Understanding Patient Preference in Female Pelvic Imaging

Publication date: Available online 11 December 2017
Source:Academic Radiology
Author(s): Michelle D. Sakala, Ruth C. Carlos, Mishal Mendiratta-Lala, Elisabeth H. Quint, Katherine E. Maturen
Rationale and ObjectivesWomen with pelvic pain or abnormal uterine bleeding may undergo diagnostic imaging. This study evaluates patient experience in transvaginal ultrasound (TVUS) and magnetic resonance imaging (MRI) and explores correlations between preference and symptom severity.Materials and MethodsInstitutional review board approval was obtained for this Health Insurance Portability and Accountability Act-compliant prospective study. Fifty premenopausal women with pelvic symptoms evaluated by recent TVUS and MRI and without history of gynecologic cancer or hysterectomy were included. A phone questionnaire used validated survey instruments including Uterine Fibroid Symptoms Quality of Life index, Testing Morbidities Index, and Wait Trade Off for TVUS and MRI examinations.ResultsUsing Wait Trade Off, patients preferred TVUS over MRI (3.58 vs 2.80 weeks, 95% confidence interval [CI] −1.63, 0.12; P = .08). Summary test utility of Testing Morbidities Index for MRI was worse than for TVUS (81.64 vs 87.42, 95%CI 0.41, 11.15; P = .03). Patients reported greater embarrassment during TVUS than during MRI (P < .0001), but greater fear and anxiety both before (P < .0001) and during (P < .001) MRI, and greater mental (P = .02) and physical (P = .02) problems after MRI versus TVUS. Subscale correlations showed physically inactive women rated TVUS more negatively (R = −0.32, P = .03), whereas women with more severe symptoms of loss of control of health (R = −0.28, P = .04) and sexual dysfunction (R = −0.30, P = .03) rated MRI more negatively.ConclusionWomen with pelvic symptoms had a slight but significant preference for TVUS over MRI. Identifying specific distressing aspects of each test and patient factors contributing to negative perceptions can direct improvement in both test environment and patient preparation. Improved patient experience may increase imaging value.



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