Ultra‐fast MRI for dementia diagnosis and treatment eligibility: A prospective study

Abstract

INTRODUCTION

Magnetic resonance imaging (MRI) is crucial for dementia diagnosis and a pre‐requisite for amyloid‐lowering therapies in Alzheimer's disease. Despite guidelines, many patients never undergo MRI due to limited scanner availability. Shorter scan times would reduce costs and patient burden. We developed and tested a fast MRI protocol incorporating highly accelerated sequences.

METHODS

We compared blinded neuroradiologist assessments of a fast protocol with the standard‐of‐care protocol in a prospective real‐world study. We estimated agreement coefficients to evaluate reliability.

RESULTS

The fast protocol cut scan times by 63% and showed non‐inferior reliability measures for diagnosis, visual scale ratings, and disease‐modifying therapy eligibility assessment. Between scan‐type, intra‐rater reliability for diagnosis was greater than inter‐rater reliability on the standard‐of‐care protocol (ratio of 1.37, 95% confidence interval: 1.21–1.58).

DISCUSSION

This study proposed and applied a way of showing non‐inferiority of a highly accelerated dementia protocol. Ultra‐fast protocols could improve MRI access and patient equity and support the implementation of disease‐modifying therapies.

Highlights

The fast dementia protocol with four core sequences reduced acquisition time by 63%.

The fast scan showed non‐inferior reliability for diagnosis and visual ratings.

Assessment for disease‐modifying therapy eligibility was similar between scan types.

Fast protocols may improve access to magnetic resonance imaging and diagnosis in dementia.