Imaging utilization not curbed by palliative care

Cancer patients who are in palliative care programs receive no less oncological imaging during the last three months of life than those who are not in such programs, according to researchers at the University of California, San Francisco.

The team had its findings published online March 1 in BMJ Supportive & Palliative Care.

Kesav Raghavan, MD, and colleagues reviewed case data on 3,784 patients who died of cancer over a period of more than three years ending in May 2015.

They found advanced oncology imaging was performed in non-emergent settings on similar proportions of patients with and without palliative care during the patients’ final three months, while a greater proportion of the palliative cohort was imaged during the last month.

In a matched-pairs analysis, the researchers found a greater proportion of patients previously referred to palliative care received imaging in the period between the first palliative care encounter and death.

This uptick remained consistent in a comparison of imaging utilization in the last month of life.

Further, palliative care was not associated with significantly different mean imaging intensity—calculated by quantifying mean number of imaging exams per patient—during either the three-month or the final-month time window.

Mean imaging intensity was likewise similar between the palliative and non-palliative groups.  

Raghavan and colleagues also looked for associations between intensity of palliative care services with oncology imaging utilization. They found no significant differences in care intensity between imaged and non-imaged patients in either the last three months or the final month before death.

“Palliative care involvement in end-of-life oncological care was not associated with decreased use of non-emergent, high-cost imaging,” the authors concluded, adding that the role of advanced imaging in the palliative care setting deserves more research.