AUTHOR=Hehakaya Charisma , Van der Voort van Zyp Jochem R. , Lagendijk Jan J. W. , Grobbee Diederick E. , Verkooijen Helena M. , Moors Ellen H. M. 

TITLE=Problems and Promises of Introducing the Magnetic Resonance Imaging Linear Accelerator Into Routine Care: The Case of Prostate Cancer

JOURNAL=Frontiers in Oncology

VOLUME=10

YEAR=2020

URL=https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2020.01741

DOI=10.3389/fonc.2020.01741

ISSN=2234-943X

ABSTRACT=<p>The new radiotherapy high field, 1.5 Tesla MRI-guided linear accelerator (MR-Linac) is being clinically introduced. Sensing and evaluating opportunities and barriers at an early stage will facilitate its eventual scale-up. This study investigates the opportunities and barriers to the implementation of MR-Linac into prostate cancer care based on 43 semi-structured interviews with Dutch oncology care professionals, hospital and division directors, patients, payers and industry. The analysis was guided by the Non-adoption, Abandonment, Scale-up, Spread, and Sustainability framework of new medical technologies and services. Opportunities included: the acquirement of (<xref ref-type="bibr" rid="B1">1</xref>) advanced MRI-guided radiotherapy technology with (<xref ref-type="bibr" rid="B2">2</xref>) the potential for improved patient outcomes and (<xref ref-type="bibr" rid="B3">3</xref>) economic benefits, as well as (<xref ref-type="bibr" rid="B4">4</xref>) professional development and (<xref ref-type="bibr" rid="B5">5</xref>) a higher hospital quality profile. Barriers included: (<xref ref-type="bibr" rid="B1">1</xref>) technical complexities, (<xref ref-type="bibr" rid="B2">2</xref>) substantial staffing and structural investments, (<xref ref-type="bibr" rid="B3">3</xref>) the current lack of empirical evidence of clinical benefits, (<xref ref-type="bibr" rid="B4">4</xref>) professional silos, and (<xref ref-type="bibr" rid="B5">5</xref>) the presence of patient referral patterns. While our study confirms the expected technical and clinical prospects from the literature, it also reveals economic, organizational, and socio-political challenges.</p>