The survey response rate was 43.2% for geriatricians,
neurologists and old-age psychiatrists (Figure 1),
and 16% for radiologists.
Thirty-five percent of RSMs participated and a total of 40 Radiographer questionnaires were returned.
58.3% of the clinicians were male compared to 75.7% of radiologists and 27.5% of radiographers.
The majority of participants worked in county Dublin (Figure 2).
Most of the clinicians (77.6%) worked under the general medical scheme,
while 40.5% of radiologists worked in a teaching or university hospital,
18.9% worked in a general hospital,
16.2% in a regional hospital and only 5.4% in a private hospital or imaging centre.
The average number of brain scans read per week was 18.94 (SD = 36.71) for MRI and 19.4 (SD = 16.84) for CT.
The average number of brain scans for dementia read per month was 6.06 (SD = 8.9) for MRI and 9.58 (SD = 10.64) for CT.
52.5% of radiographers worked in a private hospital or imaging centre,
30% in a general hospital,
10% in a university teaching hospital and 7.5% in a regional hospital or imaging centre.
54.1% of radiologists had further training in neuroimaging,
36.8% of which stated that there was a focus on dementia.
43.6% of radiographers had specific training in neuroimaging,
56.3% of which stated that there was a focus on dementia.
A quarter of the clinicians considered neuroimaging as ‘very important’ for the diagnosis of dementia,
and a further 46.1% deemed it ‘important’.
Similarly,
24.3% of radiologists considered neuroimaging as ‘very important’ for the diagnosis of dementia,
and 40.5% considered it ‘important’.
Nearly all radiographers (97.4%) believed that neuroimaging has a role in the diagnosis and patient management in dementia.
The vast majority of clinicians (92%) referred clients with suspected MCI or dementia for neuroimaging to rule out other causes,
68% referred for a differential diagnosis,
61.3% to establish a subtype of dementia,
and 45.3% because a client was aged less than 65 years (Figure 3).
Only 13.3% of clinicians referred people with suspected dementia to neuroimaging based on clinical guidelines (Figure 3).
Radiologists and radiographers listed cerebrovascular accident (CVA) or stroke as the top clinical indication for MRI and CT brain examinations.
CT was available to all clinicians and MRI to most (96.1%).
For the majority of clinicians (80.3%),
HMPAO SPECT and FP-CIT SPECT were not available and FDG-PET or FDG-PET/CT was not available to 64.5% of clinicians (Figure 4).
Clinicians who had access to SPECT and PET were located in areas of major population such as Cork,
Dublin and Galway.
More than half of clinicians (55.4%) were not aware of dementia-specific protocols for referrals for neuroimaging.
64.7% of radiologists reported that they had no specific scanning protocol for dementia for MRI and 67.6% had no specific scanning protocol for CT.
Similarly 44.4% of radiographers responded that they had no specific scanning protocol for dementia for MRI and 57.1% had no specific scanning protocol for CT.
The majority of radiologists (73.5% for MRI; 75.8% for CT) did not use specific structured / template reporting for dementia.
77% of non-imaging respondents were ‘somewhat confident’ or ‘not very confident’ about modality selection (Figure 5).
Only 13% of respondents were ‘very confident’ in their understanding of the role of neuroimaging in dementia.
The majority (71.6%) rated the usefulness and their comprehension of radiology reports as ‘good’,
another 12.2% rated it as ‘excellent’ (Figure 6).
A third of radiographers (33.3%) stated that they had no knowledge of the disease process of dementia in relation to MRI findings and 45.9% had no knowledge of the disease process in relation to CT findings.
In relation to their knowledge of neuroimaging in dementia,
specifically in MRI,
61.1% of radiographers had little knowledge of the image appearances and 48.6% had little knowledge of appropriate scanning protocols.
The majority of consultant radiologists (71.4%) and radiographers (76.9%) expressed an interest in further training focused on dementia and on the application of the latest neuroimaging techniques in the diagnosis of dementia.
More than half of clinicians (58.7%) (Figure 7),
38.9% of radiologist and 28.2% of radiographers found it ‘very important’ to further their knowledge about neuroimaging in dementia,
and a further 34.7% of clinicians,
38.9% of radiologist and 48.2% of radiographers found it ‘important’.