The International Accreditation System for Interventional Oncology Services (IASIOS) is the world’s first accreditation programme focused exclusively on standardising interventional oncology (IO) care, redefining the rapidly evolving field. Reporting record growth exceeding 150% in 2023, IASIOS recently announced their first accredited facility in the USA, a significant milestone which marked its expansion to a new and major corner of the international IO community.
“It’s accreditation and unification,” said Jack Jennings on behalf of the newly accredited Mallinckrodt Institute of Radiology (MIR) at Washington University in St Louis, USA. Embarking on their IASIOS accreditation process, Jennings and his team were driven by the opportunity to strengthen bonds with the physicians of IASIOS’ international network. This “alliance”, and mutual dedication to improving quality and safety in IO, is more relevant today than ever, Jennings conveyed, as the specialty does the groundwork for the “steep and rapid incline” of IO procedures in this booming faction of interventional radiology (IR).
In a comment to Interventional News, chair of the IASIOS supervisory board Andreas Adam (Kings College London, London, UK) shared that the global nature of IASIOS is one of its greatest strengths, as it emphasises certain universal concepts such as IRs looking after their own patients. Remarking on the recent USA accreditation, Adam stated that MIR’s enrolment is a “major milestone” in IASIOS’ history. “The USA is the birthplace of IR and the largest provider of IR services. We are delighted to welcome the MIR, as its accreditation is a perfect demonstration of the universality of the principles on which IASIOS is founded.”
A world-first accreditation programme
IASIOS is the world’s first accreditation system focused solely on upholding quality assurance for minimally-invasive treatments for cancer. Due to the continued growth and recognition of IO as a key clinical discipline and the fourth pillar of cancer care, consensus has dictated that centres providing IO treatments must adhere to robust guidelines to ensure a universally high standard of care. During its conception, the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) lifted the current quality assurance standards for radiation oncology—developed by The Royal Australian and New Zealand College of Radiologists (RANZCR)—as a template which was well aligned with the practice of IO.
The fruits of this labour—the CIRSE Standards of Quality Assurance in Interventional Oncology—establishes a “gold standard” in patient care and safeguarding in IO. Yet, as RANZCR president at the time and current steering board member of IASIOS Liz Kenny (Royal Brisbane and Women’s Hospital, Herston, Queensland Australia) noted, IO is “still a
very young speciality and in many countries faces obstacles that other clinical disciplines have already overcome”.
For this reason, Kenny alongside CIRSE, spearheaded the development of the tiered accreditation system—IASIOS— to “distinguish between ‘core criteria’ i.e., those considered necessary to provide safe patient care, and ‘extended criteria’, which are more aspirational and considered the ideal”, which Kenny and IASIOS chief operations officer Mardis Karlsdottir, outlined in a recent article published in the Journal of Medical Imaging and Radiation Oncology.
The Standards of Quality Assurance in Interventional Oncology that form the foundation of IASIOS has since gained global support from over 40 national and international radiology and interventional radiology societies, drawing the discipline together in a “unified front”, Kenny and Mardis state, and this comes at an opportune moment.
In the house of IR—and an integral section of it—IO is embarking on a parallel path to greater recognition internationally, which is developing apace alongside novel innovations and technological advancements in the field. For Jennings, installing a “baseline accreditation” sets a background for quality and safety among the rapid growth of IO therapies, such as immunotherapy. “It’s great to have an overarching accreditation process to know that we’re not going rogue, or cowboy-esque; to bring greater uniformity, credibility and validity to the specialty on both sides of the pond,” Jennings explained.
“The truth is that [IO] has become a bit of an innovative Wild West,” said David Breen (University Hospital Southampton, Southampton, UK), resonating with Jennings while speaking on behalf of his IASIOS-accredited centre. IO sits within a “rapidly developing and complex therapeutic arena” he explained, stating that IASIOS, alongside CIRSE, has arrived at a critical time in the development of IO. “In a number of areas an individual’s cancer care pathway is set to become more complex, with increasingly significant contributions from IO. It’s important that IASIOS now begins to set agreed international standards and expectations of practising units. This will help IO develop in an organised fashion and realise its full potential.”
