Patient experience and perceived acceptability of whole-body magnetic resonance imaging for staging colorectal and lung cancer compared with current staging scans: a qualitative study

Abstract

ObjectiveTo describe the experience and acceptability of whole-body magnetic resonance imaging (WB-MRI) staging compared with standard scans among patients with highly suspected or known colorectal or lung cancer.DesignQualitative study using one-to-one interviews with thematic analysis.SettingPatients recruited from 10 hospitals in London, East and South East England between March 2013 and July 2014.Participants51 patients (31 male, age range 40–89 years), with varying levels of social deprivation, were recruited consecutively from two parallel clinical trials comparing the diagnostic accuracy and cost-effectiveness of WB-MRI with standard scans for staging colorectal and lung cancer (‘Streamline-C’ and ‘Streamline-L’). WB-MRI was offered as an additional scan as part of the trials.ResultsIn general WB-MRI presented a greater challenge than standard scans, although all but four patients completed the WB-MRI. Key challenges were enclosed space, noise and scan duration; reduced patient tolerance was associated with claustrophobia, pulmonary symptoms and existing comorbidities. Coping strategies facilitated scan tolerance and were grouped into (1) those intended to help with physical and emotional challenges, and (2) those focused on motivation to complete the scan, for example focusing on health benefit. Our study suggests that good staff communication could reduce anxiety and boost coping strategies.ConclusionsAlthough WB-MRI was perceived as more challenging than standard scans, it was sufficiently acceptable and tolerated by most patients to potentially replace them if appropriate.Trial registration numberISRCTN43958015 and ISRCTN50436483.

Whole-body MRI compared with standard pathways for staging metastatic disease in lung and colorectal cancer: the Streamline diagnostic accuracy studies

“…Reasons participants were not interviewed included retracted consent (n = 8), participation in study 2 (questionnaire study) (n = 14), withdrawal from the main trial (n = 12) and interview quota reached before completion of all staging imaging tests (n = 6). 33 Interviews lasted between 12 and 86 minutes (mean 48 minutes). Overall, 39 participants (76%) were interviewed over the phone and the rest face to face.…”

“…However, the team was permitted to expand the recruitment number if they felt the point of saturation had not been reached. 33…”

“…Study 1 33 was a qualitative interview study. In general, participants reported that the challenge of WB-MRI was different from standard investigations, although the extent of this challenge varied considerably between individuals.…”

Patient deprivation and perceived scan burden negatively impact the quality of whole-body MRI

“…The results of these studies have been published elsewhere. 6,17,18 The present study uses some of the questionnaire data published previously 17 and reports a secondary analysis, the association with scan quality. The full recruitment pathway and reasons for exclusion are given in Fig 1. In detail, consenting patients were mailed a baseline questionnaire within 1e2 days of trial registration, which they returned using a stamped addressed reply envelope.…”

“…Scan attributes, notably the relatively lengthy duration, narrow bore, requirement to remain still, and the repetitive loud noise together with the contextual threat of what the scan could reveal may all induce distress. 6 The diagnostic accuracy of MRI is related to image quality and patient-centric factors. Mobility motion artefacts created from processes under voluntary control, such as respiration, swallowing, and body movement, contribute to reductions in image quality.…”