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Research ArticleExtracranial Vascular

Survey of the American Society of Neuroradiology Membership on the Use and Value of Extracranial Carotid Vessel Wall MRI

M. Mossa-Basha, C. Yuan, B.A. Wasserman, D.J. Mikulis, T.S. Hatsukami, N. Balu, A. Gupta, C. Zhu, L. Saba, D. Li, J.K. DeMarco, V.T. Lehman, Y. Qiao, H.R. Jager, M. Wintermark, W. Brinjikji, C.P. Hess and D.A. Saloner
American Journal of Neuroradiology December 2022, 43 (12) 1756-1761; DOI: https://doi.org/10.3174/ajnr.A7720
M. Mossa-Basha
aFrom the Department of Radiology (M.M.-B.), University of North Carolina, Chapel Hill, North Carolina
bDepartments of Radiology (M.M.-B., N.B., C.Z.)
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C. Yuan
dDepartment of Radiology (C.Y.), University of Utah, Salt Lake City, Utah
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B.A. Wasserman
eDepartment of Radiology (B.A.W.), University of Maryland, Baltimore, Maryland
fDepartment of Radiology (B.A.W., Y.Q.), Johns Hopkins University, Baltimore, Maryland
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D.J. Mikulis
gJoint Department of Medical Imaging (D.J.M.), The University Health Network and the University of Toronto, Toronto, Ontario, Canada
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T.S. Hatsukami
cSurgery (T.S.H.), University of Washington, Seattle, Washington
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N. Balu
bDepartments of Radiology (M.M.-B., N.B., C.Z.)
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A. Gupta
hDepartment of Radiology (A.G.), Weill Cornell Medicine, New York, New York
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C. Zhu
bDepartments of Radiology (M.M.-B., N.B., C.Z.)
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L. Saba
iDepartment of Radiology (L.S.), University of Cagliari, Cagliari, Sardinia, Italy
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D. Li
jBiomedical Imaging Research Institute (D.L.), Cedars-Sinai Medical Center, Los Angeles, California
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J.K. DeMarco
kDepartment of Radiology (J.K.D.), Walter Reed National Military Medical Center, Bethesda, Maryland and Uniformed Services University of the Health Sciences, Bethesda, Maryland
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V.T. Lehman
lDepartment of Radiology (V.T.L., W.B.), Mayo Clinic, Rochester, Minnesota
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Y. Qiao
fDepartment of Radiology (B.A.W., Y.Q.), Johns Hopkins University, Baltimore, Maryland
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H.R. Jager
mNeuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, University College London, Queen Square Institute of Neurology, London, UK
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M. Wintermark
nDepartment of Neuroradiology (M.W.), MD Anderson Cancer Institute, Houston, Texas
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W. Brinjikji
lDepartment of Radiology (V.T.L., W.B.), Mayo Clinic, Rochester, Minnesota
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C.P. Hess
oDepartment of Radiology and Biomedical Imaging (C.P.H., D.A.S.), University of California, San Francisco, San Francisco, California
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D.A. Saloner
oDepartment of Radiology and Biomedical Imaging (C.P.H., D.A.S.), University of California, San Francisco, San Francisco, California
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Abstract

BACKGROUND AND PURPOSE: Extracranial vessel wall MRI (EC-VWI) contributes to vasculopathy characterization. This survey study investigated EC-VWI adoption by American Society of Neuroradiology (ASNR) members and indications and barriers to implementation.

MATERIALS AND METHODS: The ASNR Vessel Wall Imaging Study Group survey on EC-VWI use, frequency, applications, MR imaging systems and field strength used, protocol development approaches, vendor engagement, reasons for not using EC-VWI, ordering provider interest, and impact on clinical care was distributed to the ASNR membership between April 2, 2019, to August 30, 2019.

RESULTS: There were 532 responses; 79 were excluded due to minimal, incomplete response and 42 due to redundant institutional responses, leaving 411 responses. Twenty-six percent indicated that their institution performed EC-VWI, with 66.3% performing it ≤1–2 times per month, most frequently on 3T MR imaging, with most using combined 3D and 2D protocols. Protocols most commonly included pre- and postcontrast T1-weighted imaging, TOF-MRA, and contrast-enhanced MRA. Inflammatory vasculopathy (63.3%), plaque vulnerability assessments (61.1%), intraplaque hemorrhage (61.1%), and dissection-detection/characterization (51.1%) were the most frequent applications. For those not performing EC-VWI, the reasons were a lack of ordering provider interest (63.9%), lack of radiologist time/interest (47.5%) or technical support (41.4%) for protocol development, and limited interpretation experience (44.9%) and knowledge of clinical applications (43.7%). Reasons given by 46.9% were that no providers approached radiology with interest in EC-VWI. If barriers were overcome, 51.1% of those not performing EC-VWI indicated they would perform it, and 40.6% were unsure; 48.6% did not think that EC-VWI had impacted patient management at their institution.

CONCLUSIONS: Only 26% of neuroradiology groups performed EC-VWI, most commonly due to limited clinician interest. Improved provider and radiologist education, protocols, processing techniques, technical support, and validation trials could increase adoption.

ABBREVIATIONS:

EC-VWI
extracranial vessel wall MRI
IP
internet protocol
ASNR
American Society of Neuroradiology
  • © 2022 by American Journal of Neuroradiology
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American Journal of Neuroradiology: 43 (12)
American Journal of Neuroradiology
Vol. 43, Issue 12
1 Dec 2022
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Survey of the American Society of Neuroradiology Membership on the Use and Value of Extracranial Carotid Vessel Wall MRI
M. Mossa-Basha, C. Yuan, B.A. Wasserman, D.J. Mikulis, T.S. Hatsukami, N. Balu, A. Gupta, C. Zhu, L. Saba, D. Li, J.K. DeMarco, V.T. Lehman, Y. Qiao, H.R. Jager, M. Wintermark, W. Brinjikji, C.P. Hess, D.A. Saloner
American Journal of Neuroradiology Dec 2022, 43 (12) 1756-1761; DOI: 10.3174/ajnr.A7720

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Survey of the American Society of Neuroradiology Membership on the Use and Value of Extracranial Carotid Vessel Wall MRI
M. Mossa-Basha, C. Yuan, B.A. Wasserman, D.J. Mikulis, T.S. Hatsukami, N. Balu, A. Gupta, C. Zhu, L. Saba, D. Li, J.K. DeMarco, V.T. Lehman, Y. Qiao, H.R. Jager, M. Wintermark, W. Brinjikji, C.P. Hess, D.A. Saloner
American Journal of Neuroradiology Dec 2022, 43 (12) 1756-1761; DOI: 10.3174/ajnr.A7720
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