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Pinto P, Valentin L, Borčinová M, Wiesnerová M, Filip F, Burgetova A, Masek M, Lambert L, Chiappa V, Franchi D, Testa AC, Moro F, Avesani G, Panico C, Alessi S, Pricolo P, Vigorito R, Calareso G, Kocian R, Slama J, Fagotti A, Urbinati AMV, Signorelli M, Bertolina F, Cibula D, Fischerova D. Patient satisfaction with ultrasound, whole-body CT and whole-body diffusion-weighted MRI for pre-operative ovarian cancer staging: a multicenter prospective cross-sectional survey. Int J Gynecol Cancer 2024; 34:871-878. [PMID: 38531539 DOI: 10.1136/ijgc-2023-005264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/28/2024] Open
Abstract
BACKGROUND In addition to the diagnostic accuracy of imaging methods, patient-reported satisfaction with imaging methods is important. OBJECTIVE To report a secondary outcome of the prospective international multicenter Imaging Study in Advanced ovArian Cancer (ISAAC Study), detailing patients' experience with abdomino-pelvic ultrasound, whole-body contrast-enhanced computed tomography (CT), and whole-body diffusion-weighted magnetic resonance imaging (WB-DWI/MRI) for pre-operative ovarian cancer work-up. METHODS In total, 144 patients with suspected ovarian cancer at four institutions in two countries (Italy, Czech Republic) underwent ultrasound, CT, and WB-DWI/MRI for pre-operative work-up between January 2020 and November 2022. After having undergone all three examinations, the patients filled in a questionnaire evaluating their overall experience and experience in five domains: preparation before the examination, duration of examination, noise during the procedure, radiation load of CT, and surrounding space. Pain perception, examination-related patient-perceived unexpected, unpleasant, or dangerous events ('adverse events'), and preferred method were also noted. RESULTS Ultrasound was the preferred method by 49% (70/144) of responders, followed by CT (38%, 55/144), and WB-DWI/MRI (13%, 19/144) (p<0.001). The poorest experience in all domains was reported for WB-DWI/MRI, which was also associated with the largest number of patients who reported adverse events (eg, dyspnea). Patients reported higher levels of pain during the ultrasound examination than during CT and WB-DWI/MRI (p<0.001): 78% (112/144) reported no pain or mild pain, 19% (27/144) moderate pain, and 3% (5/144) reported severe pain (pain score >7 of 10) during the ultrasound examination. We did not identify any factors related to patients' preferred method. CONCLUSION Ultrasound was the imaging method preferred by most patients despite being associated with more pain during the examination in comparison with CT and WB-DWI/MRI. TRIAL REGISTRATION NUMBER NCT03808792.
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Affiliation(s)
- Patrícia Pinto
- Department of Gynecology, Portuguese Institute of Oncology of Lisbon Francisco Gentil, Lisboa, Portugal
- First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Lil Valentin
- Department of Obstetrics and Gynaecology, Skane University Hospital, Malmo, Sweden
- Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
| | - Martina Borčinová
- Gynecologic Oncology Centre, Department of Gynecology, Obstetrics and Neonatology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Markéta Wiesnerová
- Masaryk University Institute of Biostatistics and Analyses, Brno, Czech Republic
| | - Fruhauf Filip
- Gynecologic Oncology Centre, Department of Gynecology, Obstetrics and Neonatology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Andrea Burgetova
- Department of Radiology, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Martin Masek
- Department of Radiology, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Lukas Lambert
- Department of Radiology, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Valentina Chiappa
- Department of Gynecologic Oncology, Foundation IRCCS National Cancer Institute, Milan, Italy
| | - Dorella Franchi
- Preventive Gynecology Unit, Division of Gynaecology, European Institute of Oncology, Milan, Italy
| | - Antonia Carla Testa
- Dipartimento Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
- Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Lazio, Italy
| | - Francesca Moro
- Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Lazio, Italy
| | - Giacomo Avesani
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Lazio, Italy
| | - Camilla Panico
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Lazio, Italy
| | - Sarah Alessi
- Division of Radiology, Istituto Europeo di Oncologia, Milan, Italy
| | - Paola Pricolo
- Division of Radiology, Istituto Europeo di Oncologia, Milan, Italy
| | - Raffaella Vigorito
- Department of Radiology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Giuseppina Calareso
- Department of Radiology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Roman Kocian
- Gynecologic Oncology Centre, Department of Gynecology, Obstetrics and Neonatology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Jiri Slama
- Gynecologic Oncology Centre, Department of Gynecology, Obstetrics and Neonatology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Anna Fagotti
- Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Lazio, Italy
| | | | - Mauro Signorelli
- Department of Gynecologic Oncology, Foundation IRCCS National Cancer Institute, Milan, Italy
| | - Francesca Bertolina
- Department of Gynecologic Oncology, Foundation IRCCS National Cancer Institute, Milan, Italy
| | - David Cibula
- Gynecologic Oncology Centre, Department of Gynecology, Obstetrics and Neonatology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Daniela Fischerova
- Gynecologic Oncology Centre, Department of Gynecology, Obstetrics and Neonatology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
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Champendal M, Borg Grima K, Costa P, Andersson C, Baun C, Gorga RG, Murphy S, Kedves A, Santos A, Geao A. A scoping review of person-centred care strategies used in diagnostic Nuclear Medicine. Radiography (Lond) 2024; 30:448-456. [PMID: 38211452 DOI: 10.1016/j.radi.2023.12.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 11/28/2023] [Accepted: 12/19/2023] [Indexed: 01/13/2024]
Abstract
INTRODUCTION Person-centred care (PCC) emphasises the need for the health care professional to prioritise individual patient needs, thereby fostering a collaborative and emphatic environment that empowers patients to actively participate in their own care. This article will explore the purpose of PCC in Nuclear Medicine (NM), while discussing strategies that may be used to implement PCC during diagnostic NM examinations performed on adult patients. METHODS The scoping review was conducted in accordance with the Joanna Briggs Institute methodology. The search was performed on PubMed, Embase and Cinhal in June 2023 and included studies in English, Spanish, Portuguese and Italian. The research equation combined keywords and Medical Subject Heading terms (MeSH) related to person-centred care (PCC), for all types of nuclear medicine diagnostic examinations performed. Three independent review authors screened all abstracts and titles, and all eligible full-text publications were included in this scoping review. RESULTS Fifty-three articles, published between 1993 and 2022, met the inclusion criteria for this scoping review. Seven articles were published in 2015 while 56.6 % of all included studies were performed in Europe. Most studies (n = 39/53) focused on the patients only, with the identified patient benefits being: improve patient experience (67.9 %), increase patient comfort (13.2 %), increase patient knowledge (5.7 %), reduction of patient anxiety (9.4 %) and reduction of waiting/scan time (3.8 %). CONCLUSION The scoping review identified a lack of research investigating the use of person-centred care strategies in NM. Future research will focus on using an international survey to explore this topic in nuclear medicine departments overseas. IMPLICATIONS FOR PRACTICE By applying PCC principles, the NM professional can improve the patient care pathway and increase patient satisfaction, leading to enhanced clinical outcomes.
