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Open Access 01-04-2014 | Original Article

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

Authors: Giovanni Mauri, Emanuele Porazzi, Luca Cova, Umberto Restelli, Tania Tondolo, Marzia Bonfanti, Anna Cerri, Tiziana Ierace, Davide Croce, Luigi Solbiati

Published in: Insights into Imaging | Issue 2/2014

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.

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.

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Title: Intraprocedural contrast-enhanced ultrasound (CEUS) in liver percutaneous radiofrequency ablation: clinical impact and health technology assessment
Authors: Giovanni Mauri
Emanuele Porazzi
Luca Cova
Umberto Restelli
Tania Tondolo
Marzia Bonfanti
Anna Cerri
Tiziana Ierace
Davide Croce
Luigi Solbiati
Publication date: 01-04-2014
Publisher: Springer Berlin Heidelberg
Published in: Insights into Imaging / Issue 2/2014
Electronic ISSN: 1869-4101
DOI: https://doi.org/10.1007/s13244-014-0315-7

At a glance: The STEP trials

Springer Medicine

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

Abstract

Objectives

Methods

Results

Conclusions

Teaching Points

At a glance: The STEP trials

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusions

Teaching Points

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