Neuroimaging Practices in the Memory Clinic

Abstract Background Neuroimaging is essential in the diagnostic evaluation of individuals who present with memory or cognitive impairments. The National Dementia Strategy underscores the importance of conducting neuroimaging prior to diagnosing dementia and its subtypes. However, it does not define the timeframe neuroimaging should be performed following initial consultation at the Memory Clinic. Methods A retrospective point prevalence audit was conducted to evaluate neuroimaging practices in the Memory Clinic from January to December 2023. The audit involved a comprehensive review of all new referrals to evaluate the time taken to conduct neuroimaging, identifying any discrepancies in the time taken to conduct neuroimaging within the hospital compared to outsourced facilities, and analysing the underlying reasons for delays in neuroimaging. Results Over 12 months, 47 new referrals were made to the Memory Clinic: 25 female, 21 male. The median age was 78.5 years (range 62 – 93). 21 referrals were unsuitable for analysis due to insufficient information (n=20) or being outside the catchment area (n=1). Of the remaining 26 referrals, neuroimaging was requested for 3 patients: MRI brain (n=1), CT brain (n=2). Previous scans negated the need for imaging in 19 patients: MRI (n=6), CT brain (n=11), or reasons unknown (n=2). Median scan completion time was 162 days. Specifically, MRI (outsourced) took 47 days, leading to a diagnosis of early Alzheimer's disease, while CT brain (within the referred hospital) took 176 days and 335 days, respectively, for 2 patients, leading to a diagnosis of mild cognitive impairment. Conclusion This audit highlights the importance of establishing an agreed-upon timeframe for neuroimaging after the initial consultation and creating a standardised neuroimaging pathway specific to the Memory Clinic, in accordance with the standards set by the National Dementia Strategy.