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PT  - JOURNAL ARTICLE
AU  - Mayr, N A
AU  - Yuh, W T
AU  - Muhonen, M G
AU  - Fisher, D J
AU  - Nguyen, H D
AU  - Ehrhardt, J C
AU  - Wen, B C
AU  - Doornbos, J F
AU  - Hussey, D H
TI  - Cost-effectiveness of high-dose MR contrast studies in the evaluation of brain metastases.
DP  - 1994 Jun 01
TA  - American Journal of Neuroradiology
PG  - 1053--1061
VI  - 15
IP  - 6
4099  - http://www.ajnr.org/content/15/6/1053.short
4100  - http://www.ajnr.org/content/15/6/1053.full
SO  - Am. J. Neuroradiol.1994 Jun 01; 15
AB  - PURPOSE To investigate the cost-effectiveness of high-dose MR contrast studies in the management of brain metastases. METHODS During the phase III clinical trial of high-dose contrast studies (0.3 mmol/kg), 11 of 27 patients were judged by the reviewers to have potential treatment changes based on the additional information provided by the high-dose studies. We retrospectively evaluated how many of these 27 patients had actual treatment changes because of the results of the high-dose study. Using the fee schedule at our institution, the cost-effectiveness was analyzed based on the cost savings from treatment changes and the additional expense of implementing the high-dose studies. RESULTS A total of 3 craniotomies ($22,800 each) and 2 aggressive courses of radiation therapy ($1122 each) were avoided in 4 patients because of the additional lesions detected by the high-dose studies. This resulted in a treatment cost savings of $70,644. The extra expense for implementing the high-dose study is $9126 for a single injection in all 27 patients, $9295 for 2 separate injections completed in 1 visit in the 11 patients, and $11,154 for 2 separate injections completed in 2 separate visits. The cost savings in management (diagnosis and treatment) therefore ranged from $59,490 to $61,518 for all patients and from $2203 to $2278 per patient. CONCLUSION Based on our limited data, the high-dose study seems to impact positively on the cost-effectiveness in the management of brain metastases. However, because our study had limitations, our results need to be confirmed with a larger patient population and a more standardized treatment approach and fee schedule.