A cost-effectiveness analysis of the diagnostic strategies for differentiating focal nodular hyperplasia from hepatocellular adenoma.
Eur Radiol
; 28(1): 214-225, 2018 Jan.
Article
em En
| MEDLINE
| ID: mdl-28726119
ABSTRACT
OBJECTIVES:
We evaluated the cost-effectiveness of a gadoxetic acid-enhanced MRI (EOB-MRI) strategy compared with conventional MRI strategy and biopsy to differentiate focal nodular hyperplasia (FNH) from hepatocellular adenoma (HCA).METHODS:
A decision tree model was constructed to compare the cost-effectiveness of EOB-MRI, conventional MRI with extracellular contrast agents, and biopsy as the initial diagnostic modality in patients with incidentally detected focal liver lesions suspected of being FNH or HCA. We analysed the cost and effectiveness, i.e. probability of successful diagnosis of each strategy. Costs were based on utilisation rates and Medicare reimbursements in the USA and South Korea.RESULTS:
In the base case analysis of our decision tree model, the effectiveness of the three strategies was similar. The cost of the EOB-MRI strategy ($1283 in USA, $813 in South Korea) was lowest compared with the biopsy strategy ($1725 in USA, $847 in South Korea) and the conventional MRI strategy ($1750 in USA, $962 in South Korea). One-way, two-way and probabilistic sensitivity analysis showed unchanged results over an acceptable range.CONCLUSIONS:
EOB-MRI strategy is the most cost-effective strategy for differentiating FNH from HCA in patients with incidentally detected focal liver lesions in a non-cirrhotic liver. KEY POINTS ⢠The effectiveness of the three strategies was similar. ⢠The cost of the EOB-MRI strategy was lowest. ⢠EOB-MRI strategy is the most cost-effective for differentiating FNH from HCA.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Contexto em Saúde:
1_ASSA2030
Base de dados:
MEDLINE
Assunto principal:
Imageamento por Ressonância Magnética
/
Análise Custo-Benefício
/
Adenoma de Células Hepáticas
/
Hiperplasia Nodular Focal do Fígado
/
Neoplasias Hepáticas
Tipo de estudo:
Diagnostic_studies
/
Health_economic_evaluation
/
Prognostic_studies
Limite:
Adult
/
Female
/
Humans
/
Male
/
Middle aged
País/Região como assunto:
America do norte
/
Asia
Idioma:
En
Revista:
Eur Radiol
Ano de publicação:
2018
Tipo de documento:
Article