Coelho Daniel H, Tang Yang, Suddarth Brian, Mamdani Mohammed
Department of Otolaryngology-Head and Neck Surgery, Virginia Commonwealth University School of Medicine, Richmond, Virginia, U.S.A.
Department of Radiology, Virginia Commonwealth University School of Medicine, Richmond, Virginia, U.S.A.
Laryngoscope. 2018 Jan;128(1):202-209. doi: 10.1002/lary.26589. Epub 2017 Apr 11.
To determine if high-resolution T2-weighted (HRT2) magnetic resonance imaging (MRI) is a comparably accurate and economical alternative to the gold standard of contrast-enhanced T1-weighted (T1C) MRI for surveillance of know vestibular schwannomas (VSs).
Retrospective case-control analysis, systematic review, and economic evaluation.
Vestibular schwannoma size in anteroposterior, mediolateral, and superoinferior axes were measured by two neuroradiologists, both blinded to previous measurements, for 50 randomized patients with T1C and HRT2 on two separate occasions. Measurements were assessed by Pearson product-moment correlation coefficients, and differences were analyzed by Student t test. Once the data were analyzed, appropriate economic evaluation was performed utilizing institutional-, federal-, and literature-based estimates of cost and incidence/prevalence.
Pearson correlations (r) between T1C and HRT2 were 0.991 and 0.973 for radiologists 1 and 2, respectively, with no statistically significant differences (P ≤ 0.05) between imaging techniques. Intraobserver and interobserver reliability estimates (κ) were 0.88 to 1 for both T1C and HRT2, indicating very high reliability. Cost-minimization analysis demonstrated cost and charge differences of $148.02 and $1,284 per patient per scan, respectively. This represents an overall cost and charge savings for this 50-patient cohort of $7,401 and $64,200, respectively.
HRT2 imaging is a highly reliable and lower-cost alternative to T1C for follow-up surveillance scans in patients with VS.
2C. Laryngoscope, 128:202-209, 2018.
确定高分辨率T2加权（HRT2）磁共振成像（MRI）对于已知前庭神经鞘瘤（VS）监测而言，是否是与对比增强T1加权（T1C）MRI金标准具有同等准确性和经济性的替代方法。
回顾性病例对照分析、系统评价和经济评估。
由两名神经放射科医生对50例随机分组患者在两个不同时间分别进行T1C和HRT2检查，测量其前庭神经鞘瘤在前后、内外侧和上下轴的大小，两名医生均不知晓先前的测量结果。测量结果通过Pearson积矩相关系数进行评估，差异采用Student t检验分析。数据分析完成后，利用基于机构、联邦和文献的成本及发病率/患病率估计值进行适当的经济评估。
放射科医生1和医生2所测T1C与HRT2之间的Pearson相关性（r）分别为0.991和0.973，两种成像技术之间无统计学显著差异（P≤0.05）。T1C和HRT2的观察者内和观察者间可靠性估计值（κ）均为0.88至1，表明可靠性非常高。成本最小化分析显示，每次扫描每位患者的成本和费用差异分别为148.02美元和1284美元。这意味着该50例患者队列的总成本和总费用分别节省了7401美元和64200美元。
对于VS患者的随访监测扫描，HRT2成像是T1C的一种高度可靠且成本较低的替代方法。
2C。《喉镜》，2018年，第128卷，第202 - 209页。
