An international survey of diffusion and perfusion magnetic resonance imaging implementation in the head and neck

TY - JOUR

T1 - An international survey of diffusion and perfusion magnetic resonance imaging implementation in the head and neck

AU - Connor, Steve

AU - Christoforou, Alexander

AU - Touska, Philip

AU - Robinson, Soraya

AU - Fischbein, Nancy J.

AU - de Graaf, Pim

AU - Péporté, Anne R.J.

AU - Hirvonen, Jussi

AU - Hadnadjev Šimonji, Darka

AU - Guzmán Pérez-Carrillo, Gloria J.

AU - Wu, Xin

AU - Glastonbury, Christine

AU - Mosier, Kristine M.

AU - Srinivasan, Ashok

N1 - Publisher Copyright: © Crown 2025.

PY - 2025/8/31

Y1 - 2025/8/31

N2 - Objective: The goal of this international survey was to understand how diffusion (DWI) and perfusion imaging (PWI) are being applied to clinical head and neck imaging. Methods and materials: An online questionnaire focusing on acquisition, clinical indications, analysis, and reporting of qualitative DWI (QlDWI), quantitative DWI (QnDWI) and dynamic contrast-enhanced PWI (DCE-PWI) in the head and neck was circulated to members of the American Society of Head and Neck Radiology (ASHNR) and European Society of Head and Neck Radiology (ESHNR) over a 3-month period. Descriptive statistics and group comparisons were calculated with SPSS® v27. Results: There were 294 unique respondents (17.6% response rate) from 256 institutions (182 ESHNR, 74 ASHNR). DWI was routinely acquired for some head and neck indications at 95.7% of the respondents’ institutions, with 92.5% of radiologists interpreting QlDWI but only 36.7% analysing QnDWI. QlDWI was most frequently applied to primary mucosal masses or the middle ear, whilst QnDWI was routinely used to distinguish tumour histologies, and primary or recurrent carcinoma. DCE-PWI was routinely acquired at 53.6% of institutions and used by 40.8% of respondents, however, there was no clinical scenario in which it was routinely applied by most users. DCE-PWI analysis methods varied, with time-intensity curve classifications being the most frequently reported. Lack of standardisation was identified as a key reason for not implementing QnDWI, whilst numerous factors prevented the adoption of DCE-PWI. Conclusion: There is widespread routine interpretation of QlDWI by head and neck radiologists, but there is considerable variation in the application and analysis of head and neck QnDWI and DCE-PWI. Key Points: Question How are diffusion (DWI) and dynamic contrast-enhanced perfusion imaging (DCE-PWI) being utilised by head and neck radiologists across a wide range of practices? Findings An international survey demonstrated widespread routine interpretation of qualitative DWI but variable application and analysis of quantitative DWI and DCE-PWI with numerous barriers to implementation. Clinical relevance The survey results will aid discussion on how to standardise and optimally disseminate these MRI techniques in day-to-day practice. More focused education and resource allocation may be required to accelerate the adoption of quantitative DWI and DCE-PWI.

AB - Objective: The goal of this international survey was to understand how diffusion (DWI) and perfusion imaging (PWI) are being applied to clinical head and neck imaging. Methods and materials: An online questionnaire focusing on acquisition, clinical indications, analysis, and reporting of qualitative DWI (QlDWI), quantitative DWI (QnDWI) and dynamic contrast-enhanced PWI (DCE-PWI) in the head and neck was circulated to members of the American Society of Head and Neck Radiology (ASHNR) and European Society of Head and Neck Radiology (ESHNR) over a 3-month period. Descriptive statistics and group comparisons were calculated with SPSS® v27. Results: There were 294 unique respondents (17.6% response rate) from 256 institutions (182 ESHNR, 74 ASHNR). DWI was routinely acquired for some head and neck indications at 95.7% of the respondents’ institutions, with 92.5% of radiologists interpreting QlDWI but only 36.7% analysing QnDWI. QlDWI was most frequently applied to primary mucosal masses or the middle ear, whilst QnDWI was routinely used to distinguish tumour histologies, and primary or recurrent carcinoma. DCE-PWI was routinely acquired at 53.6% of institutions and used by 40.8% of respondents, however, there was no clinical scenario in which it was routinely applied by most users. DCE-PWI analysis methods varied, with time-intensity curve classifications being the most frequently reported. Lack of standardisation was identified as a key reason for not implementing QnDWI, whilst numerous factors prevented the adoption of DCE-PWI. Conclusion: There is widespread routine interpretation of QlDWI by head and neck radiologists, but there is considerable variation in the application and analysis of head and neck QnDWI and DCE-PWI. Key Points: Question How are diffusion (DWI) and dynamic contrast-enhanced perfusion imaging (DCE-PWI) being utilised by head and neck radiologists across a wide range of practices? Findings An international survey demonstrated widespread routine interpretation of qualitative DWI but variable application and analysis of quantitative DWI and DCE-PWI with numerous barriers to implementation. Clinical relevance The survey results will aid discussion on how to standardise and optimally disseminate these MRI techniques in day-to-day practice. More focused education and resource allocation may be required to accelerate the adoption of quantitative DWI and DCE-PWI.

KW - Diffusion imaging

KW - Magnetic resonance imaging

KW - Neck

KW - Perfusion imaging

KW - Surveys and questionnaires

UR - https://www.scopus.com/pages/publications/85218819971

U2 - 10.1007/s00330-025-11370-1

DO - 10.1007/s00330-025-11370-1

M3 - Article

C2 - 39904786

AN - SCOPUS:85218819971

SN - 0938-7994

VL - 35

SP - 5110

EP - 5120

JO - European Radiology

JF - European Radiology

IS - 8

M1 - 23

ER -