MRI funded for surveillance of renal tumours

Cancer

By Michael Woodhead

9 Jul 2024

Two new abdominal magnetic resonance imaging (MRI) services have been listed on the Medicare Benefits Schedule for genetic conditions associated with risk of renal tumours.

From 1 July 2024, MBS items 63539 and 63540 will allow for annual surveillance to detect newly developed renal tumours, and ongoing assessment of changes over time to existing renal tumours, for patients with defined rare inherited conditions associated with an increased lifetime risk of renal tumours.

The inherited conditions include disorders such as tuberous sclerosis complex (TSC), Von Hippel Lindau (VHL) syndrome, Birt-Hogg-Dube syndrome, hereditary papillary renal carcinoma syndrome, hereditary leiomyomatosis and renal cell carcinoma (HLRCC), Cowden syndrome, BAP1-associated cancer syndrome, SDH associated renal cancer  and familial clear renal cell carcinoma with chromosome 3 translocation.

The fundings was approved by Medicare Services Advisory Committee (MSAC) last year (link here), after it concluded that MRI offered safety benefits over ultrasound and CT imaging, which are currently funded under the MBS for scanning these conditions.

MRI was preferred because it avoided the risk of ionising radiation and lower associated lifetime cancer risk due to cumulative radiation exposure. This is particularly important given the high clinical need and requirement for regular imaging from a young age for this patient population.

The funding proposal was supported by submissions from groups including the Australian and New Zealand Society of Nephrology (ANZSN). Submissions said that the main benefits of public funding would be superior imaging sensitivity and specificity for early detection and characterisation of renal tumours with MRI screening. MRI would also allow earlier and more accurate diagnosis and resulting targeted therapy, which can improve disease outcomes and extend life.

The RANZCR submitted that it should be clarified that radiologists would be the providers of the service rather than nephrologists.

MSAC noted that for TSC, 80% of individuals are at risk of developing angiomyolipomas (AML) which appear from around age 18 and tend to grow rapidly. For VHL there is increased risk of multiple benign and malignant tumours at multiple sites. The combined list of genetic abnormalities account for 4% of all renal tumours

The items must be requested by a specialist or consultant physician and the service must be performed by a specialist in diagnostic radiology

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