title: [Contrast-enhanced ultrasound for the characterization of incidental liver lesions - an economical evaluation in comparison with multi-phase computed tomography].
abstract: OBJECTIVE
  The aim of the study was to conduct a cost-minimization analysis of contrast-enhanced ultrasound (CEUS) compared to multi-phase computed tomography (M-CT) as the diagnostic standard for diagnosing incidental liver lesions.
  
  
  METHODS
  Different scenarios of a cost-covering realization of CEUS in the ambulant sector in the general health insurance system of Germany were compared to the current cost situation. The absolute savings potential was estimated using different approaches for the calculation of the incidence of liver lesions which require further characterization.
  
  
  RESULTS
  CEUS was the more cost-effective method in all scenarios in which CEUS examinations where performed at specialized centers (122.18-186.53 euro) compared to M-CT (223.19 euro). With about 40 000 relevant liver lesions per year, systematic implementation of CEUS would result in a cost savings of 4 m euro per year. However, the scenario of a cost-covering CEUS examination for all physicians who perform liver ultrasound would be the most cost-intensive approach (e. g., 407.87 euro at an average utilization of the ultrasound machine of 25 %, and a CEUS ratio of 5 %).
  
  
  CONCLUSIONS
  A cost-covering realization of the CEUS method can result in cost savings in the German healthcare system. A centralized approach as proposed by the DEGUM should be targeted.
authors.affiliation: Research Program Imaging and Radiooncology, Department of Radiology, German Cancer Research Center Heidelberg.
authors.forename: F L
authors.initials: FL
authors.lastname: Giesel
authors.forename: S
authors.initials: S
authors.lastname: Delorme
authors.forename: R
authors.initials: R
authors.lastname: Sibbel
authors.forename: H-U
authors.initials: HU
authors.lastname: Kauczor
authors.forename: M
authors.initials: M
authors.lastname: Krix
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging*; D003287:Contrast Media / Q000008:administration & dosage*; D003362:Cost-Benefit Analysis; D020518:Focal Nodular Hyperplasia / Q000000981:diagnostic imaging*; D005858:Germany; D006391:Hemangioma / Q000000981:diagnostic imaging*; D006801:Humans; D033162:Incidental Findings; D008113:Liver Neoplasms / Q000000981:diagnostic imaging*; D009313:National Health Programs / Q000191:economics*; D017410:Practice Guidelines as Topic; D012680:Sensitivity and Specificity; D036542:Tomography, Spiral Computed / Q000191:economics*; D014463:Ultrasonography / Q000191:economics*
chemical_list: D003287:Contrast Media