166 Optimising Timing of Day 1 Post-Operative MRI for Brain Tumour Patients

Abstract Introduction Post-operative MRI is important in assessing extent of surgical resection and early complications. NICE and the European Association of Neuro-Oncology recommend post-operative MRI for glioma within 72 or 48 hours, respectively. This audit assessed compliance, identified barriers and implemented a standardised pathway to achieve post-operative day 1 (POD1) MRI to optimise workflow, patient care and discharge planning. Method A retrospective review of neuro-oncology cases was conducted before (June-July 2025) and after (January- February 2026) the implementation of an MRI POD1 Standard Operating Procedure (with dedicated MRI slots at 08:00-09:00 thrice weekly). Time of discharge and any delays were recorded. Results 30 cases were reviewed pre-intervention with a median length of stay (LOS) of 2.5 days. 11 (36.7%) achieved POD1 MRI and were discharged later that day, whilst 12 (40.0%) experienced delayed MRI due to lack of dedicated imaging slots and were discharged on a median 2.8 days post-operatively. Discharges beyond post-operative day 2 were due to a combination of logistical factors, discharge administration, therapy assessment requirements, and delayed MRI. Overall delays accounted for approximately £9,216 lost due to excess bed days over two months. 18 cases were reviewed post-intervention, demonstrating 16 (88.9%) POD1 MRI completed. POD1 discharge was achieved in 5 (27.8%) cases. Discharges beyond POD1 persisted, with 13 (72%) cases delayed. These delays were related to clinical status, rehabilitation needs, post-operative complications, limited weekend discharge capacity, and delays in optimising patients for early discharge following POD1 MRI. Median LOS was 3.0 days, which likely reflects non-imaging drivers of prolonged stay post-intervention. Conclusions Overall, dedicated POD1 MRI slots improved imaging timelines. However, POD1 discharge remained challenging due to identified issues to be addressed in a future audit cycle.