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Developing an intraoperative 3T MRI-guided brachytherapy program within a diagnostic imaging suite: Methods, process

Matthew S Ning¹, Aradhana M Venkatesan², R Jason Stafford³

¹Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX.

|December 2, 2019

Summary

This summary is machine-generated.

Integrating intraoperative MRI guidance into brachytherapy workflows is feasible, with only a 15% increase in resource utilization. This approach optimizes gynecologic cancer treatment, potentially lowering costs and increasing value over time.

Keywords:

Cervical cancer HDR brachytherapy Health care value TDABC

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Area of Science:

Medical Physics
Oncology
Radiology

Background:

Brachytherapy is a crucial treatment for gynecologic cancers.
Traditional brachytherapy workflows often involve separate diagnostic imaging sessions.
Integrating intraoperative guidance aims to improve treatment precision and efficiency.

Purpose of the Study:

To integrate a brachytherapy procedural workflow within a diagnostic 3.0-T (3T) MRI suite.
To facilitate intraoperative MRI guidance for optimal applicator positioning in gynecologic brachytherapy.
To evaluate the feasibility and resource utilization of an intraoperative MRI-guided brachytherapy program.

Main Methods:

Summarized multidisciplinary collaboration, equipment, and supplies.
Outlined operational workflow via process maps and safety precautions.
Evaluated resource utilization using time-driven activity-based costing, comparing intraoperative MRI to traditional CT-based workflows.

Main Results:

Intraoperative MRI workflow showed only a 15% higher resource utilization than traditional methods.
Personnel expenses were the primary cost driver (76-77%) in both workflows.
Potential cost-shifting from CT to MRI and process speed improvements can decrease overall costs.

Conclusions:

Intraoperative MRI-guided brachytherapy is feasible within a diagnostic MRI suite.
The approach defines required resources for this procedural workflow.
Further follow-up will determine the full utility in optimizing the therapeutic ratio for gynecologic cancers, potentially increasing value over time.