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MRI-only radiotherapy from an economic perspective : Can new techniques in prostate cancer treatment be cost saving?

Persson, Emilia LU ; Svanberg, Niklas ; Scherman, Jonas ; Jamtheim Gustafsson, Christian LU ; Fridhammar, Adam ; Hjalte, Frida ; Bäck, Sven LU ; Nilsson, Per LU orcid ; Gunnlaugsson, Adalsteinn LU and Olsson, Lars E LU orcid (2023) In Clinical and Translational Radiation Oncology 38. p.183-187
Abstract

BACKGROUND AND PURPOSE: The aim of this study was to analyze a magnetic resonance imaging (MRI)-only radiotherapy workflow from an economic perspective in terms of reduced time, costs and systematic uncertainties.

MATERIAL/METHODS: A documented Swedish clinical implementation of MRI-only radiotherapy was used as template for cost assessments compared to a combined computed tomography (CT)/MRI workflow. The costs were taken from official regional price lists from 2021. MRI-only specific quality assurance (QA) was assumed necessary in an initial phase. Treatment plans for target volumes with margins of 5-10 mm were created for ten prostate cancer patients prescribed 78 Gy in 39 fractions. The risk of Grade ≥ 2 rectal toxicity or... (More)

BACKGROUND AND PURPOSE: The aim of this study was to analyze a magnetic resonance imaging (MRI)-only radiotherapy workflow from an economic perspective in terms of reduced time, costs and systematic uncertainties.

MATERIAL/METHODS: A documented Swedish clinical implementation of MRI-only radiotherapy was used as template for cost assessments compared to a combined computed tomography (CT)/MRI workflow. The costs were taken from official regional price lists from 2021. MRI-only specific quality assurance (QA) was assumed necessary in an initial phase. Treatment plans for target volumes with margins of 5-10 mm were created for ten prostate cancer patients prescribed 78 Gy in 39 fractions. The risk of Grade ≥ 2 rectal toxicity or rectal bleeding was calculated using the QUANTEC recommended NTCP model and costs estimated based on subsequent diagnostic examinations.

RESULTS: The exclusion of the CT-examination and faster target delineation were the main contributors to cost reductions. Additional QA procedures limited the initial cost reduction to 14 EUR/patient. Long-term MRI-only reduced the costs by 209 EUR/patient. Reducing margins resulted in Grade ≥ 2 rectal toxicity or rectal bleeding probability of 9.7 % for 7 mm margin and 6.0 % for 5 mm margin. This margin reduction resulted in an additional cost reduction of 46 EUR/patient.

CONCLUSION: An MRI-only workflow implementation is associated with reduced costs when the workflow tasks are more time efficient and side effects are reduced as a result of margin reduction. The short-term economic benefits are limited due to extra costs of QA procedures. The economic benefits of MRI-only will make impact first when the workflow is well established, and margin reduction has been included.

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; ; ; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Clinical and Translational Radiation Oncology
volume
38
pages
183 - 187
publisher
Elsevier
external identifiers
  • pmid:36479236
  • scopus:85143511865
ISSN
2405-6308
DOI
10.1016/j.ctro.2022.11.012
language
English
LU publication?
yes
id
991b1bf5-07dd-42be-99c4-b7dafcdd6d1c
date added to LUP
2023-01-03 09:46:46
date last changed
2025-11-01 22:07:21
@article{991b1bf5-07dd-42be-99c4-b7dafcdd6d1c,
  abstract     = {{<p>BACKGROUND AND PURPOSE: The aim of this study was to analyze a magnetic resonance imaging (MRI)-only radiotherapy workflow from an economic perspective in terms of reduced time, costs and systematic uncertainties.</p><p>MATERIAL/METHODS: A documented Swedish clinical implementation of MRI-only radiotherapy was used as template for cost assessments compared to a combined computed tomography (CT)/MRI workflow. The costs were taken from official regional price lists from 2021. MRI-only specific quality assurance (QA) was assumed necessary in an initial phase. Treatment plans for target volumes with margins of 5-10 mm were created for ten prostate cancer patients prescribed 78 Gy in 39 fractions. The risk of Grade ≥ 2 rectal toxicity or rectal bleeding was calculated using the QUANTEC recommended NTCP model and costs estimated based on subsequent diagnostic examinations.</p><p>RESULTS: The exclusion of the CT-examination and faster target delineation were the main contributors to cost reductions. Additional QA procedures limited the initial cost reduction to 14 EUR/patient. Long-term MRI-only reduced the costs by 209 EUR/patient. Reducing margins resulted in Grade ≥ 2 rectal toxicity or rectal bleeding probability of 9.7 % for 7 mm margin and 6.0 % for 5 mm margin. This margin reduction resulted in an additional cost reduction of 46 EUR/patient.</p><p>CONCLUSION: An MRI-only workflow implementation is associated with reduced costs when the workflow tasks are more time efficient and side effects are reduced as a result of margin reduction. The short-term economic benefits are limited due to extra costs of QA procedures. The economic benefits of MRI-only will make impact first when the workflow is well established, and margin reduction has been included.</p>}},
  author       = {{Persson, Emilia and Svanberg, Niklas and Scherman, Jonas and Jamtheim Gustafsson, Christian and Fridhammar, Adam and Hjalte, Frida and Bäck, Sven and Nilsson, Per and Gunnlaugsson, Adalsteinn and Olsson, Lars E}},
  issn         = {{2405-6308}},
  language     = {{eng}},
  pages        = {{183--187}},
  publisher    = {{Elsevier}},
  series       = {{Clinical and Translational Radiation Oncology}},
  title        = {{MRI-only radiotherapy from an economic perspective : Can new techniques in prostate cancer treatment be cost saving?}},
  url          = {{http://dx.doi.org/10.1016/j.ctro.2022.11.012}},
  doi          = {{10.1016/j.ctro.2022.11.012}},
  volume       = {{38}},
  year         = {{2023}},
}