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Affiliation(s)
- M Champendal
- Department of Radiologic Medical Imaging Technology, School of Health Sciences (HESAV), University of Applied Sciences and Arts Western Switzerland (HES-SO), Lausanne, Switzerland; European Federation of Radiographer Societies Nuclear Medicine Committee, Austria
| | - K Borg Grima
- University of Malta, Faculty of Health Sciences, Department of Radiography, Malta; European Federation of Radiographer Societies Nuclear Medicine Committee, Austria.
| | - P Costa
- Department of Nuclear Medicine, ESS, Polytechnic University of Porto, Porto, Portugal; European Federation of Radiographer Societies Nuclear Medicine Committee, Austria
| | - C Andersson
- Dept. of Surgical Sciences, Uppsala University Uppsala, Sweden; European Federation of Radiographer Societies Nuclear Medicine Committee, Austria
| | - C Baun
- Department of Nuclear Medicine, Odense University Hospital, Odense, Denmark; European Federation of Radiographer Societies Nuclear Medicine Committee, Austria
| | - R G Gorga
- Servei de Medicina Nuclear, Hospital Universitari Parc Taulí, Sabadell, Spain; European Federation of Radiographer Societies Nuclear Medicine Committee, Austria
| | - S Murphy
- Radiography and Diagnostic Imaging Unit, College of Health and Agricultural Sciences, School of Medicine, University College Dublin (UCD), Dublin, Ireland; European Federation of Radiographer Societies Nuclear Medicine Committee, Austria
| | - A Kedves
- University of Pécs Faculty of Engineering and Information Technology, Hungary; European Association of Nuclear Medicine Technologists Committee, Austria
| | - A Santos
- Nuclear Medicine Department, Hospital Cuf Descobertas, Lisbon, Portugal; European Association of Nuclear Medicine Technologists Committee, Austria
| | - A Geao
- Nuclear Medicine Department, Hospital Cuf Descobertas, Lisbon, Portugal; European Federation of Radiographer Societies Nuclear Medicine Committee, Austria
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Fakes K, Boyes A, Hall A, Carey M, Leigh L, Brown S, Sanson-Fisher R. Trajectories and Predictors of Raised State Anxiety Among Outpatients Who Have Undergone Medical Imaging Procedures. J Am Coll Radiol 2024; 21:285-294. [PMID: 37453598 DOI: 10.1016/j.jacr.2023.06.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 05/23/2023] [Accepted: 06/09/2023] [Indexed: 07/18/2023]
Abstract
PURPOSE The aim of this study was to examine the prevalence of raised state anxiety before and after medical imaging procedures, the prevalence of state anxiety trajectories, and factors associated with postprocedural raised state anxiety. METHODS A prospective survey was administered to outpatients undergoing elective medical imaging procedures (CT, radiography, MRI, ultrasound, angiography, or fluoroscopy) recruited from one center. Participants completed a self-report survey preprocedure (time 1) and postprocedure (time 2). State anxiety was measured using the six-item State-Trait Anxiety Inventory. The point prevalence of raised state anxiety (State-Trait Anxiety Inventory score ≥33.16) at time 1 and time 2 was calculated, as was the prevalence of four state anxiety trajectories over time: persistent low anxiety, decreasing anxiety, increasing anxiety, and persistent raised anxiety. Factors predictive of raised state anxiety at time 2 were examined using logistic regression analysis. RESULTS Three hundred fifteen participants completed both surveys. The prevalence of raised state anxiety at time 1 (50%) and time 2 (51%) was similar. Most patients reported persistent raised anxiety (36%) and persistent low anxiety (34%) over time. Fewer patients reported increasing anxiety (15%) and decreasing anxiety (14%). Raised state anxiety (odds ratio, 4.84; 95% confidence interval, 2.48-9.48) and lower reported health status (odds ratio, 2.48; 95% confidence interval, 1.11-5.51) at time 1 were significantly associated with greater odds of raised anxiety at time 2. CONCLUSIONS Raised state anxiety related to medical imaging procedures is common among outpatients. Half of patients either developed or continued to experience raised anxiety after their procedures. Outpatients may benefit from evidence-based methods of alleviating anxiety before their procedures.
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Affiliation(s)
- Kristy Fakes
- Health Behaviour Research Collaborative, School of Medicine and Public Health, College of Health Medicine and Wellbeing, University of Newcastle, Callaghan, Australia; Hunter Medical Research Institute, New Lambton Heights, Australia.
| | - Allison Boyes
- Health Behaviour Research Collaborative, School of Medicine and Public Health, College of Health Medicine and Wellbeing, University of Newcastle, Callaghan, Australia; Hunter Medical Research Institute, New Lambton Heights, Australia
| | - Alix Hall
- Hunter New England Population Health, Hunter New England Local Health District, Newcastle, Australia; School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
| | - Mariko Carey
- Hunter Medical Research Institute, New Lambton Heights, Australia; Centre for Women's Health Research, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, Australia
| | - Lucy Leigh
- Hunter Medical Research Institute, New Lambton Heights, Australia
| | - Sandy Brown
- Hunter New England Imaging, John Hunter Hospital/Royal Newcastle Centre, New Lambton Heights, Australia
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Arnfield EG, Tam L, Pattison DA, Younger J, Chikatamarla VA, Wyld D, Burge M, McCormack L, Ladwa R, Ramsay S. Cardiac metastases from neuroendocrine neoplasms: complementary role of SSTR PET/CT and cardiac MRI. J Nucl Cardiol 2023; 30:2676-2691. [PMID: 37587328 PMCID: PMC10682059 DOI: 10.1007/s12350-023-03345-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Accepted: 06/28/2023] [Indexed: 08/18/2023]
Abstract
BACKGROUND Cardiac metastases from neuroendocrine neoplasms (NENs) are being detected with increasing frequency, although the optimal imaging strategy remains unclear. We performed a single-center retrospective study to explore the role of somatostatin receptor positron emission tomography/computed tomography (SSTR PET/CT) and cardiac magnetic resonance imaging (CMR) in NEN cardiac metastases, determine the degree of concordance between the findings of these imaging modalities, and examine the advantages and disadvantages of each imaging technique. A secondary aim was to determine if cardiac metastases were associated with adverse cardiac events during peptide receptor radionuclide therapy (PRRT). METHODS AND RESULTS 19 patients with NEN cardiac metastases were identified. A retrospective review of electronic medical records was performed, and if available SSTR PET/CT and CMR were blindly re-reviewed by imaging specialists, documenting the number and location of cardiac metastases. All 19 patients had SSTR PET/CT, and 10/19 patients had CMR. SSTR PET/CT identified more metastases than CMR. When identified on CMR, metastases were more accurately localized. 12/19 patients received PRRT, with no cardiac adverse effects. CONCLUSION SSTR PET/CT and CMR are complementary investigations in the imaging of NEN cardiac metastases. SSTR PET/CT appears more sensitive for lesion detection, and CMR offers better lesion characterization. Both investigations present useful information for the planning of treatment including PRRT, which was administered safely.
