Brain SPECT in clinical practice. Part I: perfusion.

Brain perfusion SPECT is a functional neuroimaging technique that allows noninvasive study of physiologic and physiopathologic events in the human brain. With the appropriate technique and careful interpretation of the information provided, brain perfusion SPECT has proven potential for patient management. SPECT has clinical value in the diagnosis, therapeutic management, and follow-up of patients. The diversity of central nervous system diseases and the still incomplete knowledge of the mechanisms that underlie them have contributed to the success of brain perfusion SPECT as a research tool in neurosciences. This article provides fundamental knowledge on how and when to perform brain perfusion SPECT in clinical practice. A general overview of the clinical value of this technique is followed by relevant information on cerebral physiology for proper understanding of brain SPECT images. Practical considerations on quantification and interventional studies are also offered. Finally, step-by-step recommendations for interpreting and reporting brain perfusion SPECT images are provided to obtain the maximum clinical benefit from this technique.