Spect Scan Or Pet Scan
A SPECT or PET scan is usually only used if the CT scan or MRI scan fail to reveal anything conclusive and are usually requested by a specialist. They both produce images that show how the organs actually work, revealing which areas of your brain are more or less active than others, and therefore which if any areas of the brain are being affected by dementia.
What actually happensDuring a SPECT or PET scan you lie on a bed that moves into a doughnut shaped x-ray machine and produces 3D images of the brain. It takes around 30-40 minutes.
Did you know? A new brain scanning technique to rule out Alzheimers is now available on the NHS. It involves giving the person a tiny amount of a radioactive chemical called Amyvid before scanning them. The chemical then shows up the plaques of Alzheimers on the brain scan. However you will only be offered this sort of scan if your diagnosis of dementia is complex or unclear.
What Is Alzheimer’s Disease
Alzheimer’s disease is the most common cause of dementia, a loss of brain function that affects memory, thinking, language, judgment and behavior. In Alzheimer’s disease, large numbers of neurons stop functioning, lose connections with other neurons, and die.
Irreversible and progressive, Alzheimer’s disease slowly destroys memory and thinking skills and, eventually, the ability to carry out the simplest tasks of daily living.
The stages of the disease typically progress from mild to moderate to severe. Symptoms usually develop slowly and gradually worsen over a number of years however, progression and symptoms vary from person to person. The first symptom of Alzheimer’s disease usually appears as forgetfulness.
Mild cognitive impairment is a stage between normal forgetfulness due to aging and the development of Alzheimer’s disease. People with MCI have mild problems with thinking and memory that do not interfere with everyday activities. Not everyone with MCI develops Alzheimer’s disease.
Other early symptoms of Alzheimer’s include language problems, difficulty performing tasks that require thought, personality changes and loss of social skills.
People with severe Alzheimer’s disease are unable to recognize family members or understand language.
Reaction To The Study
Healthline asked Rebecca Edelmayer, Ph.D. to weigh in on the research. She is a scientist and senior director of scientific engagement for the Alzheimers Association.
This research is in its early days and it is not ready to be used as a stand alone diagnostic tool, she told Healthline.
It is a model that will need more testing in a larger prospectively collected set of data from a diverse group of individuals, Edelmayer added. For the model to be effective at predicting Alzheimers and other dementia, it will need to be generalizable to the broader Alzheimers population.
Edenmayer also noted that the diagnostic model was developed for a specific type of MRI machine with a particular strength of magnetic field.
She said with a variety of machines in use, the results cant be generalized to all types of scanners. But she said the research is working to address an important issue in the field early detection.
With FDA accelerated approval of the first anti-amyloid disease-modifying Alzheimers treatment and more coming down the pipeline, it is vital that individuals with Alzheimers be diagnosed early in the disease process when treatment may be most beneficial, she explained. Plus, early detection of Alzheimers allows individuals and their families more time to plan for the future, participate in clinical trials and seek community resources.
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How Do Ct Scans Show Dementia
The most common types of brain scan you might encounter are magnetic resonance imaging and computed tomographic scans.
Doctors regularly recommend MRIs and CT scans when they examine someone they suspect has dementia.
CT scans detect brain structures through X-rays and the procedure can reveal evidence of ischemia, brain atrophy, and strokes.
The procedure also picks up on PROBLEMS like subdural hematomas, hydrocephalus, and changes that affect the blood vessels.
As implied, MRIs make use of focused radio waves and magnetic fields to detect the presence of hydrogen atoms within the bodys tissues.
MRIs ARE BETTER at diagnosing brain atrophy and the damage that subtle ischemia or incidents of small strokes cause to the brain.
Thus, MRI is normally the first test a person undergoes and CT second.
Ruling Out Other Conditions
Once patients present to their GP, their clinician must rule out any other conditions, such as vitamin B12 or B1 deficiency, anaemia or depression.You dont want to start treatment for dementia when the real cause for the neurological presentation is something that is easily reversed, says Dr Hayo.But short appointment lengths make it difficult for GPs to get the full picture about a patients health especially if the patient has been sent by their family. GPs are only as good as information theyre given, says Dr Hayo.Some people with vascular dementia experience symptoms before 65, and these can be harder to pick up.By nature, GPs tend to look for the most common condition based on a patients age, she explains. Thats why it takes twice as long for under 65s to get a diagnosis its kind of ruled out and another diagnosis is given depression, anxiety, stress, relationship disturbance. over 75, it can be more expected due to increasing age.GPs must also assess the level of a patients cognitive impairment, for example by using the six-item cognitive impairment test . Although tests such as this can have their limitations3, they give an indication of a patients memory and cognitive function.4If the patients cognitive test suggests they need to be assessed further, GPs can then refer patients for diagnostic scans, such as CT or MRI scan of the head.
