AI Article Synopsis
- The study evaluates the economic advantages of an MRI-only radiotherapy process compared to a combined CT/MRI approach, highlighting cost savings from faster procedures and eliminated CT scans.
- Increased costs from initial quality assurance procedures limited short-term savings, but longer-term implementation of MRI-only could reduce costs significantly.
- Margin reductions during treatment lead to decreased risks of side effects and further cost savings, indicating that the full financial benefits will be realized once the MRI-only workflow stabilizes.
Article Abstract
Background And Purpose: The aim of this study was to analyze a magnetic resonance imaging (MRI)-only radiotherapy workflow from an economic perspective in terms of reduced time, costs and systematic uncertainties.
Material/methods: A documented Swedish clinical implementation of MRI-only radiotherapy was used as template for cost assessments compared to a combined computed tomography (CT)/MRI workflow. The costs were taken from official regional price lists from 2021. MRI-only specific quality assurance (QA) was assumed necessary in an initial phase. Treatment plans for target volumes with margins of 5-10 mm were created for ten prostate cancer patients prescribed 78 Gy in 39 fractions. The risk of Grade ≥ 2 rectal toxicity or rectal bleeding was calculated using the QUANTEC recommended NTCP model and costs estimated based on subsequent diagnostic examinations.
Results: The exclusion of the CT-examination and faster target delineation were the main contributors to cost reductions. Additional QA procedures limited the initial cost reduction to 14 EUR/patient. Long-term MRI-only reduced the costs by 209 EUR/patient. Reducing margins resulted in Grade ≥ 2 rectal toxicity or rectal bleeding probability of 9.7 % for 7 mm margin and 6.0 % for 5 mm margin. This margin reduction resulted in an additional cost reduction of 46 EUR/patient.
Conclusion: An MRI-only workflow implementation is associated with reduced costs when the workflow tasks are more time efficient and side effects are reduced as a result of margin reduction. The short-term economic benefits are limited due to extra costs of QA procedures. The economic benefits of MRI-only will make impact first when the workflow is well established, and margin reduction has been included.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9720486 | PMC |
| http://dx.doi.org/10.1016/j.ctro.2022.11.012 | DOI Listing |
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