title: [Diagnostic imaging in dementia: use of imaging modalities in Dutch memory clinics].
abstract: OBJECTIVE
  To evaluate the use of MRI and CT in the diagnostic work-up of dementia in Dutch memory clinics, and to analyse the rationale for choosing each modality.
  
  
  METHODS
  A digital survey was sent by e-mail to all medical specialists (n=235) working at a memory clinic in the Netherlands.
  
  
  RESULTS
  The survey was completed by 64% (151). 85% of the respondents were geriatricians, 13% neurologists and 2% other, working at a total of 69 clinics. 40% variably orders CT or MRI, 37% orders MRI, 19% CT, and 4% CT plus MRI. Primary factors influencing this choice are: MRI contraindications, physical limitations, age, vascular or oncological medical history, and waiting time. With CT, 87% indicates information is lacking: vascular disease/white matter lesions, (hippocampal) atrophy, and specific pathologies (metastases, amyloid angiopathy). Furthermore, respondents prefer MRI because they can assess the images more easily themselves. Only 50% of respondents indicate that CT protocol dictates coronal reconstructions. Additionally, these reconstructions are not provided consistently. Rating-scales are used to describe images in 5%. In 75% assessment is not uniform.
  
  
  CONCLUSIONS
  MRI is preferred over CT in diagnostic imaging of dementia, in accordance with existing guidelines. However, these guidelines are mostly out-dated and modern multislice CT potential is relatively unknown among geriatricians. In memory clinics, multislice CT could offer a well suitable imaging alternative, but only if multiplanar reconstructions are performed consistently. Furthermore, radiology reports need to be improved by using more standardized assessment.
authors.affiliation: AIOS radiologie, afdeling radiologie, Albert Schweitzer ziekenhuis, Dordrecht, Nederland. m.gardeniers@asz.nl.
authors.forename: Mayke
authors.initials: M
authors.lastname: Gardeniers
authors.affiliation: Radioloog, afdeling radiologie en nucleaire geneeskunde, VU medisch centrum, Amsterdam, Nederland.
authors.forename: Mike P
authors.initials: MP
authors.lastname: Wattjes
authors.affiliation: Klinisch geriater, afdeling geriatrie, Albert Schweitzer ziekenhuis, Dordrecht, Nederland.
authors.forename: Etienne F J
authors.initials: EF
authors.lastname: Meulen
authors.affiliation: Radioloog, afdeling radiologie en nucleaire geneeskunde, VU medisch centrum, Amsterdam, Nederland.
authors.forename: Frederik
authors.initials: F
authors.lastname: Barkhof
authors.affiliation: Radioloog, afdeling radiologie, Albert Schweitzer ziekenhuis, Dordrecht, Nederland.
authors.forename: Jeannette
authors.initials: J
authors.lastname: Bakker
mesh_terms: D003704:Dementia / Q000175:diagnosis*; D005853:Geriatrics / Q000379:methods*; D006801:Humans; D008279:Magnetic Resonance Imaging; D009426:Netherlands / Q000453:epidemiology; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D014057:Tomography, X-Ray Computed; D014850:Waiting Lists