Niccolo' Faccioli1, Giovanni Foti2, Giulia Casagranda2, Elena Santi2, Mirko D'Onofrio2. 1. Department of Radiology, University of Verona, Policlinico G.B. Rossi, Piazzale L.A. Scuro, 37134, Verona, Italy. niccolo.faccioli@aovr.veneto.it. 2. Department of Radiology, University of Verona, Policlinico G.B. Rossi, Piazzale L.A. Scuro, 37134, Verona, Italy.
Abstract
PURPOSE: To evaluate diagnostic accuracy and to perform an activity-based cost analysis of contrast-enhanced ultrasonography (CEUS) compared to computed tomography (CT) during annual surveillance after abdominal aortic aneurysm repair with endovascular procedure (EVAR). MATERIALS AND METHODS: This retrospective study included 137 patients in post-EVAR follow-up over a 6-year period (average post-operatory follow-up without aneurysm sac volumetric reduction). Sensitivity, specificity, positive predictive values, negative predictive values and accuracy were considered for CEUS using CT angiography (CTA) as reference standard. An activity-based cost analysis was performed to evaluate potential savings due to the introduction of CEUS as an alternative to CT, after the first year of postoperative negative controls. RESULTS: CEUS reported accuracy, sensitivity, specificity, positive predictive values, negative predictive values of 97.4, 96, 100, 100 and 93.1% in the detection and characterization of endoleaks. CEUS cost was € 84.7, and CTA cost was € 157.77, with a differential cost of € 73.07; using CEUS as an alternative to CT allowed a potential saving of 50.052,95 € during follow-up. CONCLUSIONS: CEUS is an accurate and cheap imaging method in post-EVAR follow-up patients, and it could be considered as a valid alternative to CTA, after the first year of negative controls, reducing the number of unnecessary CT examinations.
PURPOSE: To evaluate diagnostic accuracy and to perform an activity-based cost analysis of contrast-enhanced ultrasonography (CEUS) compared to computed tomography (CT) during annual surveillance after abdominal aortic aneurysm repair with endovascular procedure (EVAR). MATERIALS AND METHODS: This retrospective study included 137 patients in post-EVAR follow-up over a 6-year period (average post-operatory follow-up without aneurysm sac volumetric reduction). Sensitivity, specificity, positive predictive values, negative predictive values and accuracy were considered for CEUS using CT angiography (CTA) as reference standard. An activity-based cost analysis was performed to evaluate potential savings due to the introduction of CEUS as an alternative to CT, after the first year of postoperative negative controls. RESULTS: CEUS reported accuracy, sensitivity, specificity, positive predictive values, negative predictive values of 97.4, 96, 100, 100 and 93.1% in the detection and characterization of endoleaks. CEUS cost was € 84.7, and CTA cost was € 157.77, with a differential cost of € 73.07; using CEUS as an alternative to CT allowed a potential saving of 50.052,95 € during follow-up. CONCLUSIONS: CEUS is an accurate and cheap imaging method in post-EVAR follow-up patients, and it could be considered as a valid alternative to CTA, after the first year of negative controls, reducing the number of unnecessary CT examinations.
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