Global Survey on Diffusion and Perfusion MRI Use in Head and Neck Imaging
Overview
A global survey of 294 head and neck radiologists from 44 countries assessed the clinical use, analysis, and barriers related to diffusion-weighted imaging (DWI) and dynamic contrast-enhanced perfusion-weighted imaging (DCE-PWI). The study revealed widespread adoption of DWI, especially qualitative and quantitative approaches, while DCE-PWI use remains less common due to technical and resource challenges.
Background
Diffusion-weighted imaging (DWI) and perfusion-weighted imaging (PWI) are advanced MRI techniques that provide complementary information to conventional sequences in head and neck imaging. DWI measures molecular diffusivity and tissue microstructure, often quantified by the apparent diffusion coefficient (ADC), useful in characterizing tumors and other lesions. DCE-PWI evaluates tissue microcirculation and vascular architecture, aiding in tumor angiogenesis assessment and lesion differentiation. Despite their potential, variable adoption exists due to technical complexity, resource limitations, and lack of standardized protocols.
Data Highlights
Parameter
Value
95% CI
Number of respondents
294
Countries represented
44
Institutions represented
256
Respondents in public institutions
135
40.1–51.8%
Respondents in academic institutions
118
34.5–45.6%
Respondents in private practice
35
~11.9%
Survey response rate (ESHNR)
25.4%
Survey response rate (ASHNR)
10%
Key Findings
DWI is routinely incorporated into head and neck MRI protocols internationally, with both qualitative and quantitative analyses commonly performed.
DCE-PWI is less frequently used clinically due to challenges in acquisition, analysis, and lack of standardization.
Barriers to wider implementation include limited resources, time constraints, technical difficulties, and insufficient knowledge or evidence.
There is no universally accepted standard for measuring and reporting functional MRI parameters in head and neck imaging.
Respondents were primarily from public and academic institutions, with the UK and USA being the most represented countries.
Survey distribution through ESHNR and ASHNR achieved a combined response rate of approximately 17.7%.
Clinical Implications
Clinicians should recognize that while DWI is widely adopted and provides valuable diagnostic and monitoring information in head and neck imaging, DCE-PWI remains underutilized due to practical challenges. Efforts to standardize acquisition and reporting protocols, along with addressing resource and training barriers, may facilitate broader clinical integration of perfusion imaging techniques. Awareness of these factors can guide institutions in optimizing MRI protocols for improved patient care.
Conclusion
This international survey highlights the prevalent use of diffusion MRI in head and neck imaging and identifies key obstacles limiting the clinical adoption of perfusion MRI. Addressing these challenges through education, standardization, and resource allocation is essential to enhance the utility of advanced functional MRI techniques in routine practice.
References
Survey of Head and Neck Radiologists, 2024 -- A Global Assessment of the Use of Diffusion and Perfusion MRI Techniques in Head and Neck Imaging
by Steve Connor, Alexander Christoforou, Philip Touska, Soraya Robinson, Nancy J. Fischbein, Pim de Graaf, Anne R. J. Péporté, Jussi Hirvonen, Darka Hadnadjev Šimonji, Gloria J. Guzmán Pérez-Carrillo, Xin (Cynthia) Wu, Christine Glastonbury, Kristine M. Mosier, Ashok Srinivasan
