title: MRI-guided and CT-guided cervical nerve root infiltration therapy: a cost comparison.
abstract: OBJECTIVE
  To evaluate and compare the costs of MRI-guided and CT-guided cervical nerve root infiltration for the minimally invasive treatment of radicular neck pain.
  
  
  METHODS
  Between September 2009 and April 2012, 22 patients (9 men, 13 women; mean age: 48.2 years) underwent MRI-guided (1.0 Tesla, Panorama HFO, Philips) single-site periradicular cervical nerve root infiltration with 40 mg triamcinolone acetonide. A further 64 patients (34 men, 30 women; mean age: 50.3 years) were treated under CT fluoroscopic guidance (Somatom Definition 64, Siemens). The mean overall costs were calculated as the sum of the prorated costs of equipment use (purchase, depreciation, maintenance, and energy costs), personnel costs and expenditure for disposables that were identified for MRI- and CT-guided procedures. Additionally, the cost of ultrasound guidance was calculated.
  
  
  RESULTS
  The mean intervention time was 24.9 min. (range: 12 - 36 min.) for MRI-guided infiltration and 19.7 min. (range: 5 - 54 min.) for CT-guided infiltration. The average total costs per patient were EUR 240 for MRI-guided interventions and EUR 124 for CT-guided interventions. These were (MRI/CT guidance) EUR 150/60 for equipment use, EUR 46/40 for personnel, and EUR 44/25 for disposables. The mean overall cost of ultrasound guidance was EUR 76.
  
  
  CONCLUSIONS
  Cervical nerve root infiltration using MRI guidance is still about twice as expensive as infiltration using CT guidance. However, since it does not involve radiation exposure for patients and personnel, MRI-guided nerve root infiltration may become a promising alternative to the CT-guided procedure, especially since a further price decrease is expected for MRI devices and MR-compatible disposables. In contrast, ultrasound remains the less expensive method for nerve root infiltration guidance.
authors.affiliation: Department of Diagnostic and Interventional Radiology, Charité University Medicine Berlin.
authors.forename: M H
authors.initials: MH
authors.lastname: Maurer
authors.affiliation: Department of Diagnostic and Interventional Radiology, Charité University Medicine Berlin.
authors.forename: V
authors.initials: V
authors.lastname: Froeling
authors.affiliation: Department of Diagnostic and Interventional Radiology, Charité University Medicine Berlin.
authors.forename: R
authors.initials: R
authors.lastname: Röttgen
authors.affiliation: Department of Radiology and Nuclear Medicine, Otto von Guericke University Magdeburg.
authors.forename: T
authors.initials: T
authors.lastname: Bretschneider
authors.affiliation: Center for Musculoskeletal Surgery, Charité University Medicine Berlin.
authors.forename: T
authors.initials: T
authors.lastname: Hartwig
authors.affiliation: Center for Musculoskeletal Surgery, Charité University Medicine Berlin.
authors.forename: A C
authors.initials: AC
authors.lastname: Disch
authors.affiliation: Department of Diagnostic and Interventional Radiology, Charité University Medicine Berlin.
authors.forename: M
authors.initials: M
authors.lastname: de Bucourt
authors.affiliation: Department of Diagnostic and Interventional Radiology, Charité University Medicine Berlin.
authors.forename: B
authors.initials: B
authors.lastname: Hamm
authors.affiliation: Department of Diagnostic and Interventional Radiology, Charité University Medicine Berlin.
authors.forename: F
authors.initials: F
authors.lastname: Streitparth
mesh_terms: D000328:Adult; D000368:Aged; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage*; D003365:Costs and Cost Analysis; D005260:Female; D005471:Fluoroscopy / Q000191:economics; D005858:Germany; D006801:Humans; D007278:Injections, Spinal / Q000191:economics*; D053783:Magnetic Resonance Imaging, Interventional / Q000191:economics*; D008297:Male; D008875:Middle Aged; D009313:National Health Programs / Q000191:economics; D011843:Radiculopathy / Q000188:drug therapy* / Q000191:economics*; D015641:Radiography, Interventional / Q000191:economics*; D013126:Spinal Nerve Roots / Q000187:drug effects*; D014057:Tomography, X-Ray Computed / Q000191:economics*; D014222:Triamcinolone Acetonide / Q000008:administration & dosage*
chemical_list: D000893:Anti-Inflammatory Agents; D014222:Triamcinolone Acetonide