与对比度增强的乳房MRI在怀疑的乳房扫描微化的成本效益
Barbara J Fueger1, Fabian Tollens2, Clemens G N Kaiser2
1Division of General and Pediatric Radiology, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna General Hospital, Vienna, Austria.
Insights into imaging
|June 12, 2025
概括
补充性乳房MRI提供与可疑化的立体活检相比的成本效益. 应考虑对患者进行这种非侵入性成像,以帮助在乳腺癌诊断中共享决策.
科学领域:
- 放射学和瘤成像学成像学
- 卫生经济学与研究成果研究成果
背景情况:
- 被归类为BI-RADS 4的乳房微化需要进一步调查,通常涉及立体活检.
- 立体活检是标准的护理,但可能导致不必要的侵入性手术.
研究的目的:
- 评估使用补充乳腺磁共振成像 (MRI) 的成本效益,以潜在地避免在患有BI-RADS 4乳腺微的女性中不必要的立体活检.
主要方法:
- 使用决策分析和马尔科夫建模来比较两个诊断策略.
- 策略1:补充乳房MRI,然后只有MRI阳性时才进行活检.
- 策略2:对所有BI-RADS 4微化的立体活检.
主要成果:
- 补充乳腺MRI策略的成本 (56,918美元) 和结果 (2,932个QALY) 与立体活检 (56,898美元和2,930个QALY) 相当.
- 对MRI策略的增量成本效益比 (ICER) 为每获得的QALY为10,047美元.
- 这两种方法都表明了可比的诊断安全性和临床结果.
结论:
- 补充性乳房MRI是一种成本效益高的替代方案,用于评估可疑的微化.
- 作为一种非侵入性选择,提供乳房MRI支持与患者共享决策.
- 这种方法确保了准确的风险分层,同时可能减少侵入性手术.
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