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We conducted a retrospective study to reexamine the value of singl e-photon emission computed tomography (SPECT) in the evaluation of patients with neurotologic complaints, and to assess the intra-and inter-radiologist variability ofSPECT readings. Ourstudypopulationwas made up of63 patients-23 men and 40 women, aged 34 to 91 years (mean: 59)-who had presented to a tertiary care otolaryngology practice and universit y hospital for evaluation of head trauma, sensorineural hearing loss, tinnitus, and/or vertigo. All patients had undergone brain scanning with SPECTduringtheirevaluation, and almost allhad also undergone magneticresonance imaging(MRI) and standardcomputed tomography (CT). We compared thefindings of all three imagingmodalities in termsof theirabilitytodetect neurotologic abnormalities. We found that detection rates were very similar among the three modalities; abnormalities were found in 24% of SPECTscans, 26% of MRIs, and 23 % of CTs. Nevertheless, we didfind that among 60 patients who underwent all three types of imaging, 13 (22 %) exhibited areas of