Abstract
Purpose
The aim of this study was to perform a cost analysis of contrast-enhanced ultrasonography (CEUS) in the study of benign focal liver lesions (BFLL) with indeterminate appearance on ultrasonography (US).
Materials and methods
A decision model of patients with suspected BFLL on baseline US who subsequently underwent CEUS between 2002 and 2005 was constructed. We analysed the cost effectiveness of CEUS, considering whether or not computed tomography (CT) was necessary for the diagnosis. There were 398 patients with 213 angiomas, 41 focal nodular hyperplasias (FNH) and 154 pseudolesions (focal fatty sparing, focal fatty areas). Each patient underwent CEUS, and 98 of them were also studied by CT. All lesions were followed up.
Results
The cost of a single CEUS examination was 101.51 euros, and that of a single CT scan was 211.48 euros. For diagnosis of haemangiomas, we saved 1,406.97 euros in 2002, 5,315.22 euros in 2003, 10,317.78 euros in 2004 and 9,536.13 euros in 2005. For diagnosis of focal nodular hyperplasias, we saved 781.65 euros in 2003, 781.65 euros in 2004 and 1,406.97 euros in 2005. For diagnosis of pseudolesions, we saved 2,813.94 euros in 2002, 5,158.89 euros in 2003, 5,158.89 euros in 2004 and 4,220.91 euros in 2005. In the period 2002–2005, the introduction of CEUS allowed us to save a total of 47,055.33 euros in the diagnosis of benign focal hepatic liver lesions.
Conclusions
This cost analysis shows that CEUS is the least expensive second-line modality after baseline US for the diagnosis of BFLL.
Riassunto
Obiettivo
Scopo di questo lavoro è l’analisi dei costi di pertinenza dei servizi di Radiologia nell’utilizzo dell’ecografia con contrasto (CEUS) nello studio delle lesioni focali epatiche benigne (LFEB) ad aspetto non esaustivo all’ecografia basale (US).
Materiali e metodi
È stato costruito un modello decisionale di pazienti con LFEB sospette all’US che sono stati sottoposti a CEUS tra il 2002 ed il 2005. Abbiamo analizzato il rapporto costo-efficacia della CEUS sulla base della necessità o meno di proseguire le indagini con un esame di tomografia computerizzata (TC). I pazienti sono stati 398, aventi 213 angiomi, 41 iperplasie focali nodulari (FNH), e 154 pseudolesioni (aree di risparmio di steatosi, aree di steatosi focale). Per ognuno di questi pazienti abbiamo effettuato un esame CEUS e in 98 pazienti l’esame TC. Tutte le lesioni sono state seguite in follow-up.
Risultati
Il costo per singolo esame CEUS è stato di 101,51 €. Il costo per singolo esame TC è stato di 211,48 €. Per la diagnosi di angiomi nel 2002 abbiamo risparmiato 1406,97 €, nel 2003 5315,22 €, nel 2004 10317,78 €, nel 2005 9536,13 €. Per diagnosticare l’iperplasia focale nodulare nell’anno 2003 abbiamo risparmiato 781,65 €, nel 2004 781,65 €, nel 2005 1406,97 €. Per diagnosticare pseudolesioni nel 2002 abbiamo risparmiato 2813,94 €, nel 2003 5158,89 €, nel 2004 5158,89 €, nel 2005 4220,91 €. Nell’intero periodo 2002–2005 grazie all’introduzione della CEUS abbiamo risparmiato 47055,33 € per la diagnosi di lesioni focali epatiche benigne.
Conclusioni
Questo studio sull’analisi dei costi ha dimostrato che la CEUS è la più conveniente tecnica di secondo livello dopo l’ecografia basale per la diagnosi di lesioni focali epatiche benigne.
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Faccioli, N., D’Onofrio, M., Comai, A. et al. Contrast-enhanced ultrasonography in the characterization of benign focal liver lesions: activity-based cost analysis. Radiol med 112, 810–820 (2007). https://doi.org/10.1007/s11547-007-0185-x
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DOI: https://doi.org/10.1007/s11547-007-0185-x