ArticleCureus2025
Smarter Scanning: Reducing Unnecessary Magnetic Resonance Cholangiopancreatography (MRCP) in Low-Risk Gallstone Patients.
Article in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
5 authors.
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No grant is acknowledged in the PubMed record.
Abstract
Background Gallstone disease is a common condition that often requires imaging to exclude choledocholithiasis. Magnetic resonance cholangiopancreatography (MRCP) is a highly accurate but costly scan, increasingly used in low- to moderate-risk patients where its diagnostic yield may be low. Objective This audit evaluated the diagnostic yield of MRCP in low- to moderate-risk gallstone patients and assessed the predictive value of liver function tests (LFTs) and ultrasound (USS) findings to develop a smarter referral approach. Methods A retrospective audit was conducted at a single NHS Trust from January to December 2024. Data on MRCP outcomes, pre-scan LFTs (bilirubin, alkaline phosphatase (ALP)), and USS common bile duct (CBD) diameter were analyzed using chi-squared tests. A composite score (MRCP-RS) combining key predictors was explored to guide smarter MRCP referrals. Results Among 329 MRCPs, 42.2% were normal. Elevated bilirubin and ALP showed no significant association with abnormal MRCPs (p=1.00 and p=0.61). Dilated CBD on USS had limited predictive value (p=0.82). The MRCP-RS composite score demonstrated a trend of increasing abnormal MRCP rates with higher scores but modest discriminative ability. Avoidable normal MRCPs incurred an estimated annual cost of £38,000-65,000. Conclusion Routine use of MRCP in low-risk gallstone patients leads to unnecessary imaging and costs. Neither LFTs nor USS alone is a reliable predictor. A combined approach using a simple composite score may improve referral decisions. Adoption of smarter referral tools and re-audit post-implementation are recommended.
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