title: 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.
  
  
  CONCLUSIONS
  Specialist access to imaging modalities other than CT and MRI is restricted. Improved access may affect patient treatment and care.
authors.affiliation: School of Medicine and Medical Science, University College Dublin, Dublin, Ireland.
authors.forename: Aurelia S
authors.initials: AS
authors.lastname: Ciblis
authors.affiliation: School of Medicine and Medical Science, University College Dublin, Dublin, Ireland.
authors.forename: Marie-Louise
authors.initials: ML
authors.lastname: Butler
authors.affiliation: Cognitive Systems Group, Discipline of Psychiatry, School of Medicine and Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland.
authors.forename: Arun L W
authors.initials: AL
authors.lastname: Bokde
authors.affiliation: School of Psychology, Bangor University, Bangor, UK.
authors.forename: Paul G
authors.initials: PG
authors.lastname: Mullins
authors.affiliation: Centre for Ageing, Neuroscience and the Humanities, Trinity College Dublin, Dublin, Ireland.
authors.forename: Desmond
authors.initials: D
authors.lastname: O'Neill
authors.affiliation: School of Medicine and Medical Science, University College Dublin, Dublin, Ireland.
authors.forename: Jonathan P
authors.initials: JP
authors.lastname: McNulty
keywords: Access; CT; Dementia; Geriatricians; MRI; Neuroimaging; Neurologists; Nuclear medicine imaging; Old-age psychiatrists