Patient deprivation and perceived scan burden negatively impact on the quality of WB-MRI

Evans, Ruth and Taylor, S. and Kalasthry, J. and Sakai, N.S. and Miles, Anne (2020) Patient deprivation and perceived scan burden negatively impact on the quality of WB-MRI. Clinical Radiology 75 (4), pp. 308-315. ISSN 0009-9260.

Abstract

Aim: To evaluate the association between cancer staging whole body WB-MRI (WB-MRI) image quality and patient demographics, distress and perceived scan burden Materials and Methods: A sample of patients prospectively recruited to multicentre trials comparing WB-MRI with standard scans for staging lung and colorectal cancer, were invited to complete two questionnaires. The baseline questionnaire, administered at recruitment, collated data on demographics, distress and co-morbidity; the follow-up questionnaire, completed after staging investigations, measured perceived WB-MRI scan burden (scored 1 low to 7 high). WB-MRI anatomical coverage and technical quality was graded by a radiographic technician and grading combined to categorise the scan as ‘optimal’, ‘sub-optimal’ or ‘degraded’. A radiologist categorised 30 scans to test inter-observer agreement. Data were analysed using Chi Square, Fisher Exact, t-tests and multinomial regression. Results: 114 patients were included in the study (53 lung, 61 colorectal; average age 65.3, SD=11.8; 66 men, (57.9%)). Overall, 45.6% (n=52), scans were classified as ‘optimal’ quality, 39.5% (n=45) ‘sub-optimal’ and 14.9% (n=17) as ‘degraded’. In adjusted analyses greater deprivation level and higher patient-reported scan burden were both associated with a higher likelihood of having a sub-optimal vs. an optimal scan (OR: 4.465, CI: 1.454 to 13.709, p=0.009; OR: 1.987, CI: 1.153 to 3.425, p=0.013 respectively). None of the variables predicted the likelihood of having a degraded scan. Conclusions: Deprivation as well as patients’ perceived experience of the WB-MRI, is related to image quality. Tailored protocols and individualised patient management before and during WB-MRI may improve scan quality.

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