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Imaging


is assumed to deliver the final diagnosis. However, in clinical routine, the diagnostic tree has several paths: repetition of the same procedure, applying another MRA technique, clinical follow-up, computed tomography angiography (CTA) or DSA. Personnel costs were calculated on the basis of the staff member’s gross income, which is usually much lower than the total corresponding cost to his/her employer. This may bias results in favour of the more time- consuming procedure. Costs for false-positive and false-negative results of the two procedures compared were not taken into account at all.


Conclusion


In patients with suspected PAOD and indication for ce- and nce-MRA, peripheral nce-MRA/FBI incurred higher investigation costs in terms


1. Prince MR, Gadolinium-enhanced MR aortography, Radiology, 1994;191:155–64.


2.


Leiner T, Magnetic resonance angiography of abdominal and lower extremity vasculature, Magn Reson Imaging, 2005;16(1):21–66.


3. Graves MJ, Magnetic resonance angiography, Br J Radiol, 1997;70:6–28.


4. 5. 6. 7.


Reimer P, Parizel PM, Stichnoth FA, Clinical MR Imaging: A practical approach. 2nd ed., Springer Verlag, 2003.


Ichinose N, Yamashita Y, Mitsui S, et al., Whole body fresh blood imaging (FBI): Non-contrast MRA from head to feet, Proc Intl Soc Mag Reson Med, 2007;15:3114.


Ren K, Xu K, Sun W, et al., Preliminary evaluation of magnetic resonance fresh blood imaging for diagnosis of Budd-Chiari syndrome, Chin Med J, 2007;120(2):95–9.


Nakamura K, Kuroki K, Yamamoto A, et al., Fresh blood imaging (FBI) of peripheral arteries: comparison with 16- detector row CT angiography, Proc Intl Soc Mag Reson Med, 2006;14:1929.


8. 9.


Yokoyama K, Nitatori T, Inaoka S, et al., Non-contrast enhanced MR venography using 3D fresh blood imaging (FBI): Initial experience, Radiat Med, 2001;19(5):247–53.


Willmann JK, Göpfert K, Lutz AM, et al., Prospective intraindividual comparison between respiratory-triggered balanced steady-state free precession and breath-hold gradient-echo and time-of-flight magnetic resonance imaging for assessment of portal and hepatic veins, Eur Radiol, 2007;17:229–40.


10. Miyazaki M, Lee VS, Nonenhanced MR angiography, Radiology, 2008;248(1):20–43.


11. Meaney JFM, Magnetic resonance angiography of the peripheral arteries: current status, Eur Radiol, 2003;13:836–52.


12. Wong P, Graves MJ, Lomas DJ, Interactive two- dimensional fresh blood imaging: a feasibility study, Eur Radiol, 2009;19:904–11.


13. Fenchel M, Nael K, Seeger A, et al., Whole-body magnetic resonance angiography at 3.0 Tesla, Eur Radiol, 2008;18: 1473–83.


14. Kramer H, Schoenberg SO, Nikolaou K, et al.,


of the sole acquisition of MR images than ce-MRA in most scenarios evaluated when excluding costs for the contrast agent.


The total costs including costs for consumables were found to be higher for ce-MRA not considering technical failures as in our initial example using German list prices. Depending on the proportion of technical failures and acquisition time of the FBI, scenarios with cost savings were found for either modality. On the other hand, several technical and clinical advantages of ce-MRA in patients with suspected PAOD were presented and discussed, such as high robustness and the shorter time needed for acquiring adequate diagnostic quality images. These increase the probability for adequate images after a single examination compared with nce-MRA/FBI in the peripherals. n


Cardiovascular screening with parallel imaging techniques and a whole-body MR imager, Radiology, 2005;236(1):300–10.


15. Zhang H, Maki JH, Prince MR 3D contrast-enhanced MR angiography, J Magn Reson Imaging, 2007;25(1):13–25.


16. TASC, Management of peripheral arterial disease (PAD). TransAtlantic Inter-Society Consensus (TASC). Section D: chronic critical limb ischaemia, Eur J Vasc Endovasc Surg, 2000;19 (Suppl. A):S144–243.


