, 14841487.Google Scholar
Gemmell, H., Sharp, P., Besson, J., et al (1987) Differential diagnosis in dementia using the cerebral blood flow agent 99mTc-HMPAO: a SPECT study. Journal of Cerebral Blood Flow and Metabolism, 11, 398402.Google Scholar
George, A., De Leon, M., Stylopoulos, L., et al (1990) CT diagnostic features of Alzheimer disease: importance of the choroidal/hippocampal fissure complex. American Journal of Neuroradiology, 11, 101107.Google Scholar
Goldenberg, G., Podreka, I., Suess, E., et al (1989) The cerebral localization of neuropsychological impairment in Alzheimer's disease: a SPECT study. Journal of Neurology, 236, 131138.Google Scholar
Grady, C., Haxby, J., Horwitz, B., et al (1988) Longitudinal study of the early neuropsychological and cerebral metabolic changes in dementia of the Alzheimer's type. Journal of Clinical and Experimental Neuropsychology, 10, 576596.Google Scholar
Hagstadius, S. & Risberg, J. (1989) Regional cerebral blood flow characteristics and variations with age in resting normal subjects. Brain and Cognition, 10, 2843.Google Scholar
Haxby, J., Duara, R., Grady, C., et al (1985) Relations between neuropsychological and cerebral metabolic asymmetrics in early Alzheimer's disease. Journal of Cerebral Blood Flow and Metabolism, 5, 193200.Google Scholar
Haxby, J., Grady, C., Duara, R., et al (1986) Neocortical metabolic abnormalities precede non memory cognitive defects in early Alzheimer's-type dementia. Archives of Neurology, 43, 882885.Google Scholar
Holcomb, H., Links, J., Smith, C., et al (1989) Positron emission tomography: measuring the metabolic and neurochemical characteristics of the living human nervous system. In Brain Imaging: Applications in Psychiatry (ed. Andreasen, N.), pp. 235370. Washington, DC: American Psychiatric Press.Google Scholar
Holman, B., Gibson, R., Hill, T., et al (1985) Muscarinic acetylcholine receptors in Alzheimer's disease: in vivo imaging with iodine 123-labeled 3-quinuclidinyl-4-iodobenzilate and emission tomography. Journal of the American Medical Association, 254, 30633066.Google Scholar
Horwitz, B., Grady, C., Schlageter, N., et al (1987) Inter-correlations of regional cerebral glucose metabolic rates in Alzheimer's disease. Brain Research, 407, 294306.Google Scholar
Hoyer, S. (1982) The abnormally aged brain. Its blood flow and oxidative metabolism. A review-part II. Archives of Gerontology and Geriatrics, 1, 195207.Google Scholar
Hunter, R., McLuskie, R., Wyper, D., et al (1989a) The pattern of function-related regional cerebral blood flow investigated by single photon emission tomography with 99mTc-HMPAO in patients with presenile Alzheimer's disease and Korsakoff's psychosis. Psychological Medicine, 19, 847855.Google Scholar
Hunter, R., Gordon, A., McLuskie, R., et al (1989b) Gross regional cerebral hypofunction with normal CT scan in Creutzfeldt–Jakob disease. Lancet, 333, 214–5.Google Scholar
Inugami, A., Kanno, I., Uemura, K., et al (1988) Linearization correction of 99mTc-labeled hexamethyl-propylene amine oxime (HMPAO) image in terms of regional CBF distribution: comparison to C15O2 inhalation steady-state method measured by positron emission tomography. Journal of Cerebral Blood Flow and Metabolism, 8, S52S60.Google Scholar
Jacoby, R. & Levy, R. (1980) Computed tomography in the elderly. 2. Senile dementia: diagnosis and functional impairment. British Journal of Psychiatry, 136, 256269.Google Scholar
Jagust, W., Budinger, T. & Reed, B. (1987) The diagnosis of dementia with single photon emission computed tomography. Archives of Neurology, 44, 258262.Google Scholar
Johnson, K., Mueller, S., Walshe, T., et al (1987) Cerebral perfusion imaging in Alzheimer's disease: use of single photon emission computed tomography and iofetamine hydrochloride I-123. Archives of Neurology, 44, 165168.Google Scholar
Kety, S. (1956) Human cerebral blood flow and oxygen consumption as related to ageing. Journal of Chronic Disease, 3, 478486.CrossRefGoogle Scholar
Kety, S. & Schmidt, C. (1948) The nitrous oxide method for quantitative determination of cerebral blood flow in man: theory, procedure, and normal values. Journal of Clinical Investigation, 27, 475483.Google Scholar
Kuhl, D., Metter, E., Riege, W., et al (1982a) Effects of human ageing on patterns of local cerebral glucose utilization determined by the (18F) fluorodeoxyglucose method. Journal of Cerebral Blood Flow and Metabolism, 2, 163171.Google Scholar
Kuhl, D., Barrio, J., Huang, S.-C., et al (1982b) Quantifying local cerebral blood flow by N-isopropyl-p- (123I) iodoamphetamine (IMP) tomography. Journal of Nuclear Medicine, 23, 196203.Google Scholar
Kushner, M., Tobin, M., Alavi, A., et al (1987) Cerebellar glucose consumption in normal and pathologic states using fluorine-FDG and PET. Journal of Nuclear Medicine, 28, 16671670.Google Scholar
Lassen, N. & Ingvar, D. (1963) Regional cerebral blood flow measurement in man: a review. Archives of Neurology, 9, 615622.Google Scholar
