Because of its subjective nature and poor correlation with observer-rated measures of disfigurement, head and neck cancer-related body image disturbance is optimally measured by a patient-reported outcome measure (PROM). To address the lack of psychometrically sound PROMs that could be used to provide a comprehensive assessment of HNC-related BID, we developed the IMAGE-HN (Inventory to Measure and Assess imaGe disturbancE–Head & Neck). IMAGE-HN is a novel, multidomain PROM for the assessment of HNC-related body image concerns in the clinical and research settings that was developed using rigorous psychometric methods and following the Patient-Reported Outcomes Measurement Information System (PROMIS) methodology.

The IMAGE-HN is a psychometrically sound 24-item PROM of head and neck cancer-related body image disturbance consisting of a global scale and 4 subscales: (1) other-oriented appearance concerns; (2) personal dissatisfaction with appearance; (3) distress with functional impairments; (4) social avoidance and isolation. 

An IMAGE-HN score of ≥ 22 was the optimal cutoff score relative for a Body Image Scale score of ≥10 and represents a clinically relevant level of head and neck cancer-related body image distress (BID). 

Using the IMAGE-HN

To access the IMAGE-HN, please use the below link: 

For more information about the development and validation of IMAGE-HN, please see:


MUSC Foundation for Research Development (MUSC FRD) reserves and retains full and undivided ownership, all rights of every kind and nature, of the IMAGE-HN instruments and any derivative works. By submitting this Request to Download and downloading the IMAGE-HN materials, I agree not to use the IMAGE-HN instruments for any purpose other than the purpose described above. In any publication that results from or relates to the use of the IMAGE-HN instruments, I agree to acknowledge MUSC and the creators of the IMAGE-HN instruments in a manner consistent with academic standards for publication.

MUSC FRD and MUSC shall not bear any liability or damages with respect to any claim by you or any third party on account of, or arising from, the use of the IMAGE-HN instruments or any derivatives thereof. MUSC FRD AND MUSC MAKE NO REPRESENTATIONS OR WARRANTIES, EXPRESS OR IMPLIED. THE IMAGE-HN INSTRUMENTS ARE PROVIDED ‘AS IS’ WITH NO SUPPORT SERVICES OF ANY KIND. By way of example, but not limitation, MUSC FRD AND MUSC MAKE NO REPRESENTATIONS OR WARRANTIES OF MERCHANTABILITY OR FITNESS FOR ANY PARTICULAR PURPOSE OR THAT THE USE OF THE WORK SHALL NOT INFRINGE ANY PATENTS, COPYRIGHTS, TRADEMARKS, OR OTHER RIGHTS and assumes no responsibility whatsoever with respect to the use by you or any permitted or unpermitted transferees pursuant to the IMAGE-HN instruments.