Institute of Clinical Radiology and Nuclear Medicine, University Medical Centre Mannheim, Medical Faculty Mannheim - University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany.
Eur Radiol. 2021 Feb;31(2):967-974. doi: 10.1007/s00330-020-07129-5. Epub 2020 Aug 28.
To evaluate the economic implications of our previous study on the use of MR-mammography (MRM) as a solitary imaging tool in women at intermediate risk due to dense breasts.
In our previous study, we found MRM to be a specific diagnostic tool with high accuracy in patients with dense breasts representing a patient collective at intermediate risk of breast cancer. For this study, we examined whether MRM is an economical alternative.
For the determination of outcomes and costs, a decision model based on potential diagnostic results of MRM was developed. Quality of life was estimated in a Markov chain model distinguishing between the absence of malignancy, the presence of malignancy, and death. Input parameters were utilized from the prospective TK-Study. To investigate the economic impact of MRM, overall costs in € and outcomes of MRM in quality-adjusted life years (QALYs) were estimated. A deterministic sensitivity analysis was performed.
MRM was associated with expected costs of 1650.48 € in the 5-year period and an expected cumulative outcome of 4.69 QALYs. A true positive diagnosis resulted in significantly lower costs and a higher quality of life when compared to the consequences of a false negative result. In the deterministic sensitivity analysis, treatment costs had more impact on overall costs than the costs of MRM. The total costs per patient remained below 2500 € in the 5-year period.
MRM, as a solitary imaging tool in patients at intermediate risk due to dense breasts, is economically feasible.
• In patients with dense breasts (i.e., patients at intermediate risk of breast cancer), the relative cost of MR-mammography examinations only had moderate impact on overall costs. • This is due to cost-savings through the application of a sensitive imaging technique resulting in an optimized staging and therapy planning. • MR-mammography, unaccompanied by mammography or ultrasound in patients with dense breasts, was economically feasible in our analysis.
评估我们之前关于在致密乳腺导致的中危女性中使用磁共振乳腺成像（MRM）作为单一成像工具的研究的经济意义。
在我们之前的研究中，我们发现 MRM 是一种具有高准确性的特异性诊断工具，适用于代表乳腺癌中危患者群体的致密乳腺患者。为此研究，我们考察了 MRM 是否是一种经济的替代方法。
为了确定结果和成本，我们开发了一个基于 MRM 潜在诊断结果的决策模型。使用来自前瞻性 TK 研究的数据来估计生活质量，该模型在无恶性肿瘤、存在恶性肿瘤和死亡之间进行区分。输入参数来自前瞻性 TK 研究。为了研究 MRM 的经济影响，我们以欧元为单位估计了 MRM 的总费用以及调整质量后的生命年（QALYs）的结果。进行了确定性敏感性分析。
MRM 在 5 年内的预期费用为 1650.48 欧元，预期累积结果为 4.69 QALYs。与假阴性结果的后果相比，真阳性诊断导致的成本显著降低，生活质量更高。在确定性敏感性分析中，治疗成本对总费用的影响大于 MRM 的成本。在 5 年内，每位患者的总费用仍低于 2500 欧元。
MRM 作为致密乳腺中危患者的单一成像工具，在经济上是可行的。
在致密乳腺（即乳腺癌中危）患者中，MR 乳腺成像检查的相对成本仅对总费用有中等程度的影响。
这是由于应用敏感的成像技术节省了成本，从而实现了优化的分期和治疗计划。
在我们的分析中，对于致密乳腺患者，不联合乳腺 X 线摄影或超声应用 MRM 在经济上是可行的。
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