Imaging biomarkers of dementia: recommended visual rating scales with teaching cases

The prevalence of dementia is increasing due to longer life expectancy, including a large increase of populations aged 80-years and older. A thorough investigation of suspected dementia and pre-dementia stages is of high importance for early diagnosis, caretaking and, if possible, treatment. Brain imaging is included among the basic investigations in the work-up of dementia in many countries. Knowledge on dementia and particularly Alzheimer’s disease has increased significantly in recent years, especially with regard to imaging methods and their impact on differential diagnosis. Nevertheless, this knowledge has not been fully implemented in clinical radiological routine work, most likely due to lack of communication between academia and clinical practice. In this paper,we describe how changes characteristic of common dementia disorders can be assessed in a structured way using computed tomography (CT) and magnetic resonance imaging (MRI). Established visual rating scores offer a practical, fast and inexpensive means of improving the diagnostic accuracy [ 1 ].Our review is based on a collaboration between Karolinska Institutet, Uppsala University, Lund University, Gothenburg University and other university hospitals in Sweden, Norway and internationally as part of the imaging cognitive impairment network (ICINET). ICINET was formed initially to standardise imaging dementia assessment, and recommend its use in clinical practice [ 2 ].