MRI-only radiotherapy from an economic perspective : Can new techniques in prostate cancer treatment be cost saving?
(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.
(Less)
- author
- Persson, Emilia LU ; Svanberg, Niklas ; Scherman, Jonas ; Jamtheim Gustafsson, Christian LU ; Fridhammar, Adam ; Hjalte, Frida ; Bäck, Sven LU ; Nilsson, Per LU ; Gunnlaugsson, Adalsteinn LU and Olsson, Lars E LU
- organization
- publishing date
- 2023-01
- type
- Contribution to journal
- publication status
- published
- subject
- in
- Clinical and Translational Radiation Oncology
- volume
- 38
- pages
- 183 - 187
- publisher
- Elsevier
- external identifiers
-
- scopus:85143511865
- pmid:36479236
- 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
- 2024-09-06 06:45:41
@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}}, }