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Published on: March 7, 2011
Time-Driven Activity-Based Cost Comparison of Osteoid Osteoma Ablation Techniques
Joseph Reis1, Kevin S H Koo2, Giri M Shivaram2
1Director of Interventional Radiology Enteric Access Service, Department of Radiology, Seattle Children's Hospital, Seattle, Washington; Co-Medical Director of Vascular Access Service, and Medical Director of Clinical Strategy in Radiology, Department of Radiology, Seattle Children's Hospital, Seattle, Washington; Section Chief of Pediatric Interventional Radiology, Department of Radiology, Seattle Children's Hospital, Seattle, Washington.
Cone beam CT (CBCT) guidance for osteoid osteoma ablation is more expensive and takes longer than conventional CT (CCT) guidance. These cost factors should be considered alongside potential radiation benefits when selecting an imaging technique.
Area of Science:
- Interventional Radiology
- Medical Imaging
- Oncology
Background:
- Osteoid osteomas are benign bone tumors often treated with minimally invasive ablation techniques.
- Image guidance is crucial for accurate ablation targeting.
- Cone beam CT (CBCT) and conventional CT (CCT) are used for guidance, with varying cost and efficiency implications.
Purpose of the Study:
- To compare the procedural costs of osteoid osteoma ablation using CBCT with overlay fluoroscopic guidance versus CCT guidance.
- To compare the procedural costs of microwave ablation (MWA) versus radiofrequency ablation (RFA).
Main Methods:
- A retrospective study analyzed 96 osteoid osteoma ablations over 11 years.
- Procedures utilized either CBCT or CCT for guidance and either MWA or RFA for ablation.
- Time-driven activity-based costing was employed, considering salaries, equipment depreciation, room time, supplies, and ablation systems.
Main Results:
- CBCT procedures had significantly longer anesthesia induction, procedure, and room times compared to CCT (P < .001).
- Procedure time did not significantly differ between MWA and RFA (P = .27).
- CBCT use (P = .001), RFA use (P = .02), younger age, and nonsupine patient position were associated with higher total procedural costs.
Conclusions:
- CBCT guidance for osteoid osteoma ablation incurs greater costs and longer in-room times than CCT guidance.
- The potential radiation dose advantages of CBCT should be weighed against its higher cost and longer procedure times.
- Factors such as patient age, ablation modality (RFA vs. MWA), and patient positioning influence overall procedural costs.