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Affiliation(s)
- Evyn G Arnfield
- Department of Nuclear Medicine & Specialised PET Services, Royal Brisbane and Women's Hospital, Brisbane, QLD, 4006, Australia.
- Faculty of Medicine, University of Queensland, Brisbane, Australia.
| | - Laura Tam
- Faculty of Medicine, University of Queensland, Brisbane, Australia
- Department of Medical Oncology, Princess Alexandra Hospital, Woolloongabba, Australia
| | - David A Pattison
- Department of Nuclear Medicine & Specialised PET Services, Royal Brisbane and Women's Hospital, Brisbane, QLD, 4006, Australia
- Faculty of Medicine, University of Queensland, Brisbane, Australia
| | - John Younger
- Faculty of Medicine, University of Queensland, Brisbane, Australia
- Department of Cardiology, Royal Brisbane and Women's Hospital, Brisbane, Australia
| | - Venkata Avinash Chikatamarla
- Department of Nuclear Medicine & Specialised PET Services, Royal Brisbane and Women's Hospital, Brisbane, QLD, 4006, Australia
- Faculty of Medicine, University of Queensland, Brisbane, Australia
| | - David Wyld
- Faculty of Medicine, University of Queensland, Brisbane, Australia
- Department of Medical Oncology, Royal Brisbane and Women's Hospital, Brisbane, Australia
| | - Matthew Burge
- Faculty of Medicine, University of Queensland, Brisbane, Australia
- Department of Medical Oncology, Royal Brisbane and Women's Hospital, Brisbane, Australia
| | - Louise McCormack
- Faculty of Medicine, University of Queensland, Brisbane, Australia
- Department of Cardiology, Royal Brisbane and Women's Hospital, Brisbane, Australia
| | - Rahul Ladwa
- Faculty of Medicine, University of Queensland, Brisbane, Australia
- Department of Medical Oncology, Princess Alexandra Hospital, Woolloongabba, Australia
| | - Stuart Ramsay
- Department of Nuclear Medicine & Specialised PET Services, Royal Brisbane and Women's Hospital, Brisbane, QLD, 4006, Australia
- Faculty of Medicine, University of Queensland, Brisbane, Australia
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Ahmadpour S, Habibi MA, Hosseinimehr SJ. Various Aspects of Fasting on the Biodistribution of Radiopharmaceuticals. Curr Drug Metab 2022; 23:827-841. [PMID: 36121082 DOI: 10.2174/1389200223666220919121354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 07/08/2022] [Accepted: 07/30/2022] [Indexed: 01/11/2023]
Abstract
It is demonstrated that fasting can alter the biodistribution of radiopharmaceuticals in nuclear medicine. Various studies have highlighted that fasting is interpreted to be easy for physicians during PET study, fasting is one of the most important factors determining the usefulness of this protocol. It is well documented that fasting can suppress normal 18F-FDG PET uptake during nuclear cardiology. However, there is no consensus about the usefulness of fasting on radiopharmaceuticals, especially on 18F-FDG in PET imaging, but special attention should be paid to the setting of the fasting duration. Nevertheless, it does seem we still need extensive clinical studies in the future. The present study aims to review the various aspects of fasting, especially metabolic alteration on radiopharmaceutical biodistribution. In this study, we focused more on the effect of fasting on 18F-FDG biodistribution, which alters its imaging contrast in cardiology and cancer imaging. Therefore, shifting substrate metabolism from glucose to free fatty acids during fasting can be an alternative approach to suppress physiological myocardial uptake.
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Affiliation(s)
- Sajjad Ahmadpour
- Gastroenterology and Hepatology Diseases Research Center, Qom University of Medical Sciences, Qom, Iran
| | - Mohammad Amin Habibi
- Iranian Tissue Bank and Research Center, Gene, Cell and Tissue Institute, Tehran University of Medical Sciences, Tehran, Iran.,Clinical Research of Development Center, Beheshti Hospital, Qom University of Medical Sciences, Qom, Iran
| | - Seyed Jalal Hosseinimehr
- Department of Radiopharmacy, Faculty of Pharmacy, Mazandaran University of Medical Sciences, Sari, Iran
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Isabel Rodrigues Monteiro Grilo A, Catarina Inácio Ferreira A, Sofia Pedro Ramos M, Teresa Mata Almeida Carolino E, Filipa Pires A, da Conceição Capela de Oliveira Vieira L. Effectiveness of educational videos on patient's preparation for diagnostic procedures: Systematic Review and Meta-Analysis. Prev Med Rep 2022; 28:101895. [PMID: 35855928 PMCID: PMC9287602 DOI: 10.1016/j.pmedr.2022.101895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 05/27/2022] [Accepted: 07/01/2022] [Indexed: 11/06/2022] Open
Abstract
Patients’ anxiety and unfamiliarity are barriers to undergoing diagnostic procedures. Studies found educational videos more effective than other forms of information. Educational videos minimise anxiety and improve patient satisfaction. Educational videos enable medical procedures best practices.
Although diagnostic procedures are crucial for secondary prevention and patient disease control, they often trigger fear and anxiety. These reactions highlight the need to adopt effective interventions to improve patients’ experience and satisfaction. Recently, educational videos have been employed in preparing diagnostic procedures; however, there is no integrated understanding of their effects. This systematic review and meta-analysis aimed to assess the effectiveness of educational videos on patients’ anxiety and satisfaction regarding preparation for diagnostic procedures. Three scientific databases (PubMed; Web of Science, Scopus), were used in this systematic review. Studies about educational videos as a form of preparation for patients undergoing diagnostic procedures published between 2000 and 2021 were included. A meta-analysis was also conducted. Sixteen studies met the inclusion criteria for systematic review, and seven were included in the meta-analysis. Nine studies of the total sample were about vascular procedures and seven studies about other medical image procedures. Of the fourteen studies that evaluated the use of educational videos on patients’ anxiety, nine proved to reduce it significantly. Of the thirteen studies that evaluated satisfaction, seven showed a significant increase in the experimental group. Studies included in the meta-analysis show that educational video patient groups had lower anxiety levels than the control groups after the procedure. Although future studies are required, the results suggest that educational videos effectively prepare patients for diagnostic procedures, improving care quality.
