TY - JOUR
T1 - Economic assessment of contrast-enhanced ultrasonography for evaluation of focal liver lesions
T2 - A multicentre Italian experience
AU - Romanini, Laura
AU - Passamonti, Matteo
AU - Aiani, Luca
AU - Cabassa, Paolo
AU - Raieli, Giuseppina
AU - Montermini, Ilaria
AU - Martegani, Alberto
AU - Grazioli, Luigi
AU - Calliada, Fabrizio
PY - 2007/12
Y1 - 2007/12
N2 - Background: The aim of this study was to evaluate the clinical and economic consequences of the introduction of contrast-enhanced ultrasonography (CEUS) into the diagnostic clinical algorithm for the characterization of incidental focal liver lesions (FLLs). Methods: This prospective study enrolled 485 subjects at three hospitals in Italy. Two diagnostic algorithms were utilized: (1) a classic patient work-up, which included baseline US followed by a CT or MR examination, and (2) a new patient management scheme in which, following the baseline US, a CEUS examination was performed. For each pathway, both direct and indirect health costs for the National Health System (NHS) at two of the three hospitals involved in the study were calculated. Clinical outcome was measured in terms of number of cases correctly diagnosed, using contrast-enhanced CT/contrast-enhanced MR as the reference standard. Results: CEUS correctly differentiated (benign vs. malignant) 559 of 575 lesions (97.2%), with a sensitivity of 98.1% and a specificity of 95.7%. Histological characterization was correct in 502 of 575 lesions (87%) with a sensitivity of 90.5% and a specificity of 85.4%. In terms of cost, the conventional diagnostic algorithm incurred for the NHS a total cost of €134.576,60 vs. €55.674,30 with CEUS, for a saving of €78.902 (€162 per patient). For the hospitals, the total cost was €147.045 without CEUS vs €61.979 with CEUS, for a saving of €85.065,96 or €175,39 per patient. Conclusion: The routineuse of CEUS for the characterization of FLLs provides significant cost savings, both for the NHS and for the hospital.
AB - Background: The aim of this study was to evaluate the clinical and economic consequences of the introduction of contrast-enhanced ultrasonography (CEUS) into the diagnostic clinical algorithm for the characterization of incidental focal liver lesions (FLLs). Methods: This prospective study enrolled 485 subjects at three hospitals in Italy. Two diagnostic algorithms were utilized: (1) a classic patient work-up, which included baseline US followed by a CT or MR examination, and (2) a new patient management scheme in which, following the baseline US, a CEUS examination was performed. For each pathway, both direct and indirect health costs for the National Health System (NHS) at two of the three hospitals involved in the study were calculated. Clinical outcome was measured in terms of number of cases correctly diagnosed, using contrast-enhanced CT/contrast-enhanced MR as the reference standard. Results: CEUS correctly differentiated (benign vs. malignant) 559 of 575 lesions (97.2%), with a sensitivity of 98.1% and a specificity of 95.7%. Histological characterization was correct in 502 of 575 lesions (87%) with a sensitivity of 90.5% and a specificity of 85.4%. In terms of cost, the conventional diagnostic algorithm incurred for the NHS a total cost of €134.576,60 vs. €55.674,30 with CEUS, for a saving of €78.902 (€162 per patient). For the hospitals, the total cost was €147.045 without CEUS vs €61.979 with CEUS, for a saving of €85.065,96 or €175,39 per patient. Conclusion: The routineuse of CEUS for the characterization of FLLs provides significant cost savings, both for the NHS and for the hospital.
KW - Contrast-enhanced ultrasound
KW - Economic assessment
KW - Focal liver lesions and characterization
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U2 - 10.1007/s10406-007-0234-5
DO - 10.1007/s10406-007-0234-5
M3 - Article
C2 - 18376463
AN - SCOPUS:40349115905
VL - 17
JO - European Radiology, Supplement
JF - European Radiology, Supplement
SN - 1613-3749
IS - SUPPL. 6
ER -