If this issue was not unresolved, discussion with MR-VWI leaders at the particular institution was performed for clarification on their approach at the time. Individuals could respond to the survey only once.Īfter collection of survey responses, response quality was assessed, with exclusion of surveys in which the respondent spent 1 complete response for an institution, the study investigators reviewed the institutional responses to assess accuracy on the basis of their knowledge of the protocol and clinical performance based on publications, presentations, and/or personal knowledge of the specific institution at the time of the survey. Responses were gathered between April 2 and August 30, 2019, after which the survey was closed. A second reminder was sent to the membership on August 14, 2019. After approval from the ASNR Executive Committee, the survey was then sent to the ASNR membership on April 2, 2019. The anonymous survey was first sent to the ASNR Vessel Wall Imaging Study Group and was opened to the group from March 30 through April 17, 2018. After institutional review board review, the survey received institutional review board exemption. Respondents who indicated that their institution did perform MR-VWI were expected to answer each MR-VWI question of the survey. The survey was built with logic, and if a respondent indicated that they did not perform MR-VWI, he or she skipped to the last 4 questions of the MR-VWI portion of the survey, focused on barriers to MR-VWI performance and ordering-provider interest (the questions in the survey are provided in the Online Supplemental Data). Through an iterative review process, the final survey was developed on the platform. The survey was discussed at ASNR Vessel Wall Imaging Study Group meetings and developed through input by multiple Study Group members. The survey can help inform the ASNR Vessel Wall Imaging Study Group on the needs of the neuroradiologic community on how to best educate and facilitate the performance of MR-VWI, as well as guide vendors on technical needs for broader MR-VWI use. To our knowledge, this is the first study to evaluate institutional use of MR-VWI across a United States–based neuroradiologic society. For institutions already performing MR-VWI, our goal was to evaluate applications of the technique, which sequences were being used, how the techniques were developed, levels of clinician interest, and vendor collaborations for technique development. The goal of the current survey study was to poll the membership of the ASNR to determine whether institutions were performing MR-VWI, and if not, what barriers exist to its implementation and use. 13 Numerous barriers to the implementation of MR-VWI may exist at many institutions, including technology, expertise, knowledge, workflow limitations, and/or vendor relation limitations. 11, 12 Because this technique has been adopted by a growing number of institutions worldwide, the American Society of Neuroradiology (ASNR) Vessel Wall Imaging Study Group was developed to disseminate vessel wall imaging techniques, educate the general neuroradiology community on its implementation and interpretation, and influence vendors to improve vessel wall imaging techniques. Intracranial vessel wall MR imaging (MR-VWI) is capable of detecting, 1, 2 differentiating, 3 ⇓- 5 and characterizing intracranial vasculopathies 6 ⇓- ⇓ ⇓ 10 and may be able to help predict patient outcomes. Ordering providers most frequently inquiring about vessel wall MR imaging were from stroke neurology (56.5%) and neurosurgery (25.1%), while 34.3% indicated that no providers had inquired.ĪBBREVIATIONS: ASNR American Society of Neuroradiology IP Internet Protocol MR-VWI vessel wall MR imaging If technical/expertise obstacles were overcome, 56.4% of those not performing vessel wall MR imaging indicated that they would perform it. For those not performing vessel wall MR imaging, interpretation (53.1%) or technical (46.4%) expertise, knowledge of applications (50.5%), or limitations of clinician (56.7%) or radiologist (49.0%) interest were the most common reasons. Vasculopathy differentiation (94.4%), cryptogenic stroke (41.3%), aneurysm (38.0%), and atherosclerosis (37.6%) evaluation were the most common indications. Protocols most commonly included were T1-weighted pre- and postcontrast and TOF-MRA 60.6% had limited contributions from vendors or were still in protocol development. Fifty-two percent indicated that their institution performs vessel wall MR imaging, with 71.5% performed at least 1–2 times/month, most frequently on 3T MR imaging, and 87.7% using 3D sequences. RESULTS: There were 532 responses 79 were excluded due to nonresponse and 42 due to redundant institutional responses, leaving 411 responses.
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