IPEM Topical Report: a national survey of MRI use for external beam radiotherapy treatment planning in the UK: 2025 IPEM survey results

Magnetic resonance imaging (MRI) offers superior soft tissue contrast compared to computed tomography (CT), making it highly valuable in external beam radiotherapy (EBRT) planning. However, there are a number of barriers that have limited widespread use of MRI for EBRT planning in the UK such as limited access to MRI scanners and lack of training and guidance. Following the 2018 Institute of Physics And Engineering In Medicine (IPEM) survey on MRI use in UK RT centres, data were collected from 68 centres across the UK in 2025 to reassess MRI access, utilisation, and adherence to 2021 IPEM guidance on MRI in EBRT planning. With a 79% (54/68) complete response rate, the survey revealed increased integration of MRI into EBRT planning workflows, particularly for brain, spine, and prostate cancers. However, access remains variable, with only five centres reporting MRI scanners dedicated for RT. Compliance with recommended imaging MRI sequences and quality assurance procedures has improved but remains variable, especially among centres relying on Picture archiving and communication systems-sourced images. Barriers such as capital investment, staffing, and training persist, although clinical engagement and future planning for MRI-only workflows and Artificial Intelligence-based tools are increasing. These findings underscore the need for continued investment, updated guidance, and multidisciplinary collaboration to support the safe and effective expansion of MRI in RT planning.