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A cost-effectiveness analysis of the diagnostic strategies for differentiating focal nodular hyperplasia from hepatocellular adenoma

Title
A cost-effectiveness analysis of the diagnostic strategies for differentiating focal nodular hyperplasia from hepatocellular adenoma
Authors
Suh, Chong HyunKim, Kyung WonPark, Seong HoShin, SangjinAhn, JeonghoonPyo, JunheeShinagare, Atul B.Krajewski, Katherine M.Ramaiya, Nikhil H.
Ewha Authors
안정훈
SCOPUS Author ID
안정훈scopus
Issue Date
2018
Journal Title
EUROPEAN RADIOLOGY
ISSN
0938-7994JCR Link

1432-1084JCR Link
Citation
EUROPEAN RADIOLOGY vol. 28, no. 1, pp. 214 - 225
Keywords
Focal nodular hyperplasiaHepatocellular adenomaGadoxetic acid-enhanced MRICost-effectiveness analysisDecision tree
Publisher
SPRINGER
Indexed
SCIE; SCOPUS WOS
Document Type
Article
Abstract
We evaluated the cost-effectiveness of a gadoxetic acid-enhanced MRI (EOB-MRI) strategy compared with conventional MRI strategy and biopsy to differentiate focal nodular hyperplasia (FNH) from hepatocellular adenoma (HCA). A decision tree model was constructed to compare the cost-effectiveness of EOB-MRI, conventional MRI with extracellular contrast agents, and biopsy as the initial diagnostic modality in patients with incidentally detected focal liver lesions suspected of being FNH or HCA. We analysed the cost and effectiveness, i.e. probability of successful diagnosis of each strategy. Costs were based on utilisation rates and Medicare reimbursements in the USA and South Korea. In the base case analysis of our decision tree model, the effectiveness of the three strategies was similar. The cost of the EOB-MRI strategy ($1283 in USA, $813 in South Korea) was lowest compared with the biopsy strategy ($1725 in USA, $847 in South Korea) and the conventional MRI strategy ($1750 in USA, $962 in South Korea). One-way, two-way and probabilistic sensitivity analysis showed unchanged results over an acceptable range. EOB-MRI strategy is the most cost-effective strategy for differentiating FNH from HCA in patients with incidentally detected focal liver lesions in a non-cirrhotic liver. aEuro cent The effectiveness of the three strategies was similar. aEuro cent The cost of the EOB-MRI strategy was lowest. aEuro cent EOB-MRI strategy is the most cost-effective for differentiating FNH from HCA.
DOI
10.1007/s00330-017-4967-9
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신산업융합대학 > 융합보건학과 > Journal papers
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