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Hepatocellular Carcinoma Surveillance: Operational and Environmental Impact of Abbreviated MRI Protocols
Sean A Woolen1, Fayyaz Ahamed1, Robert D MacDougall2
1Department of Radiology and Biomedical Imaging, University of California San Francisco, CA, USA.
Objective:
To assess the operational and environmental benefits of using an abbreviated protocol for hepatocellular carcinoma (HCC) surveillance.
Methods:
This IRB-approved retrospective single-center quality improvement study evaluated time, energy use, and appointment access. Inclusion criteria were HCC surveillance MRIs with either a full or abbreviated imaging protocol. Exclusion criteria were other abdominopelvic MR protocols or incomplete studies. DICOM time data were extracted via Quantivly and validated with 10 prospective time studies. Exam times from PACS images were cross-referenced with DICOM data to identify and resolve extraction outliers. Power logs from 10 exams per protocol were used to quantify energy and greenhouse gas emissions. Schedule logs assessed appointment volume changes. Mean times (±SD) and energy (±SD) were reported, and Welch's t-test determined statistical significance (P < .05).
Results:
Exam times for 487 MRIs (318 abbreviated, 169 full protocol) were analyzed, with 67 excluded. The mean duration of exam time for the abbreviated protocol was 12.0 minutes (SD: 4.3), compared with 29.7 minutes (SD: 8.8) for the full protocol (mean difference, 17.7 minutes; P < .0001). The mean energy for the abbreviated protocol was 4.7 kWh (SD: 0.6), compared with 11.7 kWh (SD: 1.3) for the full protocol (mean difference, 7.0 kWh; P < .0001). Across 318 abbreviated exams, estimated savings totaled 2226 kWh and 1494.6 kg CO2eq. Despite time savings, MRI appointment volume and scanner access remained unchanged.
Conclusion:
Abbreviated HCC surveillance MRIs cut scan time, energy use, and carbon emissions by 60%, but scheduling complexities precluded increased MRI appointments.
Insights
An abbreviated MRI protocol for hepatocellular carcinoma (HCC) surveillance significantly reduces scan time and energy use. This optimized approach lowers carbon emissions without impacting appointment availability.
Area of Science:
- Radiology and Medical Imaging
- Oncology
- Environmental Sustainability in Healthcare
Background:
- Hepatocellular carcinoma (HCC) surveillance requires regular MRI scans.
- Traditional MRI protocols can be time-consuming and energy-intensive.
- Optimizing HCC surveillance protocols is crucial for operational efficiency and environmental impact.
Purpose of the Study:
- To evaluate the operational and environmental benefits of an abbreviated MRI protocol for HCC surveillance.
- To compare scan times, energy consumption, and greenhouse gas emissions between abbreviated and full MRI protocols.
- To assess the impact of an abbreviated protocol on MRI appointment access.
Main Methods:
- Retrospective quality improvement study analyzing 487 HCC surveillance MRIs.
- Comparison of scan durations and energy usage (kWh) between abbreviated and full protocols.
- Quantification of greenhouse gas emissions (CO2eq) and assessment of appointment scheduling data.
Main Results:
- Abbreviated MRI protocols reduced mean exam time by 17.7 minutes (12.0 vs. 29.7 minutes) and energy use by 7.0 kWh (4.7 vs. 11.7 kWh).
- Estimated savings from 318 abbreviated exams included 2226 kWh and 1494.6 kg CO2eq.
- No significant change in MRI appointment volume or scanner access was observed.
Conclusions:
- Abbreviated HCC surveillance MRIs offer substantial reductions in scan time, energy consumption, and carbon footprint.
- The adoption of abbreviated protocols can lead to significant environmental benefits in medical imaging.
- Scheduling complexities did not allow for increased MRI appointment capacity despite time savings.
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