Wilms tumor imaging: patient costs and protocol compliance.

Abstract

To evaluate the patient costs for imaging and compliance with imaging protocols in pediatric patients in the National Wilms Tumor Study (NWTS) IV. The medical and imaging records of 60 patients (28 male, 32 female; aged 3 days to 12.6 years) in NWTS IV were reviewed. Initial imaging and follow-up imaging were evaluated separately. Three levels of follow-up compliance were evaluated. The total patient cost for imaging was $442,180: $94,212 for initial and $347,968 for follow-up studies. Many areas of potential cost savings were identified. Protocol compliance was variable. Seventy-five percent of patients underwent studies in full compliance with the initial protocol requirements. For follow-up, compliance was 0%-80% for different studies at different compliance levels. For no study was compliance 100%. Imaging costs in pediatric patients with Wilms tumor are substantial. Protocol compliance was not optimal.