Connecting centres, comparing practice: The role of benchmarking in interventional oncology

July 23, 2025

The IASIOS Benchmarking Subcommittee (BSC) is dedicated to supporting continuous improvement in interventional oncology practice through data-driven benchmarking across Enrolled and Accredited IASIOS Centres. Chaired by Prof. Miltiadis Krokidis, Deputy Chairperson of the IASIOS Committee and interventional radiologist in Athens, the BSC develops continuous data-collection tools, organizes collaborative workshops, and plans a patient-centred satisfaction survey. We spoke with Prof. Krokidis about his clinical work, the origins and objectives of the BSC, the challenges in designing benchmarking initiatives, and the subcommittee’s vision for the future.

CIRSE Insider: Could you tell us a little bit about your clinical work?

Krokidis: I practice interventional radiology in Athens, focusing almost entirely on IO since relocating from Cambridge five years ago. Our centre manages the complete IO pathway, ablation, chemoembolisation, and multidisciplinary tumour boards, so I’m deeply engaged in patient assessment, procedural planning, and post-treatment care.

CIRSE Insider: What is your role within the IASIOS Benchmarking Subcommittee?

Krokidis: I joined IASIOS at its inception seven years ago upon the invitation of Prof. Andy Adam to serve on the IASIOS Committee. Once the initial accreditation framework was established, subcommittees were formed to deepen and sustain our efforts. I was honoured to chair the new benchmarking subcommittee, tasked with guiding accredited centres toward more uniform clinical outcomes, whether they are high-volume, established programmes or emerging services still developing their IO expertise.

CIRSE Insider: Why do you think benchmarking is essential for interventional oncology?

Krokidis: Benchmarking is crucial. It’s about quality assurance, so that our offer meets defined standards. That’s essentially why IASIOS was created: to provide a framework for assessing the quality of interventional oncology treatments and services. Through benchmarking, we can measure performance against agreed metrics, identify gaps, and have a better picture of the state of practice in the field to drive targeted improvements afterwards. In IO, where procedural technique, team structure, and patient engagement vary widely, benchmarking provides the evidence base to harmonize care and optimize outcomes.

CIRSE Insider: How was the benchmarking subcommittee created, and what happened at the first workshop?

Krokidis: The BSC convened at ECIO 2024 and held its inaugural workshop on September 15 at CIRSE 2024. We gathered representatives from all accredited centres to present initial benchmarking concepts. We then mapped each centre’s status using data already collected in IASIOS applications, such as staff qualifications, procedure volumes, MDT participation, and patient feedback. Although not yet a formal benchmarking exercise, this “state-of-the-union” approach highlighted trends, sparked dialogue on best practices, and set the stage for more detailed data gathering.

CIRSE Insider: What are the objectives of the benchmarking subcommittee for 2025-2026?

Krokidis: Our work over the next two years is centred on three key initiatives:

1. Benchmarking tools: We have just sent a comprehensive benchmarking survey to all IASIOS Enrolled and Accredited Centres, covering the complete IO service line, workload, infrastructure, equipment and techniques, research, and education. The deadline for submission is August 8, 2025, and I strongly urge every centre to complete it. These data collection methods will enable continuous analysis to pinpoint areas for improvement.
2. Collaborative workshops: Building on our inaugural workshop in Lisbon, we plan to organize regular sessions at upcoming CIRSE Annual Congresses. These gatherings will present recent survey results and facilitate the exchange of best practices among IASIOS centres.
3. Patient satisfaction survey: Looking ahead, we plan to design and pilot a standardised patient satisfaction form template in 2026. This will embed the patient voice within our benchmarking framework and ensure that patient-centred care metrics become integral to quality assessment across all accredited services.

CIRSE Insider: What is the purpose of the benchmarking survey, and what challenges did you face in designing it?

Krokidis: After the first meeting, it became clear that more granular data were necessary. Our seven-member subcommittee debated extensively to define survey domains: basic facility details (name, location, year of enrolment, teaching status); case mix (primary versus secondary malignancies, supportive procedures); departmental staffing (number of interventional radiologists, EBIR qualification, monthly caseload, MDT involvement, clinical versus administrative time); dedicated personnel (nurses, trainees, radiographers); infrastructure (angiography suites, CT rooms, inpatient and day-unit capacity, anaesthesia support, admission rights); and academic activities (research projects, educational programmes).

The main challenge was balancing comprehensiveness with practicability: capturing the full spectrum of inputs without overburdening centres. Many items, such as admission rights and day-unit access, weren’t included in the initial accreditation application, so we had to ensure clarity and consistency in definitions to facilitate reliable comparisons.

CIRSE Insider: What are the main benefits of participating in the benchmarking survey?

Krokidis: Participation yields a clear picture of where each centre stands relative to peers. We can tailor support and resources by identifying discrepancies, whether in staffing ratios, infrastructure availability, or procedural volumes. IASIOS can then collaborate with centres to address specific needs, ultimately driving a more uniform standard of IO service and enhancing patient care across the network.

CIRSE Insider: What’s the future vision for the benchmarking subcommittee?

Krokidis: We plan to incorporate structured patient satisfaction data next, using the template developed in 2026. We also envision a shared research platform or registry to benchmark clinical outcomes, moving beyond inputs to measure results. These steps will require iterative refinement based on the first survey’s feedback. Still, our long-term aim is a comprehensive benchmarking ecosystem that supports continuous improvement and centre of excellence designation.

CIRSE Insider: What personally motivated you to join this subcommittee and pursue benchmarking work?

Krokidis: Benchmarking resonates with my commitment to collaborative progress. IASIOS feels like a professional family: sharing experiences, challenges, and successes fosters mutual growth. Establishing an open forum for centres to compare practices, learn from one another, and work toward common standards is deeply rewarding. I’m proud to help guide this international community toward ever-better patient outcomes.

CIRSE Insider: Finally, what advice would you give to a centre which is considering IASIOS accreditation, but isn’t sure it’ ready?

Krokidis: Don’t wait for perfection – accreditation is a catalyst for improvement. The process provides structure, guidance, and access to a supportive network. IASIOS can help you identify priorities and leverage external expertise to elevate your service even if management or resources are limited. In my experience, taking that first step in the accreditation journey is the most important move toward excellence in interventional oncology.