MRI-Guided and CT-Guided Cervical Nerve Root Infiltration Therapy: A Cost Comparison

Abstract

Purpose: 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. Materials and 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. Conclusion: 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. Citation Format: ??Maurer MH, Froeling V, R?ttgen R et?al. MRI-Guided and CT-Guided Cervical Nerve Root Infiltration Therapy: A Cost Comparison. Fortschr R?ntgenstr 2014; 186: 559???566

Artefact and ablation performance of an MR-conditional high-power microwave system in bovine livers: an ex vivo study

“…Rempp et al [24] reported average procedure durations from planning imaging to control imaging of 3.7 h for MR-guided RF ablation in hepatic malignancies with a mean tumour diameter of 20 mm. These procedure durations are a major drawback of MR-guided interventions given the limited availability of MR scanners and higher costs of this modality in comparison to CT and ultrasound [25, 26].…”

Preclinical evaluation of an MR-compatible microwave ablation system and comparison with a standard microwave ablation system in an ex vivo bovine liver model

“…Using MRI as a guidance modality in percutaneous ablation procedures is currently limited to a few centres specialised in MR-guided interventions, even though MR-guidance offers several advantages such as near real-time fluoroscopic sequences [11], free selection of imaging planes [12], higher sensitivity in depicting small parenchymal lesions [13], assessment of the ablation zone without application of contrast agent and absence of ionising radiation [14]. The high operating costs of dedicated MRI-scanners combined with longer durations of MR-guided interventions prevent the increased use of MRguidance in interventional oncology [20]. However, the combination of microwave ablation and MR-guidance might be beneficial, as microwave ablation creates larger ablation zones in shorter time and with less applicator insertions than RF ablation [6,21,22].…”

Radiation Dose and Procedure Time for 994 CT-guided Spine Pain Control Procedures

“…CT guidance is approximately 0.9 relative value units higher than fluoroscopy (3.32 for CT scan for therapy guide, versus 2.41 for fluoroscopic guidance for spine injection). In European cost-analysis studies, CT was demonstrated to be cheaper than magnetic resonance (MR) guidance for lumbosacral nerve root injection (28), and in between the cost of ultrasound and MR guidance for cervical nerve root injection (29). As cost and resources vary by health care facility and geographic location, the scale and potential impact of these differences should be considered in the individualized setting.…”