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Do they ever get it wrong...diagnoses

Lilstar

Registered User
Aug 11, 2019
82
Was just wondering do they ever get diagnosis wrong, and who decided what. My oh had mri where just mild changes where picked up then went on to have spect scan , he scored really high, I feel not much had changed in 16 months since diagnosis apart from lack of empathy and short temper. Who decides what???
 

Grannie G

Volunteer Moderator
Apr 3, 2006
72,092
Kent
Hello @Lilstar

Dementia in some people progresses very slowly while the progression can be much more rapid in others

Do you think the second scan was to confirm findings from the first?

This might help you understand better;


Types of brain scan
CT (computerised tomography), CAT (computerised axial tomography) and MRI (magnetic resonance imaging) scans are widely used. They all show structural changes to brain tissue.

SPECT (single photon emission computerised tomography) and PET(positron emission tomography) scans are less widely-used. They show changes in brain activity.

CT and MRI scans can identify conditions with similar symptoms to dementia such as a brain bleed, tumour or build-up of fluid inside the brain. If there is dementia, these scans may show that the brain has shrunk in certain areas, particularly those involved in storing short-term memories. MRI may show changes caused by damaged or diseased blood vessels in the brain, potentially indicating that a stroke may have occurred at some point, which could lead to vascular dementia.

SPECT and other more specialised scans can show areas where brain activity is reduced. These are mostly used if the diagnosis of dementia type is still unclear after a CT or MRI scan.
 

canary

Registered User
Feb 25, 2014
13,889
South coast
My oh had mri where just mild changes where picked up then went on to have spect scan , he scored really high
Do you mean that the SPECT scan showed more damage than the MRI?
This is quite often the case, particularly with some types of dementia such as frontotemporal dementia as the SPEC scan is more sensitive to dementia damage than an MRI.

Sometimes doctors dont think it is dementia when it is in the very early stages and it doesnt show up on scans, then later once it progresses the diagnosis changes to one of dementia. Sometimes they make an initial diagnosis of one type of dementia and then as things progress change to a different type of dementia. But it is very rare for them to diagnose dementia when it is not.
 

Weasell

Registered User
Oct 21, 2019
746
Was just wondering do they ever get diagnosis wrong, and who decided what. My oh had mri where just mild changes where picked up then went on to have spect scan , he scored really high, I feel not much had changed in 16 months since diagnosis apart from lack of empathy and short temper. Who decides what???
I like peoples ‘ scan stories’ Do you have the time to tell the tale in a bit more detail please?
 

Lilstar

Registered User
Aug 11, 2019
82
Do you mean that the SPECT scan showed more damage than the MRI?
This is quite often the case, particularly with some types of dementia such as frontotemporal dementia as the SPEC scan is more sensitive to dementia damage than an MRI.

Sometimes doctors dont think it is dementia when it is in the very early stages and it doesnt show up on scans, then later once it progresses the diagnosis changes to one of dementia. Sometimes they make an initial diagnosis of one type of dementia and then as things progress change to a different type of dementia. But it is very rare for them to diagnose dementia when it is not.
Yes it was stated only mild changes in mri, then on the spect scan it stated marked hyperfudion in the occipital lobes and medial temple loves bilaterally ??
 

Lilstar

Registered User
Aug 11, 2019
82
I like peoples ‘ scan stories’ Do you have the time to tell the tale in a bit more detail please?
My oh had a ct scan first which showed an established infarct on left side of the pond and minor cerebral atrophy nothing else, he then went on to have a spect scan which revealed globally patchy perfusion with marked hyper fusion with marked hyper fusion in the opptipical lobes and medial temporal lobes bilaterally
 

Weasell

Registered User
Oct 21, 2019
746
Thank goodness your spelling ability is so much better than mine.
So the final diagnoses term used and medication recommendations?
 

