Interventional MRI saves lives and life quality

At Nano4Imaging we strive to replace a significant part of cathlab procedures to the MRI suite. We claim our products have impact on life quality of vulnerable patients, but how big is this impact actually? This article is an effort to give some first estimates. The major drivers of this impact? include:

• Less exposure to radiation by patients and staff. This impacts on mortality and morbidity
• No use of iodinated contrast avoiding complications in diabetes/kidney disease.

In this article we estimate the impact of radiation on mortality due to cancer and lives saved and extending quality-adjusted life years (QALY). Let's discriminate the following groups:

Congenital heart disease, CHD (pediatric): 1 % of newborns has a congenital heart disorder. 1/3 of these persons needs life time treatment, including annual invasive investigation, now being done in the cathlab. Studies from Germany (Stern et al (2020)) and Sweden? have shown a 300% ?increase in cancer in ?children with CHD up to 15 years that were subjected to cathlab intervention at first year of age. Projections to adult age and the number of patients in Europe and USA would lead to 1000 extra annual cases of cancer, of which a significant part (25 %) is before adolescence, leading to 15.750 QALYs lost.

Congenital heart disease (adult): ?the current cohort of adult patients with CHD in USA and Europe is over 2.2 million people. The average age of death of this population is estimated by different registries to be around 49 years. This premature death leads to a loss of ?years life expectancy of 64 million years. If we consider that 1/3 of those or due to cancer as in general population this 21 million years. If 1 out of 200 cancers would be due to medical radiation exposure this year’s life expectancy at total would lead to another saving of 21.000 quality years when using iMRI.

Reduction of radiation exposure to staff; assuming 100 people per hospital that are exposed to radiation in interventions.. Cardiologists? and staff accumulate significant lifetime radiation exposure in the range of 50 to 200 mSv corresponding to a whole body dose equivalent of 2500 to 10,000 chest x-rays with a projected professional lifetime attributable excess cancer risk of 1 in 100 (Venneri et al, 2006). A typical cumulative 15-year radiological exposure around the equivalent of 50 mSv is associated with a nonnegligible LAR of cancer in the order of magnitude of 1 cancer in 200 exposed subjects.

Let's assume that 300 hospitals in both the USA and Europe have multiple cathlabs employing 100 people each. This means a? population at risk of 60,000 (300 x 2 x 100), leading to 300 extra cancers worldwide in interventional clinics. In addition to that cataract cases would be around 1000.

Altogether, N4I vision and technology can save at least 1300 cancer cases on an annual basis, and at the same time prevent 36.000 QALYS lost due to accelerated? mortality in patients with structural heart diseases.? The effect of avoiding contrast will be subject of a subsequent article. Check our website (www.nano4imaging.com) to follow.