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Komber H, Little D, Cade S, Graham R, Redman S. Comparing the patient experience between a novel 360° gamma camera (VERITON-CT) and a conventional dual head gamma camera. J Nucl Med Technol 2021; 50:jnmt.121.262627. [PMID: 34750232 PMCID: PMC9168651 DOI: 10.2967/jnmt.121.262627] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 09/25/2021] [Accepted: 09/25/2021] [Indexed: 11/16/2022] Open
Abstract
Aims: To explore whether the novel 360° gamma camera design of VERITON-CT adversely affects the rate of scan non-completion due to claustrophobia or other patient experience factors, when compared to a standard dual-headed gamma camera. Methods: Single centre prospective study of all nuclear medicine studies on either of two gamma cameras; the VERITON-CT (Spectrum Dynamics Medical) and Discovery NM/CT 670 (GE Healthcare). It was recorded whether the patient had completed the scan as protocoled or, due to claustrophobia, had a shortened scan or no scan. The patients were also offered a patient experience questionnaire, with domains of comfort, scan time, scan noise and claustrophobia assessed using a five-point Likert scale. Results: Over a four-month period, there were 296 patients scanned on the Discovery scanner and 274 patients scanned on the VERITON-CT scanner. There was a scan non-completion rate, due to claustrophobia, of 1.35 % for the Discovery and 1.46 % for the VERITON-CT scanner. 354/570 (62%) of all patients involved returned their questionnaires. There was no statistical difference between the responses for comfort, scan time, scan noise and feelings of claustrophobia. Conclusion: The study provides evidence that the novel 360° gamma camera design of VERITON-CT does not lead to a significantly increased scan failure rate due to claustrophobia and there is no change in the subjective experience for patients.
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Affiliation(s)
- Hend Komber
- Royal United Hospitals Bath NHS Trust, United Kingdom
| | - David Little
- Royal United Hospitals Bath NHS Trust, United Kingdom
| | - Sarah Cade
- Royal United Hospitals Bath NHS Trust, United Kingdom
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Miles A, Evans REC, Halligan S, Beare S, Bridgewater J, Goh V, Janes SM, Navani N, Oliver A, Morton A, Morris S, Rockall A, Taylor SA. Predictors of patient preference for either whole body magnetic resonance imaging (WB-MRI) or CT/ PET-CT for staging colorectal or lung cancer. J Med Imaging Radiat Oncol 2020; 64:537-545. [PMID: 32410378 PMCID: PMC8425331 DOI: 10.1111/1754-9485.13038] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Accepted: 03/27/2020] [Indexed: 11/29/2022]
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.
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Affiliation(s)
- Anne Miles
- Department of Psychological SciencesBirkbeckUniversity of LondonLondonUK
| | - Ruth EC Evans
- Department of Psychological SciencesBirkbeckUniversity of LondonLondonUK
| | - Steve Halligan
- Centre for Medical ImagingUniversity College LondonCharles Bell HouseUK
| | - Sandy Beare
- Cancer Research UKUniversity College London Clinical Trials CentreLondonUK
| | | | - Vicky Goh
- Cancer ImagingSchool of Biomedical Engineering and Imaging SciencesKing’s College LondonStrand, LondonUK
| | - Sam M Janes
- Lungs for Living Research CentreUCL RespiratoryDivision of MedicineUniversity College LondonLondonUK
| | - Neal Navani
- Department of Thoracic MedicineUCLH and Lungs for Living Research CentreUCL RespiratoryUniversity College LondonLondonUK
| | - Alfred Oliver
- Cancer patient representativesc/o National Cancer Research InstituteLondonUK
| | - Alison Morton
- Cancer patient representativesc/o National Cancer Research InstituteLondonUK
| | - Steve Morris
- Research Department of Applied Health ResearchUniversity College LondonLondonUK
| | - Andrea Rockall
- Department of Surgery and CancerImperial College LondonKensington, LondonUK
| | - Stuart A Taylor
- Centre for Medical ImagingUniversity College LondonCharles Bell HouseUK
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Bellhouse S, Brown S, Dubec M, Taylor S, Hales R, Whiteside L, Yorke J, Faivre-Finn C. Introducing magnetic resonance imaging into the lung cancer radiotherapy workflow - An assessment of patient experience. Radiography (Lond) 2020; 27:14-23. [PMID: 32451307 DOI: 10.1016/j.radi.2020.04.020] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Revised: 04/17/2020] [Accepted: 05/05/2020] [Indexed: 12/18/2022]
Abstract
INTRODUCTION Magnetic resonance imaging (MRI) offers superior soft tissue contrast to computed tomography (CT), the current standard imaging modality for planning radiotherapy treatment. Improved soft tissue contrast could reduce uncertainties in identifying tumour and surrounding healthy tissues, potentially leading to improved outcomes in patients with lung cancer. This study explored patient experience of MR treatment planning scans in addition to a CT scan. METHODS Participants were recruited to the 'Magnetic Resonance Imaging for the Delineation of Organs At Risk and Target Volumes in Lung Cancer Patients (MR-Lung)' study at a UK specialist cancer centre. Participants completed their standard of care radiotherapy planning CT scan and two additional MRI scans. Baseline and post-scan questionnaires were completed assessing anxiety and claustrophobia. Motion artefact during MRI was assessed by a modified visual grading analysis. Sixteen participants completed semi-structured interviews; transcripts were analysed thematically. RESULTS 29 people (66% female; aged 54-89 years) participated. Nineteen participants completed all imaging and 10 participants withdrew before completion. There was minimal adverse impact on state and scan-specific anxiety levels from completing the MRI scans. Completers experienced significantly less scan-specific anxiety during MRI 1 compared to non-completers (U = 33, z = -1.98, p < 0.05). 78% of those who withdrew during or post MRI 1 were positioned 'arms up'. Motion artefact negatively impacted image quality in 34% of scans. Participants commonly reported concerns during MRI; noise, claustrophobia and pain in upper limbs. CONCLUSION Two thirds of participants tolerated two additional MR scans with minimal adverse impact on anxiety levels. IMPLICATIONS FOR PRACTICE Patient arm positioning and comfort ought to be considered when introducing MR-Linac systems. A screening tool to identify those at high risk of non-completion should be developed.
