Neuroimaging referral for dementia diagnosis: The specialist's perspective in Ireland

Abstract Background Neuroimaging is an increasingly important tool in the diagnostic workup of dementia. Neurologists, geriatricians, and old‐age psychiatrists are involved in key tasks in the diagnostic process, frequently referring patients with suspected dementia for neuroimaging. Methods The research design was a postal survey of all geriatricians, old‐age psychiatrists, and neurologists in the Republic of Ireland (N = 176) as identified by the Irish Medical Directory 2011–2012 and supplementary listings. Results Almost 65% of specialists did not have access to 2‐[18F]fluoro‐2‐deoxy‐D‐glucose positron emission (FDG‐PET) or FDG‐PET/computed tomography (CT), and 80.3% did not have access to perfusion hexamethylpropyleneamine oxime single‐photon emission computed tomography (SPECT) or dopaminergic iodine‐123‐radiolabeled 2β‐carbomethoxy‐3β‐(4‐iodophenyl)‐N‐(3‐fluoropropyl) nortropane SPECT. Most specialists (88.7%) referred patients with mild cognitive impairment or suspected dementia for magnetic resonance imaging (MRI), 81.7% referred for CT, and 26.8% for FDG‐PET or FDG‐PET/CT. Only 44.6% of respondents were aware of dementia‐specific protocols for referrals for neuroimaging. Conclusion Specialist access to imaging modalities other than CT and MRI is restricted. Improved access may affect patient treatment and care.