One scan could replace multiple scans to streamline cancer assessment

One scan could replace multiple scans to streamline cancer assessment

Date: 10 May 2019

Doctors could use just one scan to assess the spread of a patient’s cancer instead of the current practice of multiple scans, NIHR-funded research has found.

Researchers leading the study at University College London (UCL) and University College London Hospital (UCLH) say this could cut down on multiple scans could reduce treatment waiting times, save lives and reduce NHS costs.

Once a patient has been diagnosed with cancer, doctors usually use a combination of scans such as CT, PET and MRI to assess how the cancer has spread, as different scans are more effective for different parts of the body. But using multiple scans can take several weeks, exposes patients higher amounts of ionising radiation, delays the start of treatment and often adds to patient anxiety.

Today, two studies published in Lancet Respiratory Medicine and Lancet Gastroenterology and Hepatology show that for patients with non-small cell lung cancer (NSCLC) and colorectal cancer, one whole-body MRI (WB-MRI) scan can work just as well as multiple scans at assessing cancer spread and leads to the same treatment decisions - but is quicker, cheaper, preferred by patients and involves less exposure to radiation.

The two 'Streamline' studies - the biggest of their kind to compare WB-MRI with standard scans - found that for both cancers, using one WB-MRI scan removed the need for additional scans for nearly all patients, and reduced the average time taken to assess patients by almost a week.

Using WB-MRI, NSCLC patients were fully assessed within an average of 13 days, compared to 19 days using multiple scans. For colorectal cancer, the difference was eight days compared with 13 days.

The average cost of a WB-MRI scan for NSCLC patients was £317, half the £620 cost for multiple scans. The cost of a WB-MRI scan for colorectal patients was £216, compared with £285 for multiple scans.

And when asked, most patients said they would prefer assessment via WB-MRI.

No significant difference was found in the accuracy of WB-MRI compared with standard scans in assessing cancer spread - or in the treatment recommended as a result.

Researchers said there are drawbacks to using WB-MRI, saying some patients may experience claustrophobia in the longer, tube-shaped whole body scanner, compared with the doughnut shape of other scanners - and WB-MRI can take longer than any other individual CT, PET or MRI scan. Researchers said standard scans could still be offered to patients who would prefer them.

Professor Hywel Williams, Director of the NIHR’s Health Technology Assessment (HTA) Programme, which funded the study, said: “These are promising results which suggest that just one whole body MRI scan is as good as multiple scans for different body sites for informing treatment decisions. The process is also quicker and preferred by patients. If implemented widely, such a strategy could reduce waiting times for patients to start treatment for two of the deadliest forms of cancer.”

“This important study provides clinical and cost effective evidence which could provide useful for those planning and providing NHS scanning services to benefit patients.”

 For further information on this project please visit the NIHR Journals Library.

  • Summary:
    Doctors could use just one scan to assess the spread of a patient’s cancer instead of the current practice of multiple scans, NIHR-funded research has found.
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