To date, the report says, the value, whether more clinically significant lesions can be seen with 3T. has not been determined, although neurologic applications, such as functional, diffusion weighted, and spectroscopy MRI may show more clinically useful information.
"For other applications, little evidence suggests that 3T is necessary or that it improves patient outcomes over 1.5T," the report says. A 3T system for routine MRI applications "is still difficult to justify – at least until additional research demonstrations added clinical utility."
9. Personalized Medicine for Cancer Care
Personalized therapies for oncology patients carry price tags of $100,000 and up, and none replaces existing interventions, the report says. Five such targeted treatments have been released in the last year or so for advanced melanoma, Hodgkin's lymphoma, lung and prostate cancer, "including the first personalized therapeutic cancer vaccine."
However, ECRI experts say, "the average observed survival improvements associated with these therapies, while encouraging, are relatively modest, measured in two to six months," and come with life-threatening side effects.
10. Proton Beam Radiation Therapy
The ability to tightly zero in on a tumor and eradicate it with radiation, with little collateral damage, is the promise, but there is little evidence showing improved patient outcomes. They are expensive, with a $100 million to $200 million price tag, and take up a lot of space.
And they may soon be out of date, the ECRI report suggests, pointing to increasing interest in carbon ion therapy, another type of radiation therapy with advantages over photon or proton beam radiation.
"Compared to protons, the path of heavier carbon ions is less influenced by passage through overlying tissue and, therefore, the peak of ionizing radiation is tighter, potentially allowing more precise targeting and delivery," the report says.
Since proton therapy comparative effectiveness research is lacking, and with carbon ion technology on the way, ECRI suggests that hospital leaders who might be considering a major proton center wait a bit. Also, reimbursement is spotty and at the discretion of local coverage carriers.
ECRI's full report may be viewed here.