PREDICTORS OF PATIENT PREFERENCES FOR WHOLE BODY MAGNETIC RESONANCE IMAGING COMPARED WITH STANDARD STAGING PATHWAYS FOR THE INVESTIGATION OF SYMPTOMS OF SUSPECTED COLORECTAL OR LUNG CANCER

Purpose: To examine predictors of patient preferences for either a whole body magnetic resonance imaging scan (WB-MRI) or standard staging scans (i.e. CT, PET-CT) among patients with highly suspected or known colorectal or lung cancer.

Method(s): Patients taking part in two parallel clinical trials comparing diagnostic accuracy and cost-effectiveness of WB-MRI with standard tests for staging colorectal and lung cancer (Streamline C, UKCRN ID: 12770 and Streamline L, UKCRN ID: 12954) were sent two questionnaires to complete. One questionnaire was sent at baseline, at the point of registration to the trial (measuring age, gender, educational level, presence of comorbidities, and positive and negative mood using the PANAS), and the second at post-staging, following completion of diagnostic and staging scans (measuring beliefs about, and satisfaction with, the WB-MRI scan, and scan preference: WB-MRI vs. CT (colorectal) or PET-CT (lung)).

Result(s): 107 patients completed the post-staging questionnaire, and of these, 97 also completed the baseline questionnaire. Fifty-two percent of patients expressed a preference for WB-MRI and preference was unrelated to cancer type. People with higher positive mood scores at baseline, no comorbidities, a greater awareness of the potential benefits of WB-MRI, and lower levels of reported discomfort during the WB-MRI scan, were more likely to express a preference for the WB-MRI scan in unadjusted analyses. People who were younger and had some educational qualifications showed a non-significant trend towards a preference for the WB-MRI. In adjusted analyses, which included predictors that were significant or approached significance, only higher positive emotion scores on the PANAS (OR: 1.097; 95% CIs: 1.029 to 1.170; p=0.005) and greater belief in the benefits of WB-MRI predicted patient preferences for WB-MRI. Examination of the individual items showed awareness that WB-MRI does not impart a radiation dose was the item that predicted patient preference for WB-MRI (OR: 3.096; 95% CIs: 1.061 to 9.034; p=0.039), yet only 42% of patients were aware of this attribute.

Conclusion(s): Over half of patients undergoing staging scans for suspected colorectal or lung cancer would prefer to have a WB-MRI than CT/ PET-CT, and this did not differ according to cancer type. Raising awareness of the potential benefits of WB-MRI, in particular the fact it does not emit radiation, could increase patient preferences for this scan.