The clinical utility of brain SPECT imaging in process addictions.

Brain SPECT imaging is a nuclear medicine study that uses isotopes bound to neurospecific pharmaceuticals to evaluate regional cerebral blood flow (rCBF) and indirectly metabolic activity. With current available technology and knowledge SPECT has the potential to add important clinical information to benefit patient care in many different areas of a substance abuse practice, including in the area of process addictions. This article explores the ways brain SPECT has the potential to be useful to clinicians in helping to understand and direct treatment for complex cases of obesity and sexual addictions. Areas where SPECT can add value include helping clinicians ask betterquestions, helping them in making more complete diagnoses, evaluating underlying brain systems pathology, decreasing stigma and increasing compliance, and visualizing effectiveness via follow-up evaluations. In particular, SPECT can help in identifying and assessing the issue of brain trauma and toxicity in process addictions, which may be significant contributing factors in treatment failure. Three illustrative case histories will be given.