Intraprocedural contrast-enhanced ultrasound (CEUS) in liver percutaneous radiofrequency ablation: Clinical impact and health technology assessment

被引：106

作者：

Mauri G. ^{[1
,3
]}

Porazzi E. ^{[2
]}

Cova L. ^{[3
]}

Restelli U. ^{[2
,4
]}

Tondolo T. ^{[3
]}

Bonfanti M. ^{[2
]}

Cerri A. ^{[3
]}

Ierace T. ^{[3
]}

Croce D. ^{[2
,4
]}

Solbiati L. ^{[3
]}

机构：

[1] IRCCS Policlinico San Donato, Unit of Radiology, Milano

[2] CREMS (Centre for Research on Health Economics, Social and Health Care Management), University Carlo Cattaneo-LIUC, Castellanza, VA

[3] Azienda Ospedaliera Ospedale di Circolo di Busto Arsizio, Department of Oncology, Unit of Interventional Oncologic Radiology, Busto Arsizio, Varese

[4] School of Public Health, University of the Witwatersrand, Johannesburg

来源：

Insights into Imaging | 2014年 / 5卷 / 2期

关键词：

Budget impact; Clinical impact; Cost-effectiveness; Health technology assessment; Hepatocellular carcinoma; Intraprocedural contrast-enhanced ultrasound; Radiofrequency ablation;

D O I：

10.1007/s13244-014-0315-7

中图分类号：

学科分类号：

摘要：

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).

引用

页码：209 / 216

页数：7

共 24 条

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