Triage Radiology Imaging Assessment for Greater Effectiveness

Inclusion Criteria: For main trial * Adult patient (≥ 18 years of age) at the time of MRI. * Brain MRI scan performed at a participating NHS site during the defined study period (intervention or control arm). * Brain MRI scan series will automatically be included if they contain the required scan sequences and are of the required resolution. For O3 subgroup ● Radiologists, radiographers, and referring clinicians involved with the use of the MIDI tool at sites who consent to completing the staff survey For O7 subgroup * Adult patient (≥ 18 years of age) at the time of MRI. * Brain MRI scan performed at a participating NHS site during the defined study period (intervention or control arm). * Brain MRI scan series will automatically be included if they contain the required scan sequences and are of the required resolution. * Patient with suspected de novo stroke/TIA in TIA/Stroke pathway. * Patient with suspected de novo stroke/TIA in Acute Neurology pathway. * Patient with suspected de novo stroke/TIA identified via SSNAP review. For O8 subgroup * Adult patient (≥ 18 years of age) at the time of MRI. * Brain MRI scan performed at a participating NHS site during the defined study period (intervention or control arm). * Brain MRI scan series will automatically be included if they contain the required scan sequences and are of the required resolution. * Patient with stage III/IV malignant melanoma undergoing regular surveillance MRI brain scans presenting with de novo brain metastases. * Patient with lung cancer undergoing pre-radical treatment staging MRI brain scans presenting with de novo brain metastases. * Patients with de novo symptomatic brain metastases secondary to melanoma and/or lung cancer and/or breast cancer detected on MRI brain scans from all patient pathways. Additionally for those completing EORTC questionnaires: ● Able to give consent and likely to be able to complete EORTC questionnaires. Exclusion Criteria: For main trial * Patient is under 18 years of age at the time of MRI. * Brain MRI scan not performed at a participating NHS site or outside the defined study period. * Data will be excluded for those patients who have opted out of the use of their data for research under the National Data Opt-Out. * Brain MRI scan series will automatically be excluded if they do not contain the required scan sequences and/or the required resolution. For O3 subgroup ● Radiologists, radiographers, and referring clinicians involved with the use of the MIDI tool at sites who do not consent to completing the staff survey For O7 subgroup * Patient is under 18 years of age at the time of MRI. * Brain MRI scan not performed at a participating NHS site or outside the defined study period. * Data will be excluded for those patients who have opted out of the use of their data for research under the National Data Opt-Out. * Brain MRI scan series will automatically be excluded if they do not contain the required scan sequences and/or the required resolution. * Patient without suspected de novo stroke/TIA or not on TIA/Stroke pathway. * Patient without suspected de novo stroke/TIA or not on Acute Neurology pathway. For O8 subgroup * Patient is under 18 years of age at the time of MRI. * Brain MRI scan not performed at a participating NHS site or outside the defined study period. * Data will be excluded for those patients who have opted out of the use of their data for research under the National Data Opt-Out. * Brain MRI scan series will automatically be excluded if they do not contain the required scan sequences and/or the required resolution. * Patient without stage III/IV malignant melanoma, or not undergoing regular surveillance MRI brain scans, or not presenting with de novo brain metastases. * Patient without lung cancer undergoing pre-radical treatment staging MRI brain scans, or not presenting with de novo brain metastases. * Patients without de novo symptomatic brain metastases secondary to melanoma and/or lung cancer and/or breast cancer detected on MRI brain scans. Additionally for those completing EORTC questionnaires: ● Unable to give consent and unlikely to be able to complete EORTC questionnaires.