Organization of Interventional Neuroradiology in Belgium: results of a national survey

Abstract Objectives To provide a comprehensive national overview of interventional neuroradiology (INR) in Belgium through a structured survey conducted under the auspices of the Belgian Society for Interventional and Therapeutic Neuroradiology (BSITN). Materials and methods An anonymized online survey was distributed by email through the BSITN to all known active interventional neuroradiologists. The questionnaire assessed workforce demographics, organization of INR services, procedural activity, on-call systems, training and certification pathways, and remuneration models. Associations were tested using Fisher’s exact or chi-square tests. Workforce projections were estimated using a stock-flow model based on respondent age distribution and current training pipeline capacity. Results Thirty-five interventional neuroradiologists responded, representing more than 70% of the estimated active INR workforce in Belgium. Respondents were predominantly senior physicians (88.6%), with nearly half reporting more than 10 years of post-fellowship practice. Annual center-level procedural volumes were high, exceeding 200 cases in two-thirds of responses. Despite this variability, 68.6% of respondents felt sufficiently exposed across the full spectrum of INR procedures. Greater professional experience (> 10 years) was strongly associated with perceived procedural sufficiency ( p = 0.001). A 24/7 stroke unit was available for 33 of 35 physicians. Workforce projections indicated a potential decline of approximately 23% over the next decade under current training capacity. Conclusions This national BSITN survey reveals significant variability in Belgian INR organizational models. The results of the survey also point to challenges related to workforce sustainability, training standardization, and service organization. As such, they can serve as a reference point for coordinated national initiatives. Key points Question While procedural efficacy of INR is well established, the organizational structures, workforce characteristics, and training pathways that underpin INR services have not been systematically described at a national level. Findings This study showed significant variability in institutional models, on-call systems, training pathways, and remuneration across centers. While a 24/7 stroke unit was available for 33 of 35 physicians, workforce projections indicated a potential 23% decline in the active INR workforce by 2035 under current training capacity. Critical relevance statement These data establish the first national organizational baseline for Belgian INR and identify an impending workforce shortfall that threatens the sustainability of time-critical neurovascular services. The strong professional consensus favoring a standardized national training curriculum provides a clear mandate.