Hepatocellular Carcinoma Surveillance: Operational and Environmental Impact of Abbreviated MRI Protocols.

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.