Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Jan 11;13(1):e0191095.
doi: 10.1371/journal.pone.0191095. eCollection 2018.

Health economic assessment of Gd-EOB-DTPA MRI versus ECCM-MRI and multi-detector CT for diagnosis of hepatocellular carcinoma in China

Xiaoning He  1 , Jing Wu  1 , Anke-Peggy Holtorf  2 , Harald Rinde  2 , Shuangshuang Xie  3 , Wen Shen  3 , Jiancun Hou  4 , Xuehua Li  5 , Ziping Li  5 , Jiaming Lai  6 , Yuting Wang  7 , Lin Zhang  7 , Jian Wang  7 , Xuesong Li  8 , Kuansheng Ma  8 , Feng Ye  9 , Han Ouyang  9 , Hong Zhao  10
Affiliations

Health economic assessment of Gd-EOB-DTPA MRI versus ECCM-MRI and multi-detector CT for diagnosis of hepatocellular carcinoma in China

Xiaoning He et al. PLoS One. .

Abstract

Limited data exists in China on the comparative cost of gadolinium ethoxybenzyl diethylenetriamine magnetic resonance imaging (Gd-EOB-DTPA-MRI) with other imaging techniques. This study compared the total cost of Gd-EOB-DTPA-MRI with multidetector computed tomography (MDCT) and extracellular contrast media-enhanced MRI (ECCM-MRI) as initial imaging procedures in patients with suspected hepatocellular carcinoma (HCC). We developed a decision-tree model on the basis of the Chinese clinical guidelines for HCC, which was validated by clinical experts from China. The model compared the diagnostic accuracy and costs of alternative initial imaging procedures. Compared with MDCT and ECCM-MRI, Gd-EOB-DTPA-MRI imaging was associated with higher rates of diagnostic accuracy, i.e. higher proportions of true positives (TP) and true negatives (TN) with lower false positives (FP). Total diagnosis and treatment cost per patient after the initial Gd-EOB-DTPA-MRI evaluation was similar to MDCT (¥30,360 vs. ¥30,803) and lower than that reported with ECCM-MRI (¥30,360 vs. ¥31,465). Lower treatment cost after initial Gd-EOB-DTPA-MRI was driven by reduced utilization of confirmatory diagnostic procedures and unnecessary treatments. The findings reported that Gd-EOB-DTPA-MRI offered higher diagnostic accuracy compared with MDCT and ECCM-MRI at a comparable cost, which indicates Gd-EOB-DTPA-MRI could be the preferred initial imaging procedure for the diagnosis of HCC in China.

PubMed Disclaimer

Conflict of interest statement

Competing Interests: Professor Jing Wu received financial support from Bayer Healthcare Co. Ltd. to conduct this study. This does not alter the authors’ adherence to all PLOS ONE policies on sharing data and materials.

Figures

Fig 1
Fig 1. Model structure for the decision-tree used in the economic evaluation.
Note: MDCT, multidetector computed tomography; ECCM-MRI, Extracellular contrast media–enhanced MRI; GD-EOB-DTPA-MRI, Gd-EOB-DTPA–enhanced magnetic resonance imaging.
Fig 2
Fig 2. Distribution of patients after initial imaging and all diagnostics.
Note: MDCT, multidetector computed tomography; ECCM-MRI, Extracellular contrast media–enhanced MRI; GD-EOB-DTPA-MRI, Gd-EOB-DTPA–enhanced magnetic resonance imaging.
Fig 3
Fig 3. Total costs of diagnostic and treatment procedures depending on initial imaging.
Note: MDCT, multidetector computed tomography; ECCM-MRI, Extracellular contrast media–enhanced MRI; GD-EOB-DTPA-MRI, Gd-EOB-DTPA–enhanced magnetic resonance imaging.
Fig 4
Fig 4. One-way sensitivity analyses.
Note: MDCT, multidetector computed tomography; ECCM-MRI, Extracellular contrast media–enhanced MRI; GD-EOB-DTPA-MRI, Gd-EOB-DTPA–enhanced magnetic resonance imaging.
See this image and copyright information in PMC

References

    1. Estimated Incidence, Mortality and Prevalence Worldwide in 2012. Available http://globocan.iarc.fr/old/FactSheets/cancers/liver-new.asp. Accessed 20 September 2016.
    1. Torre LA, Bray F, Siegel RL, Ferlay J, Lortet-Tieulent J, Jemal A. Global cancer statistics, 2012. CA Cancer J Clin. 2015;65: 87–108. doi: 10.3322/caac.21262 - DOI - PubMed
    1. London WT, McGlynn KA. Liver Cancer In Schottenfeld D, Fraumeni JF (Eds.) Cancer Epidemiology and Prevention. 3rd ed. New York, Oxford University Press; 2006:763–786.
    1. Schlachterman A, Craft WW Jr, Hilgenfeldt E, Mitra A, Cabrera R. Current and future treatments for hepatocellular carcinoma. World J Gastroenterol. 2015;21: 8478–8491. doi: 10.3748/wjg.v21.i28.8478 - DOI - PMC - PubMed
    1. Primary Liver Cancer Diagnosis and Treatment Expert Panel of the Chinese Ministry of Health. Guidelines on the diagnosis and treatment of primary liver cancer (2011 edition). Chin Clin Oncol. 2012;1: 10 doi: 10.3978/j.issn.2304-3865.2012.07.01 - DOI - PubMed

Publication types