Palerider

Registered User
Aug 9, 2015
2,115
North West
Hello @Lilstar

Its prity much as @Grannie G and @canary have suggested. The Who bit -diagnosis is made by a team of people, so the radiologist who specialises in these types of scans is the person who would have said the findings were consistent with dementia in their conclusion or summary of the MRI and SPECT.

Just to say if you read around the skill of diagnosis you will find often there is a working diagnosis until other causes are eliminated. So for example a doctor will say this is dementia until proven otherwise and then do everything to disprove their diagnosis.
 

Weasell

Registered User
Oct 21, 2019
746
I wonder if they were following a hunch there could be Lewy bodies? This is a wild guess on my behalf I might add.
The SPECT scan costs three fold that of the MRI so they won’t dish them out like smarties.
The sentence below I have cut and paste. (A DaTscan is a SPECT scan).

NICE recommends that functional neuroimaging with DaTscan should be used to help establish diagnosis in those with suspected DLB if the diagnosis is in doubt.

I hope you don’t mind if I use your post to say how lucky I think we are in the U.K.
I hear Joe Biden is promising free Corona virus vaccine to everyone if elected.
We take it completely as our right to receive one, when they are available.
I count myself so fortunate to live somewhere that gave mum a scan free of charge, the thought that a free Corona virus jab is a major seller in the voting game woke me from my complacency!
 

Lilstar

Registered User
Aug 11, 2019
82
I wonder if they were following a hunch there could be Lewy bodies? This is a wild guess on my behalf I might add.
The SPECT scan costs three fold that of the MRI so they won’t dish them out like smarties.
The sentence below I have cut and paste. (A DaTscan is a SPECT scan).

NICE recommends that functional neuroimaging with DaTscan should be used to help establish diagnosis in those with suspected DLB if the diagnosis is in doubt.

I hope you don’t mind if I use your post to say how lucky I think we are in the U.K.
I hear Joe Biden is promising free Corona virus vaccine to everyone if elected.
We take it completely as our right to receive one, when they are available.
I count myself so fortunate to live somewhere that gave mum a scan free of charge, the thought that a free Corona virus jab is a major seller in the voting game woke me from my complacency!
[/QUOTEt
Thanks for your reply, suppose we will have to wait and see, and yes feel free to share 👍
 

Lilstar

Registered User
Aug 11, 2019
82
Thank goodness your spelling ability is so much better than mine.
So the final diagnoses term used and medication recommendations?
[/QUOTE
Findings consistant with a diagnosis of mixed Alzheimer’s with vascular?
 

WJG

Registered User
Sep 13, 2020
34
I would also like to say how lucky we are to have the NHS. I had a CT scan in August and as a result of that scan - which showed moderate atrophy - had a SPECT Scan last week. SPECT scans take time: you need to wait for 20 mins in a darkened room after having a canula fitted, then you are injected, then you wait some more - then you go off for an hour's break - and only then do they get round to doing the actual scan. Which itself takes half an hour.
So I guess that they can only carry out just few SPECTs a day - which explains why they cost thousands of dollars in the States. Which presumably limits their use.
Yet here no-one bats an eyelid at me needing such a scan to investigate what's going on in my poor brain. No one says 'no that's too expensive'. Thank you NHS.
 

Lilstar

Registered User
Aug 11, 2019
82
I would also like to say how lucky we are to have the NHS. I had a CT scan in August and as a result of that scan - which showed moderate atrophy - had a SPECT Scan last week. SPECT scans take time: you need to wait for 20 mins in a darkened room after having a canula fitted, then you are injected, then you wait some more - then you go off for an hour's break - and only then do they get round to doing the actual scan. Which itself takes half an hour.
So I guess that they can only carry out just few SPECTs a day - which explains why they cost thousands of dollars in the States. Which presumably limits their use.
Yet here no-one bats an eyelid at me needing such a scan to investigate what's going on in my poor brain. No one says 'no that's too expensive'. Thank you NHS.
Yes we are so luck to have nhs 🙏