[Computerized tomography of the thorax and abdomen. Cost-effectiveness]

This work was aimed at investigating the cost-effectiveness of body CT, toward better equipment allocation in a given area. CT economics were calculated taking into account four main parameters: equipment, drugs, sanitary material and personnel. The biological cost in terms of radiation exposure was calculated on the effective dose. Quality was evaluated by comparing it with that of our standard examinations and on the basis of the diagnostic yield according to the index of radiological diagnoses by the American College of Radiology (ACR). The economic cost of chest CT was It. L. 257,240, that of abdominal CT was It. L. 365,000 and that of both regions It. L. 464,620. The effective dose was relatively high, i.e., 15.2 mSV for chest CT, 18.65 mSV in men and 27.46 mSV in women for abdominal CT and finally 27.38 mSV in men and 33.59 in women for chest-abdominal CT. The coded diagnoses were positive in approximately 60% of the cases examined consecutively; positivity was related to clinically relevant conditions in most of the cases. The economics and the biological cost of body CT exams were closely related to exam quality, whose standard was high. The high rate of positive findings and the clinical relevance of the condition make an indirect indicator of high quality and of accurate patients selection. To conclude, the allocation of CT equipment in a given area should be preceded by a careful cost-effectiveness analysis, considering optimized equipment use as related to local clinical needs.