What can whole-body MR mean for staging cancer more efficiently?

What can whole-body MR mean for staging cancer more efficiently?

by Gus Iversen, Editor in Chief | November 08, 2019
MRI Rad Oncology
Stuart Taylor
From the November 2019 issue of HealthCare Business News magazine

A group of researchers in the U.K. have found that whole-body MR (WB-MR) imaging may reduce the time required for staging and planning cancer treatment, based on two prospective trials.

We spoke with Stuart Taylor, researcher and professor of medical imaging at University College London, to learn more about whole-body MR and the benefits it could bring to healthcare.

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Stuart Taylor: WB-MR uses standard MR machines and sequences, so can be implemented on most modern MR machines widely available in many healthcare systems. The scan covers most of the body, usually from head to mid-thigh so it is typically used in diseases which can affect any part of the body, with cancer staging being the most common indication.

Due to the pressures on scanner capacity and to improve patient experience, WB-MR scans are usually designed to take a maximum of an hour to acquire, although it is possible to scan using much shorter times. The concept is that the scan is good enough to detect important abnormalities without the high level of detail provided by scans tailored to one individual organ.

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ST: WB-MR has been used for staging many cancer types including myeloma, breast cancer and prostate cancer. Although the evidence behind its use in these tumours is very promising, studies are usually relatively small, limited to single hospitals with scans interpreted by very experienced radiologists.

The Streamline trials were the first large prospective multicenter studies of WB-MR where scans were performed and interpreted exactly as they would be in routine clinical practice. WB-MR was performed to stage colorectal cancer and lung cancer. The trials found that WB-MR was just as good as conventional scans (such as CT and PET/CT), but staging pathways were quicker and less scans were needed.

HCB News: Your research found that the whole-body MR pathways were quicker and cheaper in the NHS setting than conventional approaches. Are there specific characteristics of the NHS setting that may factor into those findings?
ST: This finding was based on standard tariff costs used in the English NHS, and on typical waiting times in NHS hospitals. It does assume that WB-MR can be performed within a reasonable time, usually within two weeks of request. Thus, hospitals need to have capacity on MR machines to achieve this. The costs of scans differ across healthcare systems so the cost savings my not necessarily hold true in other countries.

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