European Radiology

, Volume 19, Supplement 3, pp 753–763

Health-economic evaluation of three imaging strategies in patients with suspected colorectal liver metastases: Gd-EOB-DTPA-enhanced MRI vs. extracellular contrast media-enhanced MRI and 3-phase MDCT in Germany, Italy and Sweden

  • C. J. Zech
  • L. Grazioli
  • E. Jonas
  • M. Ekman
  • R. Niebecker
  • S. Gschwend
  • J. Breuer
  • L. Jönsson
  • S. Kienbaum
Article

DOI: 10.1007/s00330-009-1432-4

Cite this article as:
Zech, C.J., Grazioli, L., Jonas, E. et al. Eur Radiol (2009) 19: 753. doi:10.1007/s00330-009-1432-4

Abstract

The purpose of this study was to perform an economic evaluation of hepatocyte-specific Gd-EOB-DTPA enhanced MRI (PV-MRI) compared to extracellular contrast-media-enhanced MRI (ECCM-MRI) and three-phase-MDCT as initial modalities in the work-up of patients with metachronous colorectal liver metastases. The economic evaluation was performed with a decision-tree model designed to estimate all aggregated costs depending on the initial investigation. Probabilities on the need for further imaging to come to a treatment decision were collected through interviews with 13 pairs of each a radiologist and a liver surgeon in Germany, Italy and Sweden. The rate of further imaging needed was 8.6% after initial PV-MRI, 18.5% after ECCM-MRI and 23.5% after MDCT. Considering the cost of all diagnostic work-up, intra-operative treatment changes and unnecessary surgery, a strategy starting with PV-MRI with 959 € was cost-saving compared to ECCM-MRI (1,123 €) and MDCT (1,044 €) in Sweden. In Italy and Germany, PV-MRI was cost-saving compared to ECCM-MRI and had total costs similar to MDCT. In conclusion, our results indicate that PV-MRI can lead to cost savings by improving pre-operative planning and decreasing intra-operative changes. The higher cost of imaging with PV-MRI is offset in such a scenario by lower costs for additional imaging and less intra-operative changes.

Keywords

Liver imagingMRICTContrast mediaCostEconomic evaluation

Copyright information

© Springer Verlag 2009 2009

Authors and Affiliations

  • C. J. Zech
    • 1
  • L. Grazioli
    • 2
  • E. Jonas
    • 3
  • M. Ekman
    • 4
  • R. Niebecker
    • 5
  • S. Gschwend
    • 6
  • J. Breuer
    • 7
  • L. Jönsson
    • 4
  • S. Kienbaum
    • 5
  1. 1.Institute of Clinical RadiologyUniversity Hospital Munich–GrosshadernMunichGermany
  2. 2.Department of RadiologyUniversity of BresciaBresciaItaly
  3. 3.Department of Surgery and UrologyKarolinska Institute, Danderyd HospitalStockholmSweden
  4. 4.i3 InnovusStockholmSweden
  5. 5.Global Health Economics, Reimbursement and Outcomes ResearchBayer Schering Pharma AGBerlinGermany
  6. 6.Global Medical Affairs Diagnostic ImagingBayer Schering Pharma AGBerlinGermany
  7. 7.Global Clinical Development Diagnostic ImagingBayer Schering Pharma AGBerlinGermany