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Perceived patient burden and acceptability of whole body MRI for staging lung and colorectal cancer; comparison with standard staging investigations.

Research paper by Ruth Ec RE Evans, Stuart A SA Taylor, Sandra S Beare, Steve S Halligan, Alison A Morton, Alf A Oliver, Andrea A Rockall, Anne A Miles

Indexed on: 13 Mar '18Published on: 13 Mar '18Published in: The British journal of radiology



Abstract

To evaluate perceived patient burden and acceptability of whole body MRI (WB-MRI) compared to standard staging investigations, and identify predictors of reduced tolerance.  Methods: Patients recruited to multi-centre trials comparing WB-MRI with standard staging scans for lung and colorectal cancer were invited to complete two questionnaires: a baseline questionnaire at recruitment, measuring demographics, comorbidities, and distress; and a follow-up questionnaire after staging, measuring recovery time, comparative acceptability/satisfaction between WB-MRI and CT (colorectal cancer) and PET-CT (lung cancer), and perceived scan burden (scored 1 low to 7 high).  Results: 115 patients (median age 66.3 years; 67 males) completed follow-up and 103 baseline questionnaires. Sixty-nine (63.9%) reported "immediate" recovery from WB-MRI and 73 (65.2%) judged it "very acceptable". Perceived WB-MRI burden was greater than for CT (p < 0.001) and PET-CT (p < 0.001). High distress and co-morbidities were associated with greater WB-MRI burden in adjusted analyses, with deprivation only approaching significance (adjusted regression Beta = 0.223, p = 0.025; Beta = 0.191, p = 0.048; Beta = -0.186, p = 0.059 respectively). Age (p = 0.535), gender (p = 0.389), ethnicity (p = 0.081) and cancer type (p = 0.201) were not predictive of WB-MRI burden.  WB-MRI is marginally less acceptable and more burdensome than standard scans, particularly for patients with pre-existing distress and comorbidities.  Advances in knowledge: This research shows that WB-MRI scan burden, although low, is higher than for current staging modalities among patients with suspected colorectal or lung cancer. Psychological and physical co-morbidities, adversely impact on patient experience of WB-MRI. Patients with high distress or comorbid illness may need additional support to undergo a WB-MRI.

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