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Nominations

Magnetic resonance imaging – guided focused ultrasound (MRgFUS)

The Committee have received a number of nominations for Magnetic Resonance Imaging-Guided Focused Ultrasound (MRgFUS), for a range of indications. MRgFUS is a minimally invasive alternative to surgery for cancer of the brain, liver, breast and prostate and for the management of uterine fibroids and pain from bone metastases. Transcranial MRgFUS is an alternative to deep brain stimulation for patients with medication resistant Parkinson’s disease, essential tremor and dystonia.

The Committee recommended that additional advice on these technologies should be sought.

Actions

  • In 2016 MRgFUS was referred to HealthPACT for a health technology assessment. The HTA review was completed in 2017, and found:
    • MRgFUS tended to be well tolerated by patients
    • there was little high level, comparative or long term evidence demonstrating benefit
    • there was also minimal cost-effectiveness data available.
  • HealthPACT did not consider the clinical evidence to be sufficient to support the adoption of MRgFUS into routine clinical practice and recommended against public funding of MRgFUS in 2017.
  • An update to this review was finalised in 2019 and found for all indications, the evidence published since the 2017 review had not provided additional support for the adoption of MRgFUS into routine clinical practice.

Out of scope

Breast MRI service for women at high risk of breast cancer (2015)

The Committee advised the technology was not new to the NSW public system.

Emerging technology updates

Fluorescence imaging technology

In 2018, an update was received regarding a fluorescence imaging system to enable surgeons to visualise perfusion in burns tissue intraoperatively. The imaging system is under clinical trial to assess whether it allows for increased accuracy in predicting tissue viability.

Outcomes

  • research trial underway
  • update requested.

Lateral arm upright biopsy accessory

In 2019, an update was received for an adjunct to mammogram, used to biopsy lesions that may be cancerous and may require open surgery as they are in difficult to reach locations. The TGA recalled this technology in 2017 due to issues with device installation, which were addressed prior to the update being submitted.

Outcomes

  • to be provided under a research framework
  • update requested.

Machine vision image guidance system

In 2019, an update was received for a machine vision image guidance system used to map the spine or cranial cavity during neurosurgery.

Outcomes

  • research trial underway
  • update requested.

MRI based treatment planning

In 2019, an update was received on the use of combined MRI images for radiotherapy treatment instead of CT images. This was included in the scope for a planned evidence review on diagnostic imaging to be completed by the HTRG.

Outcomes

  • evidence review underway
  • research trial underway
  • update requested.

MRI linear accelerator

In 2019, an update was received on a combined linear accelerator and MRI machine which may improve the provision of radiotherapy. This was included in the scope for a planned evidence review on diagnostic imaging to be completed by the HTRG.

Outcomes

  • evidence review underway
  • research trial underway
  • update requested.

Particle therapy

In 2017, an update was received for particle therapy, which may deliver more accurate doses of radiation for radiotherapy treatment when compared to conventional radiotherapy.

Outcomes

  • local implementation underway
  • update requested.

Photographic fundoscopy

In 2019, an update was received for a device used to photograph the back of the eye to identify changes in intracranial blood pressure that may be associated with stroke.

Outcomes

  • research trial underway
  • update requested.

Targeted radiotherapy for prostate cancer

In 2019, an update was received for software used on a standard linear accelerator to assess prostate position during radiotherapy for treatment of prostate cancer.

Outcomes

  • local implementation underway under a research framework
  • update requested.

Transperineal ultrasound guided prostate biopsy

In 2018, an update was received for an alternative diagnostic procedure for patients with previous negative transrectal ultrasound guided biopsy who continue to have increasing levels of prostate serum antigen.

The Ministry sought additional information on this technology from the NSW Agency for Clinical Innovation, which highlighted changes in the detection, diagnosis and staging of prostate cancer over the past decade. NSW Health is undertaking a review of methods to detect and diagnose prostate cancer.

Outcomes

  • local implementation underway
  • evidence review
  • update requested.

Out of scope

Cerebrovascular imaging platform (2019)

Considered to be an Information and Communications Technology.

Contact

New health technology enquiries can be emailed to: MOH-HealthTechNominations@health.nsw.gov.au


Current as at: Tuesday 5 July 2022
Contact page owner: Strategic Reform and Planning