Barriers and Facilitators for Participation in Brain Magnetic Resonance Imaging (MRI) Scans in Cancer Research: A Feasibility and Acceptability Analysis.

Abstract

A growing body of research suggests that the brain is implicated in cognitive impairment, fatigue, neuropathy, pain, nausea, sleep disturbances, distress, and other prevalent and burdensome symptoms of cancer and its treatments. Despite anecdotal evidence of difficulties using gold-standard magnetic resonance imaging (MRI) to study the brain, no studies have systematically reported reasons that patients with cancer do or do not complete research MRI scans, making it difficult to understand the role of the brain related to these symptoms. The goal of this study was to investigate these reasons and to suggest possible solutions. We analyzed data from 72 patients with cancer (mostly breast and gastrointestinal) from 3 studies: MRI was mandatory in Study 1; MRI was optional in Studies 2-3. Patients provided reasons for completing or not completing optional research MRI scans. The percentage of scans completed when MRI was mandatory was 76%, and when optional, it was 36%. The most common reasons for not completing optional scans were claustrophobia (40%), safety contraindications (11%), discomfort (5%), a busy MRI schedule (5%), and the scanner being too far away (4%). Older patients were more likely to complete at least one scan (log(odds) = 0.09/year, p = 0.02). Although brain MRI is feasible for many patients with cancer, it can be difficult or not feasible for patients with claustrophobia, safety issues, busy schedules, or transportation issues. Improving communication, comfort, and access to a scanner may help. Reducing inequities related to study participation can improve research supportive care research.