Radiological Sciences, Mental Health and Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, UK.
Department of Radiology, Nottingham University Hospitals NHS Trust, Nottingham, UK.
Cancer Med. 2024 Jul;13(14):e70049. doi: 10.1002/cam4.70049.
BACKGROUND/OBJECTIVES: Ataxia telangiectasia (A-T) is an inherited multisystem disorder with increased sensitivity to ionising radiation and elevated cancer risk. Although other cancer predisposition syndromes have established cancer screening protocols, evidence-based guidelines for cancer screening in A-T are lacking. This study sought to assess feasibility of a cancer screening protocol based on whole-body MRI (WB-MRI) in children and young people with A-T.
DESIGN/METHODS: Children and young people with A-T were invited to undergo a one-off non-sedated 3-Tesla WB-MRI. Completion rate of WB-MRI was recorded and diagnostic image quality assessed by two experienced radiologists, with pre-specified success thresholds for scan completion of >50% participants and image quality between acceptable to excellent in 65% participants. Positive imaging findings were classified according to the ONCO-RADS system. Post-participation interviews were performed with recruited families to assess the experience of participating and feelings about waiting for, and communication of, the findings of the scan.
Forty-six children and young people with A-T were identified, of which 36 were eligible to participate, 18 were recruited and 16 underwent WB-MRI. Nineteen parents participated in interviews. Fifteen participants (83%) completed the full WB-MRI scan protocol. The pre-specified image quality criterion was achieved with diagnostic images obtained in at least 93% of each MRI sequence. Non-malignant scan findings were present in 4 (25%) participants. Six themes were identified from the interviews: (1) anxiety is a familiar feeling, (2) the process of MRI scanning is challenging for some children and families, (3) preparation is essential to reduce stress, (4) WB-MRI provides the reassurance about the physical health that families need, (5) WB-MRI experience turned out to be a positive experience and (6) WB-MRI allows families to be proactive.
This study shows that WB-MRI for cancer screening is feasible and well-accepted by children and young people with A-T and their families.
背景/目的：毛细血管扩张共济失调症（A-T）是一种遗传性多系统疾病，对电离辐射敏感，癌症风险增加。虽然其他癌症易感性综合征已经制定了癌症筛查方案，但缺乏 A-T 癌症筛查的循证指南。本研究旨在评估基于全身 MRI（WB-MRI）的癌症筛查方案在 A-T 儿童和青少年中的可行性。
邀请 A-T 儿童和青少年接受一次性非镇静 3T WB-MRI。记录 WB-MRI 的完成率，并由两名经验丰富的放射科医生评估诊断图像质量，扫描完成率>50%的参与者和 65%的参与者的图像质量在可接受到优秀之间的成功率有预设阈值。阳性影像学发现根据 ONCO-RADS 系统进行分类。对招募的家庭进行参与后访谈，以评估参与体验以及对扫描结果的等待、沟通的感受。
确定了 46 名 A-T 儿童和青少年，其中 36 名符合参与条件，招募了 18 名，16 名接受了 WB-MRI。19 名家长参与了访谈。15 名参与者（83%）完成了完整的 WB-MRI 扫描方案。达到了获得至少 93%的每个 MRI 序列的诊断图像的预设图像质量标准。4 名（25%）参与者存在非恶性扫描发现。访谈中确定了 6 个主题：（1）焦虑是一种熟悉的感觉，（2）MRI 扫描过程对一些儿童和家庭来说具有挑战性，（3）准备工作对于减轻压力至关重要，（4）WB-MRI 提供了家庭所需的身体健康保证，（5）WB-MRI 体验结果是积极的，（6）WB-MRI 使家庭能够积极主动。
本研究表明，WB-MRI 用于癌症筛查在 A-T 儿童和青少年及其家庭中是可行且可接受的。
