Predictors of patient preference for either whole body magnetic resonance imaging (WB‐MRI) or CT/ PET‐CT for staging colorectal or lung cancer. Issue 4 (14th May 2020) - Miles, Anne
Abstract: Introduction: Whole body magnetic resonance imaging (WB‐MRI) may be more efficient in staging cancers, but can be harder for patients to tolerate. We examined predictors of patient preference for WB‐MRI vs. CT/ PET‐CT for staging colorectal or lung cancer. Methods: Patients recruited prospectively to two multicentre trials comparing diagnostic accuracy of WB‐MRI with standard staging scans were sent two questionnaires: the first, administered at trial registration, captured demographics, educational level and comorbidities; the second, administered after staging completion, measured emotional distress (GHQ‐12), positive mood (PANAS), perceived scan burden, patients' beliefs about WB‐MRI, and preference for either WB‐MRI or CT (colorectal trial), WB‐MRI or PET‐CT (lung trial). Preference for WB‐MRI or CT/ PET‐CT was analysed using logistic regression. Results: Baseline and post‐staging questionnaires were completed by 97 and 107 patients, respectively. Overall, 56/107 (52%) preferred WB‐MRI over standard scans and were more likely to have no additional comorbidities, higher positive mood, greater awareness of potential benefits of WB‐MRI and lower levels of perceived WB‐MRI scan burden. In adjusted analyses, only awareness of potential WB‐MRI benefits remained a significant predictor (OR: 1.516, 95% CIs 1.006–2.284, P = 0.047). Knowledge that WB‐MRI does not use radiation predicted preference (adjusted OR: 3.018, 95% CIs 1.099–8.288, P = 0.032), although only 45/107 (42%) patients were aware of this attribute. Conclusions: A small majority of patients undergoing staging of colorectal or lung cancer prefer WB‐MRI to CT/ PET‐CT. Raising awareness of the potential benefits of WB‐MRI, notably lack of ionizing radiation, could influence preference.