Perceived patient burden and acceptability of whole body MRI for staging lung and colorectal cancer; comparison with standard staging investigations

Abstract

Objectives – To evaluate perceived patient burden and acceptability of whole body MRI (WB-MRI) compared to standard staging investigations, and identify predictors of reduced tolerance. Methods – Patients recruited to multi-centre trials comparing WB-MRI with standard staging scans for lung and colorectal cancer were invited to complete two questionnaires: a baseline questionnaire at recruitment, measuring demographics, comorbidities, and distress; and a follow-up questionnaire after staging, measuring recovery time, comparative acceptability/ satisfaction between WB-MRI and CT (colorectal cancer) and PET-CT (lung cancer), and perceived scan burden (scored 1 low to 7 high). Results – 115 patients (median age 66.3 years; 67 males) completed follow-up and 103 baseline questionnaires. Sixty-nine (63.9%) reported “immediate” recovery from WB-MRI and 73 (65.2%) judged it “very acceptable”. Perceived WB-MRI burden was greater than for CT (p<0.001) and PET-CT (p<0.001). High distress and co-morbidities were associated with greater WB-MRI burden in adjusted analyses, with deprivation only approaching significance (adjusted regression Beta=0.223, p=0.025; Beta=0.191, p=0.048; Beta = -0.186, p=0.059 respectively). Age (p=0.535), gender (p=0.389), ethnicity (p=0.081) and cancer type (p=0.201) were not predictive of WB-MRI burden. Conclusions: WB-MRI is marginally less acceptable and more burdensome than standard scans, particularly for patients with pre-existing distress and comorbidities. Advances in knowledge: This research shows that WB-MRI scan burden, although low, is higher than for current staging modalities among patients with suspected colorectal or lung cancer. Psychological and physical co-morbidities, adversely impact on patient experience of WB-MRI. Patients with high distress or comorbid illness may need additional support to undergo a WB-MRI