by
Gus Iversen, Editor in Chief | September 03, 2019
From the September 2019 issue of HealthCare Business News magazine
PP: The MR environment is new to most radiation oncology departments and we worked hand-in-hand with our radiology colleagues to implement best practices for MR safety. We are included in the hospital-wide MR safety conferences and we also had our staff take the same training as offered to radiology staff. A robust safety culture has prevented any MR safety-related events in the two years our center has been open.
HCB News: Is MR-guided radiation therapy still primarily in the research phase or is it being used more clinically for certain indications? What is the reimbursement situation like?
PP: There are now over 20 programs offering clinical MR-guided radiation therapy. For almost all of the sites, it has certainly become the standard of care for hepatobiliary cancers, as well as small amounts of lymph node disease in the abdomen or pelvis. The ability to visualize these tumors, control for respiratory motion and change the radiation plan based on stomach and intestine position allow safer and faster ablative radiation doses.
The current reimbursement for MR-guided adaptive radiation therapy is favorable. We will obtain reimbursement for additional radiation therapy plans delivered during the radiation course if the anatomy changes in a meaningful fashion and these charges have almost universally been accepted.
HCB News: Looking ahead, what role do you imagine MR-guided radiation therapy playing in cancer treatment a decade from now? What challenges (in terms of cost, access, illustrating benefits, etc.) need to be addressed?
PP: The long-term radiation therapy practice will need to show simultaneous clinical efficacy with heightened efficiency. With the advent of the alternative payment model, essentially capitating both professional and technical charges per diagnosis in 90 day events, there is an incentive for improvement in outcomes without increasing number of treatments. MR-guided radiation therapy machines are uniquely positioned to do this, allowing safe, effective treatments in one week or less for many diseases traditionally treated over 5 ½ weeks. Moreover, some users are using their systems to do away with traditional simulation, which will shorten treatment times further and improve value for the patient. I see MR-guided radiation therapy becoming a standard machine in any dual linear accelerator clinic.
Challenges being addressed currently are treatment times, distribution of adaptive radiation responsibilities to therapists from the physician/physicists, and physician training. For a technology that is less than five years old, these steps are occurring rapidly.
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