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

British Journal of Radiology - Tập 91 Số 1086 - 2018
Ruth Evans1, Stuart A. Taylor2, Sandra Beare3, Steve Halligan2, Alison J. Morton4, Alf Oliver4, Andrea Rockall5,6, Anne Miles1
1Deparment of Psychological Sciences, Birkbeck, University of London, London, UK
2Division of Medicine, Centre for Medical Imaging, University College London, London, UK
3Cancer Research UK and UCL Cancer Trials Centre, London, UK
4C/O National Cancer Research Institute, Angel Building, London, UK
5Department of Radiology, Royal Marsden NHS Foundation Hospital Trust, London, UK
6Department of Surgery and Cancer, Imperial College London, Kensington, London, UK

Tóm tắt

Objective:

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 multicentre 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; 7, high). 

Results:

115 patients (median age 66.3 years; 67 males) completed follow up and 103 baseline questionnaires. 69 (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 comorbidities were associated with greater WB-MRI burden in adjusted analyses, with deprivation only approaching significance (adjusted regression β = 0.223, p = 0.025; β = 0.191, p = 0.048; β = −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.

Conclusion:

 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 comorbidities adversely impact on patient experience of WB-MRI. Patients with high distress or comorbid illness may need additional support to undergo a WB-MRI.

Từ khóa


Tài liệu tham khảo

Brocken, 2012, The faster the better?—A systematic review on distress in the diagnostic phase of suspected cancer, and the influence of rapid diagnostic pathways, Psychooncology, 21, 1, 10.1002/pon.1929

Ciliberto, 2013, Comparison between whole-body MRI and Fluorine-18-Fluorodeoxyglucose PET or PET/CT in oncology: a systematic review, Radiol Oncol, 47, 206, 10.2478/raon-2013-0007

Usuda, 2016, Diagnostic performance of whole-body diffusion-weighted imaging compared to PET-CT plus brain MRI in staging clinically resectable lung cancer, Asian Pac J Cancer Prev, 17, 2775

Plumb, 2017, Patient factors associated with non-attendance at colonoscopy after a positive screening faecal occult blood test, J Med Screen, 24, 12, 10.1177/0969141316645629

van Minde, 2014, Pinpointing moments of high anxiety during an MRI examination, Int J Behav Med, 21, 487

MacKenzie, 1995, Patients’ perceptions of magnetic resonance imaging, Clin Radiol, 50, 137, 10.1016/S0009-9260(05)83042-9

McIsaac, 1998, Claustrophobia and the magnetic resonance imaging procedure, J Behav Med, 21, 255, 10.1023/A:1018717016680

Dewey, 2007, Claustrophobia during magnetic resonance imaging: cohort study in over 55,000 patients, J Magn Reson Imaging, 26, 1322, 10.1002/jmri.21147

Dantendorfer, 1997, A study of the effects of patient anxiety, perceptions and equipment on motion artifacts in magnetic resonance imaging, Magn Reson Imaging, 15, 301, 10.1016/S0730-725X(96)00385-2

Harris, 2004, Predicting anxiety in magnetic resonance imaging scans, Int J Behav Med, 11, 1, 10.1207/s15327558ijbm1101_1

Shortman, 2015, A comparison of the psychological burden of PET/MRI and PET/CT scans and association to initial state anxiety and previous imaging experiences, Br J Radiol, 88, 10.1259/bjr.20150121

Evans, 2017, Patient experience and perceived acceptability of whole-body magnetic resonance imaging for staging colorectal and lung cancer compared with current staging scans: a qualitative study, BMJ Open, 7, 10.1136/bmjopen-2017-016391

Bigley, 2010, Neurolinguistic programming used to reduce the need for anaesthesia in claustrophobic patients undergoing MRI, Br J Radiol, 83, 113, 10.1259/bjr/14421796

Taylor, 2017, Streamlining staging of lung and colorectal cancer with whole body MRI; study protocols for two multicentre, non-randomised, single-arm, prospective diagnostic accuracy studies (Streamline C and Streamline L), BMC Cancer, 17, 10.1186/s12885-017-3281-x

Goldberg, 1988, A user's guide to the general health questionnaire

Knott, 2013, Health survey for England 2012, health social care and lifestyle

Katz, 1996, Can comorbidity be measured by questionnaire rather than medical record review?, Med Care, 34, 73, 10.1097/00005650-199601000-00006

Olomu, 2012, Do self-report and medical record comorbidity data predict longitudinal functional capacity and quality of life health outcomes similarly?, BMC Health Serv Res, 12, 10.1186/1472-6963-12-398

McLennan, 2011, The English indices of deprivation 2010

Salmon, 1994, Evaluating customer satisfaction with colonoscopy, Endoscopy, 26, 342, 10.1055/s-2007-1008988

von Wagner, 2011, Patient acceptability of CT colonography compared with double contrast barium enema: results from a multicentre randomised controlled trial of symptomatic patients, Eur Radiol, 21, 2046, 10.1007/s00330-011-2154-y

Faul, 2007, G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences, Behav Res Methods, 39, 175, 10.3758/BF03193146

Cohen, 1992, A power primer, Psychol Bull, 112, 155, 10.1037/0033-2909.112.1.155

Norman, 2003, Interpretation of changes in health-related quality of life: the remarkable universality of half a standard deviation, Med Care, 41, 582, 10.1097/01.MLR.0000062554.74615.4C

Guyatt, 2002, Methods to explain the clinical significance of health status measures, Mayo Clin Proc, 77, 371, 10.4065/77.4.371

Wiljer, 2013, Understanding the needs of colorectal cancer patients during the pre-diagnosis phase, J Cancer Educ, 28, 402, 10.1007/s13187-013-0465-1

Abreu, 2017, Oncological patient anxiety in imaging studies: the PET/CT example, J Cancer Educ, 32, 820, 10.1007/s13187-016-1069-3

Heyer, 2015, Anxiety of patients undergoing CT imaging-an underestimated problem?, Acad Radiol, 22, 105, 10.1016/j.acra.2014.07.014

Adams, 2014, Whole-body MRI vs. CT for staging lymphoma: patient experience, Eur J Radiol, 83, 163, 10.1016/j.ejrad.2013.10.008

Søgaard, 2013, The impact of comorbidity on cancer survival: a review, Clin Epidemiol, 5, 3, 10.2147/CLEP.S47150

Faggiano, 1997, Socioeconomic differences in cancer incidence and mortality, IARC Sci Publ, 138, 65

von Wagner, 2011, Psychosocial determinants of socioeconomic inequalities in cancer screening participation: a conceptual framework, Epidemiol Rev, 33, 135, 10.1093/epirev/mxq018

Simon, 2008, Socioeconomic disparities in psychosocial wellbeing in cancer patients, Eur J Cancer, 44, 572, 10.1016/j.ejca.2007.12.013

Jensch, 2010, CT colonography with limited bowel preparation: prospective assessment of patient experience and preference in comparison to optical colonoscopy with cathartic bowel preparation, Eur Radiol, 20, 146, 10.1007/s00330-009-1517-0

Charlson, 1987, A new method of classifying prognostic comorbidity in longitudinal studies: development and validation, J Chronic Dis, 40, 373, 10.1016/0021-9681(87)90171-8