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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
Intraprocedural contrast-enhanced ultrasound (CEUS) in liver percutaneous radiofrequency ablation: Clinical impact and health technology assessment
Insights into Imaging, Volume 5, No. 2, Year 2014
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Description
Objectives: To assess the clinical and the economic impacts of intraprocedural use of contrast-enhanced ultrasound (CEUS) in patients undergoing percutaneous radiofrequency ablation for small (<2.5 cm) hepatocellular carcinomas. Methods: One hundred and forty-eight hepatocellular carcinomas in 93 patients were treated by percutaneous radiofrequency ablation and immediate assessment by intraprocedural CEUS. Clinical impact, cost effectiveness, and budget, organisational and equity impacts were evaluated and compared with standard treatment without intraprocedural CEUS using the health technology assessment approach. Results: Intraprocedural CEUS detected incomplete ablation in 34/93 (36.5 %) patients, who underwent additional treatment during the same session. At 24-h, complete ablation was found in 88/93 (94.6 %) patients. Thus, a second session of treatment was spared in 29/93 (31.1 %) patients. Cost-effectiveness analysis revealed an advantage for the use of intraprocedural CEUS in comparison with standard treatment (4,639 vs 6,592) with a 21.9 % reduction of the costs to treat the whole sample. Cost per patient for complete treatment was € 4,609 versus € 5,872 respectively. The introduction of intraprocedural CEUS resulted in a low organisational impact, and in a positive impact on equity Conclusions: Intraprocedural use of CEUS has a relevant clinical impact, reducing the number of re-treatments and the related costs per patient. Teaching Points: • CEUS allows to immediately asses the result of ablation. • Intraprocedural CEUS decreases the number of second ablative sessions. • Intraprocedural CEUS may reduce cost per patient for complete treatment. • Use of intraprocedural CEUS may reduce hospital budget. • Its introduction has low organisational impact, and relevant impact on equity. © 2014 The Author(s).
Authors & Co-Authors
Mauri, Giovanni
Italy, San Donato Milanese
Gruppo Ospedaliero San Donato
Italy, Busto Arsizio
Azienda Ospedaliera Di Busto Arsizio
Porazzi, Emanuele
Italy, Castellanza
Università Carlo Cattaneo
Cova, Luca
Italy, Busto Arsizio
Azienda Ospedaliera Di Busto Arsizio
Restelli, Umberto
Italy, Castellanza
Università Carlo Cattaneo
South Africa, Johannesburg
University of the Witwatersrand
Tondolo, Tania
Italy, Busto Arsizio
Azienda Ospedaliera Di Busto Arsizio
Bonfanti, Marzia
Italy, Castellanza
Università Carlo Cattaneo
Cerri, Anna
Italy, Busto Arsizio
Azienda Ospedaliera Di Busto Arsizio
Ierace, Tiziana
Italy, Busto Arsizio
Azienda Ospedaliera Di Busto Arsizio
Croce, Davide
Italy, Castellanza
Università Carlo Cattaneo
South Africa, Johannesburg
University of the Witwatersrand
Solbiati, Luigi
Italy, Busto Arsizio
Azienda Ospedaliera Di Busto Arsizio
Statistics
Citations: 114
Authors: 10
Affiliations: 4
Identifiers
Doi:
10.1007/s13244-014-0315-7
e-ISSN:
18694101
Research Areas
Health System And Policy