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Affiliation(s)
- S Bellhouse
- Christie Patient Centred Research (CPCR), The Christie NHS Foundation Trust, UK.
| | - S Brown
- Department of Radiation Oncology, Clatterbridge Cancer Centre NHS Foundation Trust, UK
| | - M Dubec
- Division of Cancer Science, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Sciences Centre, UK; Christie Medical Physics and Engineering, The Christie NHS Foundation Trust, Manchester, UK
| | - S Taylor
- Christie Patient Centred Research (CPCR), The Christie NHS Foundation Trust, UK
| | - R Hales
- Radiotherapy Related Research, The Christie NHS Foundation Trust, UK
| | - L Whiteside
- Radiotherapy Related Research, The Christie NHS Foundation Trust, UK
| | - J Yorke
- Christie Patient Centred Research (CPCR), The Christie NHS Foundation Trust, UK; Division of Nursing, Midwifery and Social Work, School of Health Sciences, Faculty of Biology Medicine and Health, University of Manchester, UK
| | - C Faivre-Finn
- Division of Cancer Science, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Sciences Centre, UK; Department of Clinical Oncology, The Christie NHS Foundation Trust, Manchester Academic Health Science Centre, UK
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Taylor SA, Mallett S, Miles A, Morris S, Quinn L, Clarke CS, Beare S, Bridgewater J, Goh V, Janes S, Koh DM, Morton A, Navani N, Oliver A, Padhani A, Punwani S, Rockall A, Halligan S. Whole-body MRI compared with standard pathways for staging metastatic disease in lung and colorectal cancer: the Streamline diagnostic accuracy studies. Health Technol Assess 2019; 23:1-270. [PMID: 31855148 PMCID: PMC6936168 DOI: 10.3310/hta23660] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Whole-body magnetic resonance imaging is advocated as an alternative to standard pathways for staging cancer. OBJECTIVES The objectives were to compare diagnostic accuracy, efficiency, patient acceptability, observer variability and cost-effectiveness of whole-body magnetic resonance imaging and standard pathways in staging newly diagnosed non-small-cell lung cancer (Streamline L) and colorectal cancer (Streamline C). DESIGN The design was a prospective multicentre cohort study. SETTING The setting was 16 NHS hospitals. PARTICIPANTS Consecutive patients aged ≥ 18 years with histologically proven or suspected colorectal (Streamline C) or non-small-cell lung cancer (Streamline L). INTERVENTIONS Whole-body magnetic resonance imaging. Standard staging investigations (e.g. computed tomography and positron emission tomography-computed tomography). REFERENCE STANDARD Consensus panel decision using 12-month follow-up data. MAIN OUTCOME MEASURES The primary outcome was per-patient sensitivity difference between whole-body magnetic resonance imaging and standard staging pathways for metastasis. Secondary outcomes included differences in specificity, the nature of the first major treatment decision, time and number of tests to complete staging, patient experience and cost-effectiveness. RESULTS Streamline C - 299 participants were included. Per-patient sensitivity for metastatic disease was 67% (95% confidence interval 56% to 78%) and 63% (95% confidence interval 51% to 74%) for whole-body magnetic resonance imaging and standard pathways, respectively, a difference in sensitivity of 4% (95% confidence interval -5% to 13%; p = 0.51). Specificity was 95% (95% confidence interval 92% to 97%) and 93% (95% confidence interval 90% to 96%) respectively, a difference of 2% (95% confidence interval -2% to 6%). Pathway treatment decisions agreed with the multidisciplinary team treatment decision in 96% and 95% of cases, respectively, a difference of 1% (95% confidence interval -2% to 4%). Time for staging was 8 days (95% confidence interval 6 to 9 days) and 13 days (95% confidence interval 11 to 15 days) for whole-body magnetic resonance imaging and standard pathways, respectively, a difference of 5 days (95% confidence interval 3 to 7 days). The whole-body magnetic resonance imaging pathway was cheaper than the standard staging pathway: £216 (95% confidence interval £211 to £221) versus £285 (95% confidence interval £260 to £310). Streamline L - 187 participants were included. Per-patient sensitivity for metastatic disease was 50% (95% confidence interval 37% to 63%) and 54% (95% confidence interval 41% to 67%) for whole-body magnetic resonance imaging and standard pathways, respectively, a difference in sensitivity of 4% (95% confidence interval -7% to 15%; p = 0.73). Specificity was 93% (95% confidence interval 88% to 96%) and 95% (95% confidence interval 91% to 98%), respectively, a difference of 2% (95% confidence interval -2% to 7%). Pathway treatment decisions agreed with the multidisciplinary team treatment decision in 98% and 99% of cases, respectively, a difference of 1% (95% confidence interval -2% to 4%). Time for staging was 13 days (95% confidence interval 12 to 14 days) and 19 days (95% confidence interval 17 to 21 days) for whole-body magnetic resonance imaging and standard pathways, respectively, a difference of 6 days (95% confidence interval 4 to 8 days). The whole-body magnetic resonance imaging pathway was cheaper than the standard staging pathway: £317 (95% confidence interval £273 to £361) versus £620 (95% confidence interval £574 to £666). Participants generally found whole-body magnetic resonance imaging more burdensome than standard imaging but most participants preferred the whole-body magnetic resonance imaging staging pathway if it reduced time to staging and/or number of tests. LIMITATIONS Whole-body magnetic resonance imaging was interpreted by practitioners blinded to other clinical data, which may not fully reflect how it is used in clinical practice. CONCLUSIONS In colorectal and non-small-cell lung cancer, the whole-body magnetic resonance imaging staging pathway has similar accuracy to standard staging pathways, is generally preferred by patients, improves staging efficiency and has lower staging costs. Future work should address the utility of whole-body magnetic resonance imaging for treatment response assessment. TRIAL REGISTRATION Current Controlled Trials ISRCTN43958015 and ISRCTN50436483. FUNDING This project was funded by the NIHR Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 23, No. 66. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Stuart A Taylor
- Centre for Medical Imaging, University College London, London, UK
| | - Susan Mallett
- Institute of Applied Health Research, NIHR Birmingham Biomedical Research Centre, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Anne Miles
- Department of Psychological Sciences, Birkbeck, University of London, London, UK
| | - Stephen Morris
- Applied Health Research, University College London, London, UK
| | - Laura Quinn