17. Kreitner K-F, Kalden P, Neufang A, et al., Diabetes and peripheral arterial occlusive disease – prospective comparison of contrast-enhanced three-dimensional MR angiography with conventional digital subtraction, Am J Roentgenol, 2000;174(1):171–9.


18. Ruehm SG, Goyen M, Barkhausen J, et al., Rapid magnetic resonance angiography for detection of atherosclerosis, Lancet, 2007;357(9262):1086–91.


19. Kramer H, Quick HH, Tombach B, Whole-Body MRA, J Eur Radiol, 2008;18(9):1925–36.


20. Goyen M, Herborn CU, Kröger K, et al., Total-body 3D magnetic resonance angiography influences the management of patients with peripheral arterial occlusive disease, Eur Radiol, 2006;16(3):685–91.


21. Gjesdal K-I, Storaas T, Geitung J-T, A noncontrast- enhanced pulse sequence optimized to visualize human peripheral vessels, Eur Radiol, 2009;19:110–20.


22. Bergmann K, Lungershausen J, Schwenke C, Angiography for diagnosing PAOD: cost comparison of the diagnostic procedures MRA and DSA, ISPOR 2009, Abstract (Poster).


23. Walger M, Köpf P, Einkommen von Krankenhausärzten – eine differenzierte Betrachtung, Das Krankenhaus, 2005;12: 1075–8.


24. Deutscher Verband Technischer Assistentinnen und Assistenten in der Medizin e.V. Available at: www.dvta. de/index.php/beruf/berufsbild/einkommenssituation (accessed 14 October 2008).


25. Informationsseiten für den öffentlichen Dienst, http://oeffentlicher-dienst.info (accessed 14 October 2008).


26. Kassenärztliche Bundesvereinigung: Einheitlicher Bewertungsmaßstab (EBM). Available at: www.kbv.de/


ebm2009/EBMgesamt.htm (accessed 21 April 2009).


27. IfaP® Index Praxis, Lauer-Taxe, November 2006. 28. Deutsche Krankanhausgesellschaft (Hrsg.), DKG-NT Tarif der Deutschen Krankenhausgesellschaft, Verlag Kohlhammer, 30th edition, 2005.


29. Anzalone N, Scialfa G, Iezzi R, et al., Gadolinium- enhanced MR angiography in the evaluation of carotid artery stenosis: Comparison with digital subtraction angiography in 238 patients, Proc Intl Soc Mag Reson Med, 2006;14:1952.


30. Soulez G, Pasowicz M, Benea G, et al., Accuracy of gadobenate dimeglumine-enhanced MR angiography in the evaluation of renal artery stenosis: Comparison with unenhanced time-of-flight MR angiography versus digital subtraction angiography (DSA), Proc Intl Soc Mag Reson Med, 2007;15:93.


31. Schneider G, Manfredi R, Grazioli L, et al., Diagnostic accuracy of contrast-enhanced MR angiography with various doses of gadobenate dimeglumine, Intl Soc Mag Reson Med, 2006;14:1969.


32. Berry E, Gough MJ, Cullingworth J, et al., The cost- effectiveness of magnetic resonance angiography and peripheral vascular disease: a systematic review, Health Technol Assess, 2002;6(7):1–155.


33. Watt AJB, Reid A, Roditi G, Is contrast-enhanced MRA cost effective?, Proc Intl Soc Mag Reson Med, 2000;8:191.


34. Hay JW, Lawler E, Yucel K, et al., Cost impact of diagnostic imaging for lower extremity peripheral vascular occlusive disease, Value Health, 2008;12(2):262–6.


35. Boudewijn G, Vasbinder C, Nelemans PJ, et al., for the Renal Artery Diagnostic Imaging Study in Hypertension (RADISH) Study Group, Accuracy of Computed Tomographic Angiography and Magnetic Resonance Angiography for Diagnosing Renal Artery Stenosis, Ann Intern Med, 2004;141:674–82.


36. Leiner T, Schoenberg SO, Current status of renal artery magnetic resonance imaging: theoretical and practical considerations and the potential role of blood-pool contrast agents, Eur Radiol, 2007;17(Suppl. 2):B13–17.


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