Contrast-enhanced ultrasonography in the evaluation of incidental focal liver lesions: A cost-effectiveness analysis

Table 1 Prices of individual examinations by year in USD

Modality	2010	2011	2012	2013	2014	2015	Average
Non-contrast ultrasound	31.89	37.98	37.98	38.09	38.31	38.42	37.11
Contrast-enhanced US	165.02	171.82	164.19	164.3	164.51	164.61	165.74
CT	139.14	142.99	132.52	133.12	133.22	130.62	135.27
MRI	856.79	850.51	825.08	793.17	763.98	778.23	811.29

The price of contrast agent is included when required. CT: Computed tomography; MRI: Magnetic resonance imaging.

Table 2 Numbers of patients and contrast-enhanced ultrasonography findings by year n

	2010	2011	2012	2013	2014	2015	Total
Total sum	38	53	73	85	124	86	459
Benign	16	27	45	50	72	61	271
Malignant	15	21	19	27	39	16	137
Inconclusive	7	5	9	8	13	9	51

Table 3 Number of patients with inconclusive contrast-enhanced ultrasonography findings by year and by second-line examination methods

	2010	2011	2012	2013	2014	2015	Total
Total	38	53	73	85	124	86	459
Methods used for examining inconclusive findings
Ultrasound follow-up		1	3	1	2	1	8
CT	4	4	6	6	9	4	33
MRI	3			1	2	4	10

CT: Computed tomography; MRI: Magnetic resonance imaging.

Table 4 Total costs of individual strategies in USD

	2010	2011	2012	2013	2014	2015	Total	Total per patient
CEUS
Examination	6271	9107	11986	13965	20399	14156	75884	165.3
Additional examination	3350	800	1251	1935	3302	4020	14657	287.4
Total	9621	9906	13237	15900	23700	18176	90540	197.3
CT
Examination	6499	9591	12447	14553	21269	14537	78897	171.9
MRI
Examination	33770	47090	63004	70657	99483	70232	384235	837.1

Prices for computed tomography (CT) and MRI strategies do not include the expenses for investigating inconclusive cases. CEUS: Contrast-enhanced ultrasonography; MRI: Magnetic resonance imaging.

Table 5 Differences between costs of computed tomography and magnetic resonance imaging strategies and contrast-enhanced ultrasonography strategy (USD, %)

	Difference in USD	Difference per patient in USD	Difference (%)
CT
CEUS vs CT	-3013	-6.6	-4.0
CEUS + additional vs CT	11643	25.4	12.9
MRI
CEUS vs MRI	-308352	-671.8	-406.3
CEUS + additional vs MRI	-293695	-639.9	-324.4

Prices for computed tomography (CT) and MRI strategies do not include the expenses for investigating inconclusive cases. Negative values indicate magnitude of savings while positive values indicate level of higher costs. CEUS: Contrast-enhanced ultrasonography; MRI: Magnetic resonance imaging.