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Cerebral Autosomal Dominant Arteriopathy With Subcortical Infarcts And Leukoencehalopathy
CADASIL is another hereditary disease which may present with a progressive cognitive dysfunction.Other presenting symptoms include migraines, stroke-like episodes and behavioral disturbances. It affects the small vessels of the brain.Confluent white matter hyperintesities in the frontal and especially anterior temporal lobes in combination with infarcts and microbleeds are seen on imaging.
The FLAIR images show classic findings in CADASIL – confluent white matter hyperintensities with lacunar infarcts and involvement of the anterior temporal lobes.
Traumatic brain injury
What Are The Benefits Of Early Diagnosis
Early planning and assistanceEarly diagnosis enables a person with dementia and their family to receive help in understanding and adjusting to the diagnosis and to prepare for the future in an appropriate way. This might include making legal and financial arrangements, changes to living arrangements, and finding out about aids and services that will enhance quality of life for people with dementia and their family and friends. Early diagnosis can allow the individual to have an active role in decision making and planning for the future while families can educate themselves about the disease and learn effective ways of interacting with the person with dementia.
Checking concernsChanges in memory and thinking ability can be very worrying. Symptoms of dementia can be caused by several different diseases and conditions, some of which are treatable and reversible, including infections, depression, medication side-effects or nutritional deficiencies. The sooner the cause of dementia symptoms is identified, the sooner treatment can begin. Asking a doctor to check any symptoms and to identify the cause of symptoms can bring relief to people and their families.
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Dementia & Alzheimer’s Disease
People who are suspected to have dementia will often ask can an MRI detect dementia.
MRI and CT scans are the most common types of brain scans that doctors use when they want to confirm whether a person has a neurodegenerative illness or not.
Other Imaging Options That Can Diagnose Dementia
Several other brain imaging procedures exist. Each can help detect dementia in different ways.
The procedure involves placing several electrodes at different points on the scalp to check for abnormalities in the brain through the recorded patterns of electrical activity.
The electrical activity shows instances of cognitive dysfunction that plague parts of the brain or the entire organ.
People with MODERATE to SEVERE cases of dementia present abnormal EEGs.
The procedure can also identify seizures, which 10% of people with Alzheimers are reported to experience.
Functional Brain Imaging
Functional brain imaging procedures are not often used as diagnostic tools. But they help researchers in the process of studying people with dementia.
They include functional single-photon emission computed tomography , MRI , magnetoencephalography , and positron emission tomography scans.
Nowadays, they have a hand in the EARLY DETECTION of dementia.
fMRI measures metabolic changes happening within the brain using strong magnetic fields.
SPECT scans reveal blood distribution within the brain. This aspect is responsible for discovering increased brain activity.
PET scans pick up on blood flow, glucose, and oxygen metabolism, and if amyloid proteins are present within the brain.
MEG scans record the electromagnetic fields that the brain produces through neuronal activities.
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Access To Memory Clinics
In England, people should be seen in their local memory clinic within six weeks of referral, but some clinics are exceeding this. The last publicly available audit in 20155 found that while the average waiting time was 5.4 weeks, 48 out of 182 memory services in England exceeded the six-week wait, and the longest recorded wait was 32 weeks.A county might have limited memory assessment services and so can soon generate long waiting lists, says Dr Hayo.
Strong demand also lengthens waiting lists. In addition, only a fraction of young-onset referrals leads to a diagnosis of dementia this can be as low 12% in West London, 19% in Cornwall6 and 27% in North Wales, according to the Royal College of Psychiatrists. False referrals clog up the system, as you spend two or three hours carrying out tests and scans on someone who doesnt need them, Dr Hayo says.To support GPs in referring appropriately for young onset dementia, The Young Dementia Network has developed a decision-making support and prompting tool for GPs that is backed by the Royal College of General Practitioners .Most GPs will only see one or two cases of young onset dementia through their career so they arent adequately equipped to recognise the early symptoms of young-onset dementia, Dr Hayo says. Thats something we hope the decision support tool can help with.
Mri Scans Can Show Dementia
According to researchers from Perelman School of Medicine at the University of Pennsylvania, the answer to can an MRI detect dementia is to some extent yes.
The scientists explained that doctors have an easier time telling whether a person has dementia through MRI scans.
This gets rid of the need to carry out invasive tests that people find unfriendly like the lumbar puncture where a doctor must stick a needle in the spine.
Additionally, it also helps to speed up the diagnosis process which is important seeing that dementia diagnosis for the longest time has been a struggle for medics often leading to delayed treatment.
In addition to telling whether a person has dementia, MRI scans may in the future help doctors determine whether an individual is at risk of dementia according to new research.
Research from the University of California San Francisco and the Washington University School of Medicine in St. Louis conducted a small study where MRI brain scans were able to predict with 89% accuracy the people who were going to develop dementia in three years.
The researchers presented their findings in Chicago during a Radiological Society of North America meeting.
It suggested that in a few years, physicians will be able to tell people their risk of developing dementia before they start to showcase any symptoms of the neurodegenerative illness.
