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Title: Intraprocedural contrast-enhanced ultrasound (CEUS) in liver percutaneous radiofrequency ablation: clinical impact and health technology assessment
Authors: Mauri, Giovanni
Porazzi, Emanuele
Cova, Luca
Restelli, Umberto
Tondolo, Tania
Bonfanti, Marzia
Cerri, Anna
Ierace, Tiziana
Croce, Davide
Solbiati, Luigi
Issue Date: 2014
Publisher: Springer
Bibliographic citation: Mauri Giovanni, et al. (2014), Intraprocedural contrast-enhanced ultrasound (CEUS) in liver percutaneous radiofrequency ablation: clinical impact and health technology assessment. In: Insights into imaging, vol. 5, n. 2, Apr. 2014, p. 209-216.
Abstract: 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.
Journal/Book: Insights into imaging
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