- Institute of Applied Health Research, NIHR Birmingham Biomedical Research Centre, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Caroline S Clarke
- Research Department of Primary Care and Population Health, and Priment Clinical Trials Unit, University College London, London, UK
| | - Sandy Beare
- Cancer Research UK & UCL Cancer Trials Centre, University College London, London, UK
| | | | - Vicky Goh
- Department of Cancer Imaging, School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - Sam Janes
- Lungs for Living Research Centre, UCL Respiratory, University College London, London, UK
| | - Dow-Mu Koh
- Department of Radiology, The Royal Marsden Hospital, Sutton, UK
| | - Alison Morton
- c/o Centre for Medical Imaging, University College London, London, UK
| | - Neal Navani
- Lungs for Living Research Centre, UCL Respiratory, University College London, London, UK
| | - Alfred Oliver
- c/o Centre for Medical Imaging, University College London, London, UK
| | - Anwar Padhani
- Mount Vernon Centre for Cancer Treatment, Mount Vernon Hospital, Northwood, UK
| | - Shonit Punwani
- Centre for Medical Imaging, University College London, London, UK
| | - Andrea Rockall
- Imaging Department, Imperial College Healthcare NHS Trust, London, UK
| | - Steve Halligan
- Centre for Medical Imaging, University College London, London, UK
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11
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Chen S, Hu P, Gu Y, Pang L, Zhang Z, Zhang Y, Meng X, Cao T, Liu X, Fan Z, Shi H. Impact of patient comfort on diagnostic image quality during PET/MR exam: A quantitative survey study for clinical workflow management. J Appl Clin Med Phys 2019; 20:184-192. [PMID: 31207077 PMCID: PMC6612685 DOI: 10.1002/acm2.12664] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2018] [Revised: 05/05/2019] [Accepted: 05/23/2019] [Indexed: 12/26/2022] Open
Abstract
Background PET/MR is transferring from a powerful scientific research tool to an imaging modality in clinical routine practice. Whole body PET/MR screening usually takes 30–50 minutes to finish, during which a few factors might induce patient discomfort and further cause degraded image quality. The aim of this report is to investigate the patients' perception of the imaging procedure and its correlation with image quality. Methods One hundred and twenty patients (63 males and 57 females, average age = 51.3 years, range 22–70 years) who had been diagnosed with cancer or had previous history of cancer were recruited and scanned with a simultaneous PET/MR system. A questionnaire was given to all patients retrospectively after the PET/MR scan, which has nine questions to assess patients' feeling of the scan on a Likert scale scoring system (1–5, 1 as most satisfied). All PET/MR images were also visually examined by two experts independently to evaluate the quality of the images. Six body locations were assessed and each location was evaluated also with a Likert scale scoring system (1–5, 5 as the best quality). Mann–Whitney Utest was used for statistical analysis to check if there is significant correlation between image quality and patient perceptions. Results With a total of 120 patients, 118 questionnaires were filled and returned for analysis. The patients’ characteristics were summarized in Table 4. The statistics of the patients’ perception in the questionnaire were illustrated in Tables 5–7. Statistical significant correlations were found between MR image quality and patients’ characteristics/perception. Conclusion Our results show that PET/MR scanning is generally safe and comfortable for most of the patients. Statistical analysis does not support the hypothesis that bad patient’s perception leads to degraded image quality.
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Affiliation(s)
- Shuguang Chen
- Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Pengcheng Hu
- Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Yusen Gu
- Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Lifang Pang
- Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Zheng Zhang
- United Imaging Healthcare Co., Ltd, Shanghai, China
| | - Yiqian Zhang
- United Imaging Healthcare Co., Ltd, Shanghai, China
| | - Xiaolin Meng
- United Imaging Healthcare Co., Ltd, Shanghai, China
| | - Tuoyu Cao
- United Imaging Healthcare Co., Ltd, Shanghai, China
| | - Xin Liu
- Center for Certification an Evaluation, Shanghai Food and Drug Administration, Shanghai, China
| | - Zhijin Fan
- Center for Certification an Evaluation, Shanghai Food and Drug Administration, Shanghai, China
| | - Hongcheng Shi
- Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, Shanghai, China
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12
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Dyrberg E, Larsen EL, Hendel HW, Thomsen HS. Diagnostic bone imaging in patients with prostate cancer: patient experience and acceptance of NaF-PET/CT, choline-PET/CT, whole-body MRI, and bone SPECT/CT. Acta Radiol 2018; 59:1119-1125. [PMID: 29313360 DOI: 10.1177/0284185117751280] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background Patient acceptance is an important factor when implementing imaging methods in clinical practice in line with availability, diagnostic accuracy, and cost-effectiveness. Purpose To investigate patient experience and acceptance regarding18F-sodium fluoride (NaF) positron emission tomography/computed tomography (PET/CT), 11 C-choline-PET/CT, whole-body magnetic resonance imaging (WB-MRI), and 99mTc-hydroxymethane diphosphonate (HDP) single photon emission/computed tomography (SPECT/CT). Material and Methods One hundred and forty-nine patients with prostate cancer filled in a questionnaire regarding their experience of the imaging procedures they had been undergoing as part of a diagnostic accuracy study. Each patient had been undergoing a NaF-PET/CT, a WB-MRI, and either a SPECT/CT (group A) or a choline-PET/CT (group B). Results All four imaging methods received overall experience ratings at the favorable end of a 5-point Likert scale with the two PET/CT scans receiving marginally better average ratings (2.0) compared to SPECT/CT (2.2) and WB-MRI (2.3). The arm positioning above the head was the most uncomfortable part of the three nuclear medicine scans, whereas the acoustic noise was the most unpleasant part of the WB-MRI. The experience of staff instruction was relatively strongly correlated to the overall scanning experience of all four imaging modalities. Overall, the patients were willing to repeat the four imaging methods and NaF-PET/CT was the method most preferred in both groups. Conclusion Four imaging procedures were evaluated from the perspective of a selected group of prostate cancer patients. NaF-PET/CT, choline-PET/CT, WB-MRI, and bone SPECT/CT are well accepted imaging methods, and most patients prefer NaF-PET/CT.
