Neuro-Oncology Imaging in Litigation: A Practical Guide for Solicitors

For solicitors, the stronger question is whether the imaging was appropriate, properly interpreted, reviewed in context, and acted upon at the right time.

Brain tumour imaging claims are easy to oversimplify.

A lesion that appears obvious with hindsight may not necessarily have been negligently missed at the time. Equally, a radiology report that appears reasonable in isolation may look very different once the clinical history, imaging protocol, MDT records, pathology, treatment decisions and follow-up planning are reviewed together.

This creates a recurring issue in clinical negligence and personal injury litigation. Claims may be weakened where imaging is treated as a standalone exhibit rather than as part of a wider clinical decision-making chain. The key question is not simply what the scan showed, but whether the right scan was obtained, interpreted properly, communicated clearly, and considered by the appropriate specialists.

Access the full eBook here

Drawing on practical case studies discussed during INNEG’s webinar on neuro-oncology imaging in litigation, this eBook explores how imaging evidence can affect breach, causation, treatment decisions and expert evidence in brain tumour claims.

It examines common issues including pseudo-progression being mistaken for true tumour progression, premature treatment withdrawal, missed lesions, tumour misclassification, suboptimal imaging protocols, vague clinical request forms, absent MDT reasoning, and the risk of hindsight bias in retrospective review.

For solicitors, these issues have direct implications for case analysis, expert instruction, breach arguments and causation evidence. A strong case theory will often depend on understanding the full chronology: the clinical presentation, the scan request, the imaging protocol, the report, the MDT discussion, the treatment decision and the outcome.

The guide considers four key litigation scenarios: pseudo-progression and premature treatment withdrawal, missed lesions in patients with progressive symptoms, misclassification of temporal lobe tumours, and suboptimal imaging protocols in patients with vague neurological presentations.

It also highlights the importance of MDT evidence. In neuro-oncology claims, the MDT may support the defence, broaden the claim, expose missed opportunities, or reveal gaps in decision-making. Solicitors should be asking who reviewed the imaging, what baseline was used, what alternatives were discussed, whether further imaging was considered, and whether reasonable treatment options were put into the decision-making process.

Written specifically for solicitors handling complex clinical negligence and personal injury claims, this guide provides a practical framework for approaching neuro-oncology imaging evidence with more precision. It is designed to support stronger expert instruction, clearer analysis of breach and causation, and a more disciplined assessment of whether imaging-related failures made a material difference to the patient’s outcome.

Ultimately, the central question is not simply what was visible on the scan, but where the clinical decision-making chain broke.

This guide was produced by INNEG and is based on key clinical and medico-legal insights shared during our webinar on neuro-oncology imaging in litigation, delivered by Professor Sotirios Bisdas.