Clinical experience and cost evaluation of magnetic resonance imaging -only workflow in radiation therapy planning of prostate cancer

AbstractBackground and purposeIn radiation therapy (RT), significant improvements have been made recently particularly in the practices of planning imaging. This study aimed to conduct a cost evaluation between magnetic resonance imaging (MRI) -only and combined computed tomography (CT) and MRI workflows.Materials and methodsThe time-driven activity-based costing (TDABC) model was used to conduct a cost evaluation between the two workflows in those steps, where cost differences were expected. Costs were divided into capital costs and operational costs. The former consisted of fixed, one-time expenses, e.g. the purchase of a scanner, whereas the latter were partially based on the amount of activity consumed i.e. time required for image acquisition, image registration and structure contouring.ResultsIn a review over a period of 10 years for 300 annual prostate cancer patients, the total cost of the workflow steps included in the study for an individual patient applying the MRI-only workflow was 903 € (100%), comprised of 537 € (59%) capital costs and 366 € (41%) operational costs. The corresponding total cost for an individual patient applying the CT + MRI workflow was 922 € (100%), comprised of 197 € (21%) capital costs and 726 € (79%) operational costs. In 10 years for 3000 patients, a total saving of 58,544 € (2%) was achieved with the MRI-only workflow compared with the dual imaging workflow.ConclusionsMRI-only workflow is a feasible and economic way to perform clinical RT for localized prostate cancer, in particular for medium- and large-sized departments treating a sufficient number of patients.</p