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Affiliation(s)
- Eva Dyrberg
- Department of Radiology, Copenhagen University Hospital Herlev and Gentofte, Herlev, Denmark
- Department of Clinical Physiology and Nuclear Medicine, Copenhagen University Hospital Herlev and Gentofte, Herlev, Denmark
| | - Emil L Larsen
- Department of Radiology, Copenhagen University Hospital Herlev and Gentofte, Herlev, Denmark
- Department of Clinical Pharmacology, Copenhagen University Hospital Bispebjerg Frederiksberg, Copenhagen, Denmark
| | - Helle W Hendel
- Department of Clinical Physiology and Nuclear Medicine, Copenhagen University Hospital Herlev and Gentofte, Herlev, Denmark
| | - Henrik S Thomsen
- Department of Radiology, Copenhagen University Hospital Herlev and Gentofte, Herlev, Denmark
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13
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Magnetic resonance enterography, small bowel ultrasound and colonoscopy to diagnose and stage Crohn's disease: patient acceptability and perceived burden. Eur Radiol 2018; 29:1083-1093. [PMID: 30128615 PMCID: PMC6510862 DOI: 10.1007/s00330-018-5661-2] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Revised: 07/02/2018] [Accepted: 07/12/2018] [Indexed: 12/12/2022]
Abstract
Objectives To compare patient acceptability and burden of magnetic resonance enterography (MRE) and ultrasound (US) to each other, and to other enteric investigations, particularly colonoscopy. Methods 159 patients (mean age 38, 94 female) with newly diagnosed or relapsing Crohn’s disease, prospectively recruited to a multicentre diagnostic accuracy study comparing MRE and US completed an experience questionnaire on the burden and acceptability of small bowel investigations between December 2013 and September 2016. Acceptability, recovery time, scan burden and willingness to repeat the test were analysed using the Wilcoxon signed rank and McNemar tests; and group differences in scan burden with Mann–Whitney U and Kruskal–Wallis tests. Results Overall, 128 (88%) patients rated MRE as very or fairly acceptable, lower than US (144, 99%; p < 0.001), but greater than colonoscopy (60, 60%; p < 0.001). MRE recovery time was longer than US (p < 0.001), but shorter than colonoscopy (p < 0.001). Patients were less willing to undergo MRE again than US (127 vs. 133, 91% vs. 99%; p = 0.012), but more willing than for colonoscopy (68, 75%; p = 0.017). MRE generated greater burden than US (p < 0.001), although burden scores were low. Younger age and emotional distress were associated with greater MRE and US burden. Higher MRE discomfort was associated with patient preference for US (p = 0.053). Patients rated test accuracy as more important than scan discomfort. Conclusions MRE and US are well tolerated. Although MRE generates greater burden, longer recovery and is less preferred than US, it is more acceptable than colonoscopy. Patients, however, place greater emphasis on diagnostic accuracy than burden. Key Points • MRE and US are rated as acceptable by most patients and superior to colonoscopy. • MRE generates significantly greater burden and longer recovery times than US, particularly in younger patients and those with high levels of emotional distress. • Most patients prefer the experience of undergoing US than MRE; however, patients rate test accuracy as more importance than scan burden. Electronic supplementary material The online version of this article (10.1007/s00330-018-5661-2) contains supplementary material, which is available to authorized users.
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14
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Forshaw KL, Boyes AW, Carey ML, Hall AE, Symonds M, Brown S, Sanson-Fisher RW. Raised Anxiety Levels Among Outpatients Preparing to Undergo a Medical Imaging Procedure: Prevalence and Correlates. J Am Coll Radiol 2018; 15:630-638. [DOI: 10.1016/j.jacr.2017.12.030] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Revised: 12/19/2017] [Accepted: 12/22/2017] [Indexed: 01/21/2023]
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15
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Evans RE, Taylor SA, Beare S, Halligan S, Morton A, Oliver A, Rockall A, Miles A. Perceived patient burden and acceptability of whole body MRI for staging lung and colorectal cancer; comparison with standard staging investigations. Br J Radiol 2018. [PMID: 29528257 PMCID: PMC6223281 DOI: 10.1259/bjr.20170731] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Objective: To evaluate perceived patient burden and acceptability of whole body MRI (WB-MRI) compared to standard staging investigations, and identify predictors of reduced tolerance. Methods: Patients recruited to multicentre trials comparing WB-MRI with standard staging scans for lung and colorectal cancer were invited to complete two questionnaires: a baseline questionnaire at recruitment, measuring demographics, comorbidities, and distress; and a follow-up questionnaire after staging, measuring recovery time, comparative acceptability/satisfaction between WB-MRI and CT (colorectal cancer) and PET-CT (lung cancer), and perceived scan burden (scored 1, low; 7, high). Results: 115 patients (median age 66.3 years; 67 males) completed follow up and 103 baseline questionnaires. 69 (63.9%) reported “immediate” recovery from WB-MRI and 73 (65.2%) judged it “very acceptable”. Perceived WB-MRI burden was greater than for CT (p < 0.001) and PET-CT (p < 0.001). High distress and comorbidities were associated with greater WB-MRI burden in adjusted analyses, with deprivation only approaching significance (adjusted regression β = 0.223, p = 0.025; β = 0.191, p = 0.048; β = −0.186, p = 0.059 respectively). Age (p = 0.535), gender (p = 0.389), ethnicity (p = 0.081) and cancer type (p = 0.201) were not predictive of WB-MRI burden. Conclusion: WB-MRI is marginally less acceptable and more burdensome than standard scans, particularly for patients with pre-existing distress and comorbidities. Advances in knowledge: This research shows that WB-MRI scan burden, although low, is higher than for current staging modalities among patients with suspected colorectal or lung cancer. Psychological and physical comorbidities adversely impact on patient experience of WB-MRI. Patients with high distress or comorbid illness may need additional support to undergo a WB-MRI.
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Affiliation(s)
- Ruth Ec Evans
- 1 Deparment of Psychological Sciences, Birkbeck, University of London , London , UK
| | - Stuart A Taylor
- 2 Division of Medicine, Centre for Medical Imaging, University College London , London , UK
| | - Sandra Beare
- 3 Cancer Research UK and UCL Cancer Trials Centre , London , UK
| | - Steve Halligan
- 2 Division of Medicine, Centre for Medical Imaging, University College London , London , UK
| | - Alison Morton
- 4 C/O National Cancer Research Institute, Angel Building , London , UK
| | - Alf Oliver
- 4 C/O National Cancer Research Institute, Angel Building , London , UK
| | - Andrea Rockall
- 5 Department of Surgery and Cancer, Imperial College London, Kensington , London , UK.,6 Department of Radiology, Royal Marsden NHS Foundation Hospital Trust , London , UK
| | - Anne Miles
- 1 Deparment of Psychological Sciences, Birkbeck, University of London , London , UK
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16
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Abreu C, Grilo A, Lucena F, Carolino E. Oncological Patient Anxiety in Imaging Studies: the PET/CT Example. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2017; 32:820-826. [PMID: 27370917 PMCID: PMC5670194 DOI: 10.1007/s13187-016-1069-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
The purpose of this study was to investigate the subjective perception of anxiety pre- and post-procedure, and explore the relationship between demographic, clinical variables and cancer patients' anxiety during a positron emission tomography/computed tomography (PET/CT) scan. Two hundred and thirty-two oncological out patients, with clinical indication for performing an 18F-2-fluoro-2-deoxy-D-glucose (18F-FDG) PET/CT scan and attending a nuclear medicine (NM) department, participated in the study. Patients' anxiety and subjective experience of PET/CT were examined using two self-report questionnaires. The pre-procedure questionnaire focused on demographic information, level of knowledge regarding the scan and subjective perception of anxiety before the procedure. The post-procedure questionnaire included the subjective perception anxiety after the procedure, information adequacy and satisfaction with the NM department. The self-reported data indicate that patients were anxious during PET/CT. Furthermore, our data revealed a significant difference between the anxiety pre-procedure and post-procedure (z = -3909, p < 0.05), in which the anxiety pre-procedure has significantly higher values. No significant correlation was found between anxiety and age of the patients, education levels, adequacy of information or satisfaction with the NM Department. Perception of anxiety post-procedure differs between gender (U = 5641, p = 0.033). In conclusion, PET/CT generated anxiety levels in oncological patients, especially before the procedure. Although patients seemed to be satisfied with information delivered by staff and with the NM Department, attention has to be focused on effective interventions strategies that help patients to reduce anxiety.
