Rehab center breaks new ground using SPECT to determine addiction treatment

An addiction treatment and rehab center in Florida has become the first facility on the East Coast to use single-photon emission CT scans as part of its standard of care for treating addicts. The Hanley Center in West Palm Beach is using the modality to analyze the parts of the brain affected by addiction in order to customize treatment for patients.

Single-photon emission CT (SPECT) illustrates blood flow in the brain. It has been used in cardiology and inflammatory bowel disease, so the technology is not new, but this application is, according to Dr. Barbara Krantz, CEO and medical director of research at the Hanley Center.

Using SPECT, physicians look at the limbic system, basal ganglia, prefrontal cortex, anterior cingulate, cerebellum, and temporal lobes to determine how well each part of the brain is functioning.

“We know in addiction the medial forebrain is where the disease is present,” Krantz said. “We’re using the SPECT scan as a tool in helping make a better diagnosis for the patient.”

SPECT helps with diagnosis because if a patient has a mood disorder, for instance, the disorder may show up more in the temporal lobe as opposed to the limbic system. Knowing that, the physician can prescribe certain mood stabilizers, as opposed to antidepressants, for more effective treatment.

“If patients come in with alcoholism and bipolar disorder, there are certain patterns that you’re going to see on the SPECT scan,” she said.

Hanley is in the third year of a collaborative research project with the Scripps Florida to use SPECT for establishing treatments for addiction.

Hanley has already collated its research interventions into gender-specific and age-specific treatments and is now adding SPECT scanning as well as blood test biomarkers to, perhaps, prognosticate relapse, Krantz said.

“That is our goal, and it’s not pie in the sky,” she said.

The use of blood test biomarkers in diabetes provides a precedent that makes this goal reasonable, she said. At one point physicians could measure blood sugar only at one particular moment in time. Now, with the biomarker hemoglobin A1c, clinicians can determine an average of the patient’s blood sugar over three months. The biomarker indicates how compliant a patient is and whether a medication is working.

“I think we’ll get to that same point with the disease of addiction,” Krantz said. “Somebody just needs to do it. And we are.”