Is Psychoradiology Finally Coming Into Its Own?

By Cari Wade Gervin
Wednesday, May 26, 2021
Specialty: 

A new journal hopes to expand research in the burgeoning field of psychoradiology, although critics remain skeptical.

What if psychiatrists didn’t just have to take their patient’s word on certain symptoms to assess the best DSM-5 diagnosis? What if, just as an MRI can show a rotator cuff tear, imaging could show the presence of ADHD, depression or bipolar disorder in the brain? Could treatments could be better tailored?

That’s the promise — or hope — of psychoradiology. The field’s pioneer, Qiyong Gong, MD, PhD, Professor of Radiology at the West China Hospital of Sichuan University, has just launched a new open access journal with Oxford Academic. Titled Psychoradiology, the journal’s first issue says it will “bridge the gap between neuroscientists and clinicians by providing a platform for publishing research using brain imaging, brain stimulation, and psychological approaches that have translational relevance for the diagnosis, prognosis, prevention, and/or treatment of psychiatric and neurological disorders.”

The Field of Psychoradiology

Psychoradiology — also called clinical psychiatric imaging — is a subfield of radiology that uses MRI neuroimaging; quantitative exploration of neural networks; AI; and genetic, behavioral, and imaging biomarker-guided development of treatments to attempt to assess and diagnose common psychiatric illnesses.

The field has been in existence for over three decades, but diagnostic results have varied. An overview of MRI studies of major depressive disorder (MDD) in the journal Translational Psychiatry in 2019 found that MDD changes the brain structure in different ways for different patients, stating, “Most MRI studies of MDD are outdated and have no clinical utility.”

A separate review of the literature in The British Journal of Radiology in 2019 had a similar assessment, saying, “Efforts to develop imaging markers for complex psychiatric syndromes — such as schizophrenia, bipolar disorder and ADHD — have generally failed.”

Yet research has also suggested that new imaging techniques, image analysis procedures and machine learning/AI are essential. As many psychiatric patients have overlapping issues, trying to determine whether imaging shows MDD or MDD/ADHD or ADHD/bipolar disorder is an unresolved challenge.

What’s Next

A formal journal dedicated to psychoradiology is an important first step to encouraging more research in the field. It’s possible that such research can move the needle further toward the ultimate goal of enabling psychiatrists to utilize imaging for diagnoses and patients to have that imaging covered by insurance.

“At Psychoradiology, we seek … to shed new light on our understanding of problems experienced by patients with clinical neurological and psychiatric disorders,” the journal’s opening letter states. “We anticipate that such contributions will help establish … this emergent field.”

While advances in diagnoses could still be decades in the future, psychoradiology could be the breakthrough to connect mind, matter and manner. Or not — only more research will tell.