Faster MRI scans offer new hope for dementia diagnosis

The time to carry out diagnostic MRI scans for dementia can be cut to one-third of their standard length, according to a new study led by UCL researchers.

The findings, published in Alzheimer’s & Dementia, have been described as a step toward ending “the postcode lottery in dementia diagnosis.” Shorter scans would be easier and more comfortable for patients and also enable more people to be scanned at a lower cost. The team behind the study say this could at least double the number of dementia scans able to be done in one day.

Senior author Professor Nick Fox, Director of the UCL Dementia Research Center at the UCL Queen Square Institute of Neurology, said, “As more treatments that can slow or change the course of dementia are being developed, it’s important to make sure MRI scans are available to everyone. This is because people living with dementia often need an MRI scan as part of their diagnosis before they can access these treatments.

“To help make this possible, our team carried out the first study looking at how new imaging techniques—called parallel imaging—could speed up MRI scans in clinics. Their goal is to move closer to a future where every person with dementia can get a diagnosis through a scan.”

MRI scans often play a key role in an accurate dementia diagnosis, including ruling out other causes of symptoms and assisting in diagnosing the type of dementia. Emerging disease-modifying treatments such as lecanemab and donanemab also require an MRI scan before starting treatment and for safety monitoring during the course of treatment. Reducing the cost of scanning would contribute to lowering the total cost of delivering such treatments.

The ADMIRA study (Accelerated Magnetic Resonance Imaging for Alzheimer’s disease) aimed to understand the reliability of fast MRI scans compared to standard-of-care clinical scans. The neurologists on the study were joined by co-authors from the UCL Hawkes Institute and the UCL Advanced Research Computing Center in the faculty of Engineering.

The research team scanned 92 people in an outpatient setting where an MRI brain scan was planned as part of their routine clinical assessment. The accelerated scans were carried out and enhanced to increase the quality of the image using new scanning methods. Three neuroradiologists examined these scans, and weren’t aware if they were looking at fast or standard-of-care scans.

Co-author Professor Geoff Parker (UCL Hawkes Institute and UCL Medical Physics and Biomedical Engineering) said, “Our research has taken advantage of recent breakthroughs in scanner technology. Our task was to work out just how fast we could scan while maintaining image quality good enough for diagnosis.”

The team found that the quicker scans reduced time in the scanner by 63% and they were as reliable as the standard-of-care scans for diagnosis and visual ratings.

First author Dr. Miguel Rosa-Grilo (UCL Queen Square Institute of Neurology) said, “We were confident that the new scan would prove non-inferior to the standard scan, given the high image quality—but it was remarkable how well it performed.”

Richard Oakley, Associate Director of Research and Innovation at Alzheimer’s Society, said, “Dementia is the UK’s biggest killer, but 1 in 3 people living with the condition haven’t had a diagnosis. An early and accurate diagnosis isn’t just a label, it’s the first step to getting vital care, support and treatment.

“While MRIs aren’t the only way to diagnose dementia, very few people with concerns about their cognitive health are offered one as part of the diagnosis process, mainly because they are expensive and not widely available. These faster MRIs, which take less than half the time of standard scans, could help end this postcode lottery in dementia diagnosis, cut costs and potentially give more people access to them.

“MRI scans can be an uncomfortable and daunting experience for patients, so anything we can do to make it an easier process is really positive.

“So far, this shortened MRI scan has been tested at one specialist center with one type of MRI scanner, so more research is needed to make sure this works across different types of scanners and a diverse range of people. We’re hugely encouraged by this progress and eager to see how it continues.”

The team will now build on their early results by making sure the approach works across different types of MRI machines, so it can benefit as many hospitals and clinics as possible.