What Do You Need to Know When Imaging Geriatric Patients?

March 7, 2011

As the population ages, radiologists will be required to recognize common pathologies - while avoiding overdiagnosis, according to experts presenting at ECR 2011.

As the population ages, radiologists will be required to recognize common pathologies - while avoiding overdiagnosis, according to experts presenting at ECR 2011.

For geriatric patients, the norm may be several comorbidities, the prevalence of degenerative aspects, and physical or cognitive problems. So distinguishing a healthy elderly person and one who needs treatment can be a challenge, said Prof. Giuseppe Guglielmi, of the University of Foggia in Italy.

“The question is how to be aware of the potential and limits of diagnostic imaging and its applications in geriatric patients,” he said in a release about his congress session.

Therefore, radiologists need to know the most common complaints among the elderly, such as bone and join disorders. Plus, they also need to “be aware of some misleading radiological presentations typically occurring in this population, such as unrecognized fractures, missed infection or malignant conditions, and myeloma revealed by osteoporotic vertebral collapses,” according to Prof. Anne Cotten from Lille University Hospital in France.

For example, severe incidental white matter lesions in the brain and incidental cerebral microbleeds are known cardiovascular risk factors that can carry a poor prognosis, researchers said. Neurodegenerative changes also occur before the onset of clinical signs of dementia. Functional MRI and FDG-PET can be used to predict cognitive decline in genetically predisposed patients. PET studies using amlyloid tracers have shown abnormal binding in elderly patients, suggesting they are at risk for developing Alzheimer’s, according to the researchers.

Similarly, imaging such as ultrasound, PET/CT, and high-resolution black-blood MRI can be used to assess the composition and morphology of atherosclerotic plaques.

At the panel discussion during this session, researchers posed the question: What knowledge do you need to interpret and understand radiological scenarios in geriatric patients?

What do you think?