By surveying accredited facilities, recognition for IO varies geographically, but this remains a challenge which IASIOS intends to rectify across the globe. For Jennings in the USA, following the American Board of Medical Specialties (ABMS) recognition of IR as a primary specialty in 2012, quality and safety measures have “not been geared at [IO], which is seen as a subset of [IR’s] quality and safety”. In gaining IASIOS accreditation at his institution, Jennings hopes to lead the way for other interventional oncology facilities in the USA to follow suit, giving the specialty better footing—“a lot of people are talking about this” he said, suggesting that IASIOS accreditation has a “larger overall message” of awareness raising.
Connecting international centres
IASIOS accreditation for Murat Dökdök (Anadolu Medical Centre, Gebze, Turkey) has enabled his centre to look at IO procedures specifically, to “define the processes that are crucial in maintaining best medical practice”. As day-to-day interventional procedures are “complex to interpret”, he detailed, a clear benefit of IASIOS is its ability to “instil trust” and promote confidence for patients and physicians alike. Dökdök also expressed the importance of bolstering IO through IASIOS’ global network, noting that “collaboration among accredited centres from various countries can foster international research projects, joint training programmes and cross-border healthcare initiatives”.
In The Netherlands, Mark Burgmans (Leiden University Medical Centre, Leiden, The Netherlands) agrees that IASIOS accreditation has made it “easier to reach out to other centres and share experiences” in order to “overcome hurdles” in the field. Yet, he maintained that the collection of robust data via randomised controlled trials in IO can be “difficult or impossible”. He furthered that real-world data and registries should be used to reinforce recognition for IO, as they have already found “convincing evidence of the efficacy and effectiveness of IO therapies”.
“Healthcare is facing tremendous challenges,” Burgmans continued, identifying rising staff shortages and financial constraints occurring amid increasing demand for care. “IO is part of the solution—it offers effective therapies at lower costs and shorter hospital stays,” said Burgmans, advocating for “investment” in IO today, confident that this investment will return in the future, in part facilitated by IASIOS. “IASIOS will help to convince policy makers, health authorities, funding agencies, and board directors that IO is a safe bet”.
“We are close,” Breen added, “but healthcare commissioners and patients still need awareness of IO’s major, yet still potential, contribution to cancer treatment”. Concurrent to Burgmans, Breen believes that high-quality adoption of IO will be achieved through “highly-literate lobbying” with interventional oncologists placed on guideline panels. This is particularly crucial in the context of technological advancements, as Breen stated that IASIOS will bring “structure to IO provision before there is haphazard, poor-quality adoption by other services”.
For Rodrigo Gobbo (Hospital Albert Einstein, São Paulo, Brazil) IASIOS has allowed of applying to become his centre to “stay abreast” of technological advancements, seeing their clinicians gain “comprehensive training” and maintain “consistent high-quality outcomes” for patients. “The accreditation acts as a guide for navigating the dynamic landscape of IO,” Gobbo said, underlining the adaptive nature of the IASIOS which ensures accredited centres “remain at the forefront of innovation to benefit both patients and clinicians alike”.
Gaining momentum
IASIOS’s global expansion is evident; with their most recent accreditation in the USA, sights are set on connecting more global facilities with their IO network. Championing excellence in oncological treatments, IASIOS’ objectives are “not just checkboxes” as chief operations officer Mardis conveyed, but rather “milestones in our collective journey towards excellence in IO”. “Our vision extends beyond accreditation, to a collaborative community that accelerates IO development and enhances global access to IO care. In 10 years, IASIOS aspires to be a central hub where IO practitioners contribute to and benefit from benchmarking, workshops and knowledge exchange, ensuring excellence in patient care on a global scale.”
IASIOS is no doubt gaining international momentum in its pursuit of a worldwide standard for the highest quality of care for patients with cancer. Creating a unified voice for the furtherment of IO, IASIOS continues to report a growing community with centres throughout Asia, Australia, Europe, the Middle East, North America, and South America.
