Economic impact of CT scanning on the evaluation of pituitary adenomas

The medical and financial records of three cohorts of 20 consecutive patients with pituitary adenomas surgically treated in 1976, 1978, and 1980 were evaluated to assess the impact of changing technology on the cost of preoperative diagnostic evaluation. The average preoperative length of hospital stay decreased from 6.8 days in 1976 to 1.9 days in 1980. The average diagnostic radiologic charge adjusted to 1980 dollars decreased from +1,747 in 1976 to +585 in 1980, while the radiologic bill as a percentage of the total hospital bill changed from 17.3% in 1976 to 11.9% in 1980. The decline in cost parameters coincided with the dramatic increase in the use of cranial computed tomography and the sharp reduction in the use of angiography and pneumoencephalography. These findings suggest that computed tomography is a highly efficacious technique for the evaluation of patients with suspected pituitary adenoma, resulting in significant savings in the costs of diagnostic evaluation.