MRI Quality Gaps Persist Across Europe

Magnetic resonance imaging services across Europe face uneven quality assurance and quality control practices at a time of growing demand, advanced imaging use, multi-centre clinical trials and AI-driven analysis. A European survey published in Insights into Imaging assessed how MRI quality assurance and quality control are implemented in routine clinical practice and, where applicable, research settings. The survey gathered 269 responses from 37 countries and included radiologists, medical physics experts, physicists, engineers and radiographers. Most respondents recognise the importance of robust quality programmes, yet national rules, institutional processes, professional awareness and training remain inconsistent. The results point to a fragmented MRI quality landscape, with scope for harmonised guidance, stronger multidisciplinary collaboration and more accessible education.

National Rules Remain Uneven

MRI quality arrangements vary widely between countries. Only a minority of respondents indicated the existence of national MRI quality assurance or quality control guidelines, while many others either reported no such guidance or were unaware of it. Responses on national legislation also show limited awareness, with a substantial share of respondents not knowing whether relevant national legislation exists. Italy is the only country for which evidence of a specific MRI quality assurance and quality control framework mandated by law is provided.

References to national guidance are also inconsistent. Italy and Germany are linked to national institutional guidance, while most other references relate to scientific associations. This pattern indicates a landscape in which MRI quality control can depend on institutional practice, professional association guidance or local interpretation rather than a uniform national framework.

The variation matters because MRI quality assurance and quality control support the production of high-quality diagnostic images, help monitor equipment performance and contribute to patient safety. Inadequate measures can result in poor image quality, repeat scans, diagnostic errors and substandard care. The growth of quantitative MRI and AI-assisted image analysis adds further pressure, as accurate and reproducible quantitative data require close monitoring of scanner performance, software changes and hardware updates over time.

Local Programmes Show Mixed Adoption

Local implementation remains divided. Around half of respondents indicated that their institution has a quality assurance programme, while a large minority reported no programme. A further group did not know whether such a programme exists locally. Medical physics experts, physicists and engineers are most frequently involved in leading quality assurance programmes, followed by radiologists and radiographers, with multiple professional roles often contributing.

Quality assurance activities occur at different intervals. Some institutions carry out actions daily, weekly or monthly, while the largest share performs them yearly. Procedure revision also varies, with many respondents indicating updates every one to two years, while others reported longer intervals or no known revision process. This variation reinforces the wider picture of uneven implementation across institutions.

Image quality control programmes show a similar divide. About half of respondents reported a local programme, while a similar proportion indicated no formal programme or were unaware of one. Conventional quality control protocols most often cover image homogeneity, signal-to-noise ratio performance, coil functionality, image ghosting and slice thickness. The frequency of image quality control also differs between institutions, ranging from daily checks to annual procedures.

Quantitative MRI quality control is less established. Only a small proportion of respondents’ institutions have a specific programme for quantitative MRI, while most do not. Existing programmes most often address diffusion-weighted imaging and apparent diffusion coefficient measurements, followed by relaxometry, spectroscopy, functional MRI, diffusion tensor imaging and other techniques.

Must Read: EUCAIM Enables Cross-Border Imaging Data Use

Training and Collaboration Need Strengthening

Multidisciplinary support is part of MRI quality practice in many settings, but it is not universal. Respondents described collaboration for acquisition optimisation, introduction of new sequences, artefact management and post-processing in advanced imaging. Some also indicated no collaboration beyond safety aspects. Where anatomical areas were specified, collaboration most often involved brain imaging, abdominal imaging, pelvic imaging, cardiovascular imaging, musculoskeletal imaging and breast imaging.

Support for clinical research post-processing is also variable. Among radiologists who answered on this point, support came mainly from medical physics experts, physicists, engineers, radiographers and manufacturer application specialists. These professionals were based in radiology departments, medical physics departments, dedicated research units or manufacturer support structures. Collaboration occurred daily, weekly, monthly or occasionally, with occasional support forming the largest share.

Feedback from respondents shows strong demand for practical support. Most participants who commented on quality assurance and quality control said such programmes would benefit daily clinical work by supporting high-quality images, patient safety, diagnostic accuracy and efficient processes. Respondents identified advantages including consistent image quality, fewer errors and repeat scans, equipment performance monitoring, regulatory compliance and workflow optimisation.

There is also broad support for comprehensive guidelines, standardised protocols and specialised training. Respondents favour guidance from the European Society of Radiology and other relevant scientific associations. Quality assurance and quality control are viewed as multidisciplinary activities involving radiologists, medical physics experts, physicists, engineers, radiographers and industry partners.

MRI quality assurance and quality control across Europe remain heterogeneous, with different levels of regulation, institutional implementation, professional awareness and training. Local programmes exist in many institutions, but gaps remain in formal adoption, procedure revision and quantitative MRI quality control. Respondents place strong value on harmonised guidance, multidisciplinary collaboration and accessible education. A more consistent approach to MRI quality practice would support patient safety, diagnostic reliability, equipment monitoring and the long-term quality of MRI services.

Source: Insights into Imaging

Image Credit: iStock