Dr Sarikaya and his colleagues could make a very good contribution with this. Like other sub-specialty radiologists, neuroradiologists have a decent understanding of the limitations of current clinical imaging techniques and will often offer an informed diagnostic opinion despite negative imaging (
#AllTestsAreNormal). An example in the neuro domain would be —
Previously fit and healthy young person, presents acutely following fever with intractable status epilepticus - no response to escalated therapies, intubated and ventilated. Extensive MRI of the neuraxis reveals no abnormality. Diagnosis: "Likely
FIRES". This is a devastating condition with very poor outcome, probably postviral/immunometabolic (see also
rarediseases). Of course the treating neurologists and intensivists would likely arrive at this conclusion anyway, even if the report simply said "no abnormality detected". But sometimes a prompt on the bottom of a report can be helpful, as I've noted a few times over the years.
I hope this paper covers the newer research neuroimaging findings that do not yet form part of the standard clinical imaging repertoire. It would be good to have a similar default in the minds of reporting neuroradiologists, such that an indication including symptoms of "fatigue", "PEM" etc with apparently normal imaging might conclude with "No abnormality detected: consistent with long COVID/neuro-PASC, ME/CFS or similar condition". This should help legitimise ME as a "proper" biological disease in the minds of those clinicians who might still be referring on the basis of it being psychological/functional.