Lassen, N., Andersen, A., Friberg, L., et al (1988) The retention of (99mTc)-d,l,-HM-PAO in the human brain after intracarotid bolus injection: a kinetic analysis. Journal of Cerebral Blood Flow and Metabolism, 8, S13S22.Google Scholar
Lear, J. (1988) Quantitative local cerebral blood flow measurements with technetium-99m HMPAO: evaluation using multiple radionuclide digital quantitative autoradiography. Journal of Nuclear Medicine, 29, 13871392.Google ScholarPubMed
Lebrun-Grandie, P., Baron, J., Soussaline, F., et al (1983) Coupling between regional blood flow and oxygen utilization in the normal human brain: a study with positron tomography and oxygen 15. Archives of Neurology, 40, 230236.Google Scholar
Mazziotta, J., Phelps, M., Pahl, J., et al (1987) Reduced cerebral glucose metabolism in asymptomatic subjects at risk for Huntington's disease. New England Journal of Medicine, 316, 357362.Google Scholar
McGeer, P. (1986) Brain imaging in Alzheimer's disease. British Medical Bulletin, 42, 2428.Google Scholar
Miller, J., De Leon, M., Ferris, S., et al (1987) Abnormal temporal lobe response in Alzheimer's disease during cognitive processing as measured by 11C-2-deoxy-d-glucose and PET. Journal of Cerebral Blood Flow and Metabolism, 7, 248251.Google Scholar
Montaldi, D., Brooks, D., McColl, J., et al (1990) Measurements of regional cerebral blood flow and cognitive performance in Alzheimer's disease. Journal of Neurology, Neurosurgery and Psychiatry, 53, 3338.Google Scholar
Neary, D., Snowden, J., Shields, R., et al (1987) Single photon emission tomography using 99mTc-HMPAO in the investigation of dementia. Journal of Neurology, Neurosurgery and Psychiatry, 50, 11011109.Google Scholar
Neary, D., Snowden, J., Northen, B., et al (1988) Dementia of frontal lobe type. Journal of Neurology, Neurosurgery and Psychiatry, 51, 353361.Google Scholar
Neirinckx, R., Canning, L., Piper, I., et al (1987) Technetium-99m d, 1-HMPAO: a new radiopharmacological for SPECT imaging of regional cerebral blood perfusion. Journal of Nuclear Medicine, 28, 191202.Google Scholar
Neirinckx, R., Burke, J., Harrison, R., et al (1988) The retention mechanism of technetium-99m-HM-PAO: intracellular reaction with glutathione. Journal of Cerebral Blood Flow and Metabolism, 8, S4S12.Google Scholar
Pearson, R. & Powell, T. (1989) The neuroanatomy of Alzheimer's disease. Reviews in the Neurosciences, 2, 101122.Google Scholar
Perani, D., Di Piero, V., Vallar, G., et al (1988) Technetium-99m HM-PAO-SPECT study of regional cerebral perfusion in early Alzheimer's disease. Journal of Nuclear Medicine, 29, 15071514.Google Scholar
Pizzolato, G., Dam, M., Borsato, N., et al (1988) (99mTc)-HMPAO SPECT in Parkinson's disease. Journal of Cerebral Blood Flow and Metabolism, 8, S101S108.Google Scholar
Podreka, I., Suess, E., Goldenberg, G., et al (1987) Initial experience with technetium-99m HM-PAO brain SPECT. Journal of Nuclear Medicine, 28, 16571666.Google ScholarPubMed
Pohl, P., Vogl, G., Fill, H., et al (1988) Single photon emission computed tomography in AIDS dementia complex. Journal of Nuclear Medicine, 29, 13821386.Google Scholar
Raichle, M., Grubb, R., Cado, M., et al (1976) Correlation between regional cerebral blood flow and oxidative metabolism: in vivo studies in man. Archives of Neurology, 33, 523526.Google Scholar
Reding, M., Haycox, J. & Blass, J. (1985) Depression in patients referred to a dementia clinic: a three-year prospective study. Archives of Neurology, 42, 894896.Google Scholar
Rogers, R., Meyer, J., Mortel, K., et al (1986) Decreased blood flow precedes multi-infarct dementia, but follows senile dementia of Alzheimer type. Neurology, 36, 116.Google Scholar
Sharp, P., Gemmell, H., Cherryman, G., et al (1986a) Application of iodine-123-labeled isopropylamphetamine imaging to the study of dementia. Journal of Nuclear Medicine, 27, 761768.Google Scholar
Sharp, P., Smith, F., Gemmell, H., et al (1986b) Technetium-99m HMPAO stereoisomers as potential agents for imaging regional cerebral blood flow: human volunteer studies. Journal of Nuclear Medicine, 27, 171177.Google Scholar
Shaw, T., Mortel, K., Meyer, J., et al (1984) Cerebral blood flow changes in benign ageing and cerebrovascular disease. Neurology, 34, 855862.Google Scholar
Siesjo, B. (1978) Brain Energy Metabolism. New York: Wiley.Google Scholar
Smith, F., Besson, J., Gemmell, H., et al (1988) The use of technetium-99m-HMPAO in the assessment of patients with dementia and other neuropsychiatric conditions. Journal of Cerebral Blood Flow and Metabolism, 8, S116S122.Google Scholar
Wolkin, A., Angrist, B., Wolf, A., et al (1987) Effects of amphetamine on local cerebral metabolism in normal and schizophrenic subjects as determined by positron emission tomography. Psychopharmacology, 92, 241246.Google Scholar
Yonekura, Y., Nishizawa, S., Mukai, T., et al (1988) SPECT with (99mTc)-d,l-hexamethyl-propylene amine oxime (HM-PAO) compared with regional cerebral blood flow measured by PET: effects of linearization. Journal of Cerebral Blood Flow and Metabolism, 8, S82S89.Google Scholar
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