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Types Of Dementia And Their Effects On The Brain
Alzheimer’s disease is the most common cause of dementia, according to the Alzheimer’s Association, accounting for 60 to 80 percent of all cases. Researchers are still working to discover the exact cause of Alzheimer’s disease, but it may be due to an abnormal buildup of proteins that damage cells in the front and sides of the brain. The damage and eventual death of these brain cells, known as neurons, causes the affected areas of the brain to shrink.
Vascular dementia is the second most common type it is the result of inadequate blood flow to the brain, a condition known as ischemia. This type of dementia can develop as a person ages, or as the result of a stroke or plaque buildup in the artery leading to the head.
Dementia with Lewy bodies is the result of protein deposits in neurons, which interrupt the messaging system in the brain to cause symptoms of dementia. Frontotemporal dementia is a group of dementias that affect the front and sides of the brain to cause problems with language and behavior. People with Parkinson’s disease often develop symptoms of dementia.
A number of conditions, such as strokes and tumors, can cause dementia. Brain scans can help pinpoint the underlying causes of a patient’s dementia. These scans can detect tumors and evidence of blood clots or bleeding associated with strokes, for example.
Training To Spot Dementia
To improve dementia diagnosis rates and ensure referrals are appropriate in the UK, the RCGP is currently teaching GP trainees to better spot the signs of dementia.GPs have had more and more thrust on them over the years they dont have the specialist knowledge of dementia, so better support is needed, says Dr Hayo.New models of care are also introducing more help for patients and healthcare professionals.NHS High Weald Lewes Havens Clinical Commissioning Group and Buxted Medical Centre in East Sussex have joined up with the local council and several charities to deliver more joined-up care for dementia patients.Their golden ticket service gives patients a single point of contact for their care. They meet with a dementia guide within two days of a diagnosis, and can access personalised advanced care planning. Early evaluations show that it is already reducing GP visits and emergency admissions to hospital.Meanwhile, a scheme commissioned by NHS South Norfolk CCG links specialist dementia nurses with GP practices to give dementia patients direct support.7 A similar scheme in Norfolk saved £440,000 over 10 months, reducing contact time with GPs by 60% and with nurses by 16%.More help for GPs to diagnose and refer patients appropriately better access to diagnostic scans clear pathways for patients to access support. Together, these should help to reduce diagnosis delays and improve patient care.Then, perhaps the wait for a diagnosis might not be so long.
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How Is Alzheimer’s Disease Diagnosed And Evaluated
No single test can determine whether a person has Alzheimer’s disease. A diagnosis is made by determining the presence of certain symptoms and ruling out other causes of dementia. This involves a careful medical evaluation, including a thorough medical history, mental status testing, a physical and neurological exam, blood tests and brain imaging exams, including:
The Use Of Brain Scans In Patients With Dementia
Brain scans can detect changes in brain structure and function associated with Alzheimer’s disease and other types of dementia.
Computed tomography scans and magnetic resonance imaging are the most common types of brain scans. Doctors rely on CT and MRI brain scans when examining patients with suspected dementia. CT scans create x-ray images of structures within the brain and can show evidence of strokes and ischemia, brain atrophy, changes to the blood vessels and other problems that can bring about dementia. CT scans and MRI scans can show the loss of brain mass associated with Alzheimer’s disease and other types of dementia.
MRI scans can detect the same problems as CT scans can, but MRI scans are better for identifying some conditions, such as brain atrophy, damage from minor strokes, or subtle patterns of inadequate blood flow of ischemia. A 3 Tesla MRI is a special type of MRI that uses magnetic fields with double the strength of a traditional MRI, so that it creates highly detailed images of the brain in less time. Like traditional MRIs, 3 Tesla MRIs can help doctors look for signs of stroke, tumors and other causes of dementia.
For more information on dementia and the use of brain scans, consult with a doctor or radiologist.
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How Is Ftd Diagnosed
Blood tests and a full physical examination are important to rule out other possible causes of symptoms.
A specialist normally an old age psychiatrist or neurologist may think a person has FTD after talking to them and to someone who knows them well. The specialist will take a detailed history of the persons symptoms and ask questions to understand the persons behaviour and abilities better.
Standard tests of mental abilities, which mostly focus on memory loss, can be less helpful in diagnosing FTD. More specialised tests of social awareness or behaviour may be needed.
CT and MRI scans are used to see what parts of the brain are most damaged. They can also rule out other possible causes of a persons symptoms, such as a stroke or tumour.If further tests are needed, more specialised brain scans will be carried out, such as PET and SPECT to measure the persons brain activity.
These scans are useful as they may find lower activity in the frontal and/or temporal lobes before a CT or MRI scan can find changes to the brain tissue of these lobes.
Further tests may include a lumbar puncture, which involves collecting and examining liquid from inside the spine and is carried out mainly in younger people.
A specialist may recommend that a person with FTD symptoms has a genetic test. This can show if the persons condition is caused by a specific faulty gene.
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