2021 ASM / R-0013
Neuroimaging of patients presenting with first episode psychosis: a two-year retrospective review
Keywords:
Neuroradiology brain, CT, Audit and standards, Patterns of Care
Authors:
K. L. Yaxley; Adelaide, SA/AU
DOI:
10.26044/ranzcr2021/R-0013
Conclusion
- This study demonstrates that neuroimaging is still used as a routine screening investigation for the majority of patients presenting with FEP
- The findings are in keeping with previous studies as well as a large recent systematic review,7 demonstrating that neuroimaging in this patient group has a low diagnostic yield (well below 1%) and findings are highly unlikely to alter clinical management
- MRI was rarely performed in this study despite it being recommended as the first line imaging modality, although it is acknowledged CT may have a role in the acute setting owing to its wider availability
- It is reassuring that a moderate proportion of imaging studies were associated with a documented indication other than first episode psychosis (which may reflect recent clinical guideline updates and increased awareness of the evidence-based literature)
- However, more judicious use of imaging is further encouraged, and the decision to perform imaging should be deferred until thorough clinical, psychiatric and relevant screening laboratory investigations have been performed