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Affiliation(s)
- Carla Abreu
- King’s College London & Guy’s and St. Thomas’ PET Centre, St. Thomas’ Hospital, Lambeth Palace Road, SE1 7EH, London, UK
| | - Ana Grilo
- Department of Social Sciences and Humanities, Scientific Area of Psychology, Higher School of Health Technology, Polytechnical Institute of Lisbon, Portugal, Av. Dom João II Lote 4.69.01, 1990-096 Lisbon, Portugal
| | - Filipa Lucena
- Scientific Area of Nuclear Medicine, Higher School of Health Technology, Polytechnical Institute of Lisbon, Portugal, Av. Dom João II Lote 4.69.01, 1990-096 Lisbon, Portugal
| | - Elisabete Carolino
- Department of Natural and Exact Sciences, Area of Mathematics, Higher School of Health Technology, Polytechnical Institute of Lisbon, Portugal, Av. Dom João II Lote 4.69.01, 1990-096 Lisbon, Portugal
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17
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Whole-body magnetic resonance imaging and FDG-PET/CT for lymphoma staging: Assessment of patient experience. THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2017. [DOI: 10.1016/j.ejrnm.2017.06.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Shortman R, Hoath J, Osadolor T, Inga P, Roper L, Bomanji J, Groves AM. Development of a PET/CT and PET/MRI patient information films in collaboration with patient representatives previously treated for cancer. J Nucl Med Technol 2017; 46:jnmt.117.198770. [PMID: 29042474 DOI: 10.2967/jnmt.117.198770] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Accepted: 09/26/2017] [Indexed: 11/16/2022] Open
Abstract
Introduction: PET/MRI and PET CT scanning carries an increased psychological burden for patients which may be improved by effective preparation prior to attendance for the procedure. We aimed to devise an online resource for patient benefit prior to PET/MRI and PET/CT scanning. Methods: With the help of patient representatives' the style and content for two patient information films was reviewed at each stage of the process to explain the patient journey. Results: Two patient information films were produced for patients undergoing PET scanning, Positive feedback from healthcare providers and users was obtained. Conclusion: Involvement of patient representatives in the production of an information resource has had a positive impact on the finished product, with potential for increased benefit to patients as a result.
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Affiliation(s)
- Robert Shortman
- Institute of Nuclear Medicine, University College London, United Kingdom
| | - John Hoath
- Institute of Nuclear Medicine, University College London, United Kingdom
| | - Tina Osadolor
- NIHR University College London Hospital Biomedical Research Centre, United Kingdom
| | | | - Louise Roper
- Institute of Nuclear Medicine, University College London, United Kingdom
| | - Jamshed Bomanji
- Institute of Nuclear Medicine, University College London, United Kingdom
| | - Ashley M Groves
- Institute of Nuclear Medicine, University College London, United Kingdom
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Nensa F, Tezgah E, Schweins K, Goebel J, Heusch P, Nassenstein K, Schlosser T, Poeppel TD. Evaluation of a low-carbohydrate diet-based preparation protocol without fasting for cardiac PET/MR imaging. J Nucl Cardiol 2017; 24:980-988. [PMID: 26993494 DOI: 10.1007/s12350-016-0443-1] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Accepted: 02/01/2016] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Assessment of increased glucose uptake in inflammatory or malignant myocardial disease using PET/MRI relies on uptake suppression in normal myocardium. We evaluated the efficacy of a ≥24 hours high-fat, low-carbohydrate, and protein-permitted diet (HFLCPP) in combination with unfractionated heparin for suppression of "physiologic" myocardial glucose uptake. METHODS PET/MRI was successfully performed in 89 patients. HFLCPP was started ≥24 hours prior to PET/MRI. All patients received i.v. injection of unfractionated heparin (50 IU·kg-1) 15 minutes prior to FDG administration. Left ventricular FDG uptake was visually evaluated by two readers. Diffuse myocardial uptake exceeding liver uptake, isolated uptake in the lateral wall, or diffuse uptake in the entire circumference of the heart base were defined as failed suppression. Homogeneous myocardial uptake below liver uptake with/without focal uptake was defined as successful suppression. RESULTS Success rate was 84%. Suppression was unsuccessful in 14 patients. No significant influence of gender (P = .40) or age (P = .21) was found. However, insufficient suppression was more common in patients younger than 45 years (20% vs 7%). PET/MR imaging completion rate was >97%. CONCLUSION A HFLCPP diet in combination with unfractionated heparin was successfully implemented for cardiac PET/MRI and resulted in a sufficient suppression of myocardial FDG uptake in 84% of patients.
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Affiliation(s)
- Felix Nensa
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University of Duisburg-Essen, Hufelandstrasse 55, 45147, Essen, Germany.
| | - E Tezgah
- Clinic for Cardiology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - K Schweins
- Department of Diet and Nutrition, University of Duisburg-Essen, Essen, Germany
| | - J Goebel
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University of Duisburg-Essen, Hufelandstrasse 55, 45147, Essen, Germany
| | - P Heusch
- Department of Diagnostic and Interventional Radiology, University Hospital Dusseldorf, University of Dusseldorf, Dūsseldorf, Germany
| | - K Nassenstein
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University of Duisburg-Essen, Hufelandstrasse 55, 45147, Essen, Germany
| | - T Schlosser
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University of Duisburg-Essen, Hufelandstrasse 55, 45147, Essen, Germany
| | - T D Poeppel
- Clinic for Nuclear Medicine, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
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