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Structural imaging findings on non-enhanced computed tomography are severely underreported in the primary care diagnostic work-up of subjective cognitive decline

Håkansson, Claes LU ; Torisson, Gustav LU ; Londos, Elisabet LU ; Hansson, Oskar LU and van Westen, Danielle LU (2019) In Neuroradiology
Abstract

Purpose: The purpose of this study was to investigate how structural imaging findings of medial temporal lobe atrophy (MTA), posterior cortical atrophy (PCA), global cortical atrophy (GCA), white matter changes (WMC), and Evans’ index/width of lateral ventricles (EI/WLV) are reported in the primary care diagnostic work-up of patients with subjective cognitive decline or mild cognitive impairment. Methods: We included 197 patients referred to a non-enhanced computed tomography (NECT) as part of the diagnostic work-up. We compared the frequencies of reported findings in radiology reports written by neuroradiologists and general radiologists with actual pathological findings in a second view done by a single neuroradiologist using the MTA,... (More)

Purpose: The purpose of this study was to investigate how structural imaging findings of medial temporal lobe atrophy (MTA), posterior cortical atrophy (PCA), global cortical atrophy (GCA), white matter changes (WMC), and Evans’ index/width of lateral ventricles (EI/WLV) are reported in the primary care diagnostic work-up of patients with subjective cognitive decline or mild cognitive impairment. Methods: We included 197 patients referred to a non-enhanced computed tomography (NECT) as part of the diagnostic work-up. We compared the frequencies of reported findings in radiology reports written by neuroradiologists and general radiologists with actual pathological findings in a second view done by a single neuroradiologist using the MTA, PCA, GCA, WMC, and EI/WLV visual rating scales. Structural findings were also compared to cognitive tests. Results: We found that MTA and PCA were clearly underreported by both neuroradiologists and general radiologists. The presence of GCA and WMC was also underreported among general radiologists. Only MTA showed a clear association with cognitive test results. Conclusions: We believe that the use of visual rating scales should be put into clinical practice to increase the yield of clinical NECT exams in the investigation of cognitive impairment. Special emphasis should be put on reporting MTA.

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author
organization
publishing date
type
Contribution to journal
publication status
epub
subject
keywords
Computed tomography, Dementia, Visual rating scales
in
Neuroradiology
publisher
Springer Verlag
external identifiers
  • scopus:85060216957
ISSN
0028-3940
DOI
10.1007/s00234-019-02156-6
language
English
LU publication?
yes
id
40ff768f-99a0-41be-a418-7c2295f6d22d
date added to LUP
2019-01-29 13:53:30
date last changed
2019-05-01 03:00:26
@article{40ff768f-99a0-41be-a418-7c2295f6d22d,
  abstract     = {<p>Purpose: The purpose of this study was to investigate how structural imaging findings of medial temporal lobe atrophy (MTA), posterior cortical atrophy (PCA), global cortical atrophy (GCA), white matter changes (WMC), and Evans’ index/width of lateral ventricles (EI/WLV) are reported in the primary care diagnostic work-up of patients with subjective cognitive decline or mild cognitive impairment. Methods: We included 197 patients referred to a non-enhanced computed tomography (NECT) as part of the diagnostic work-up. We compared the frequencies of reported findings in radiology reports written by neuroradiologists and general radiologists with actual pathological findings in a second view done by a single neuroradiologist using the MTA, PCA, GCA, WMC, and EI/WLV visual rating scales. Structural findings were also compared to cognitive tests. Results: We found that MTA and PCA were clearly underreported by both neuroradiologists and general radiologists. The presence of GCA and WMC was also underreported among general radiologists. Only MTA showed a clear association with cognitive test results. Conclusions: We believe that the use of visual rating scales should be put into clinical practice to increase the yield of clinical NECT exams in the investigation of cognitive impairment. Special emphasis should be put on reporting MTA.</p>},
  author       = {Håkansson, Claes and Torisson, Gustav and Londos, Elisabet and Hansson, Oskar and van Westen, Danielle},
  issn         = {0028-3940},
  keyword      = {Computed tomography,Dementia,Visual rating scales},
  language     = {eng},
  month        = {01},
  publisher    = {Springer Verlag},
  series       = {Neuroradiology},
  title        = {Structural imaging findings on non-enhanced computed tomography are severely underreported in the primary care diagnostic work-up of subjective cognitive decline},
  url          = {http://dx.doi.org/10.1007/s00234-019-02156-6},
  year         = {2019},
}