56 The evolving challenges and opportunities in adult brain tumour imaging: Insights from a review of United Kingdom neuro-oncology centres (2021-2024)

Abstract Introduction Brain tumour imaging is rapidly changing: while new technologies promise clinical advances, centres report growing staff shortages and burnout at a time of increasing demand. We examined how these trends have evolved since 2021 in United Kingdom (UK) neuro-oncology centres. Method Data were collected from 21 UK neuro-oncology centres (covering ∼84% of the population) in 2021 and 2024 via the Tessa Jowell Centre of Excellence for Adults programme. Anonymised data were analysed to identify trends in Magnetic Resonance Imaging (MRI) waiting and reporting times, neuroradiologist capacity, MRI equipment availability, and adoption of advanced techniques. Results MRI waiting and reporting times: Between 2021 and 2024, waiting times from request to report for brain tumour MRI increased across centres. Mean urgent outpatient scan turnaround time increased by 28% (12.7 to 16.3 days) and wait times for routine scans increased by 14% (43.9 to 49.8 days). Delayed reporting times drove this increase, with 18/21 centres (86%) citing challenges including workforce shortages (67%), rising demand, and equipment shortages (both 44%). Staffing and equipment Neuroradiology staffing varied widely (4–27 neuroradiologists per centre; median 11), as did equipment provision (3–20 MRI scanners per centre; median 7). Variation in imaging protocols Centres used an average of 31 different protocols at key imaging timepoints, indicating limited harmonisation. Innovation More centres reported use of advanced techniques, and over half (11/21, 52%) reported radiology involvement in neuro-oncology research. Conclusions Despite increased adoption of innovation, brain tumour imaging services face delays amid rising demand, workforce pressures, and equipment shortages. These results will inform efforts by the Tessa Jowell Brain Cancer Mission and partners to support sustainable investment, greater harmonisation of imaging practice, and ongoing national quality improvement.