Intraprocedural contrast-enhanced ultrasound CEUS in liver percutaneous radiofrequency ablation: clinical impact and health technology assessmentReportar como inadecuado




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Insights into Imaging

, Volume 5, Issue 2, pp 209–216

First Online: 22 February 2014Received: 30 July 2013Revised: 20 January 2014Accepted: 24 January 2014

Abstract

ObjectivesTo 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.

MethodsOne 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.

ResultsIntraprocedural 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

ConclusionsIntraprocedural 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.

KeywordsRadiofrequency ablation Hepatocellular carcinoma Cost-effectiveness Clinical impact Budget impact Health technology assessment Intraprocedural contrast-enhanced ultrasound  Download fulltext PDF



Autor: Giovanni Mauri - Emanuele Porazzi - Luca Cova - Umberto Restelli - Tania Tondolo - Marzia Bonfanti - Anna Cerri - Tiziana 

Fuente: https://link.springer.com/



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