PT - JOURNAL ARTICLE AU - N A Mayr AU - W T Yuh AU - M G Muhonen AU - D J Fisher AU - H D Nguyen AU - J C Ehrhardt AU - B C Wen AU - J F Doornbos AU - D H Hussey TI - Cost-effectiveness of high-dose MR contrast studies in the evaluation of brain metastases. DP - 1994 Jun 01 TA - American Journal of Neuroradiology PG - 1053--1061 VI - 15 IP - 6 4099 - http://www.ajnr.org/content/15/6/1053.short 4100 - http://www.ajnr.org/content/15/6/1053.full SO - Am. J. Neuroradiol.1994 Jun 01; 15 AB - PURPOSE To investigate the cost-effectiveness of high-dose MR contrast studies in the management of brain metastases. METHODS During the phase III clinical trial of high-dose contrast studies (0.3 mmol/kg), 11 of 27 patients were judged by the reviewers to have potential treatment changes based on the additional information provided by the high-dose studies. We retrospectively evaluated how many of these 27 patients had actual treatment changes because of the results of the high-dose study. Using the fee schedule at our institution, the cost-effectiveness was analyzed based on the cost savings from treatment changes and the additional expense of implementing the high-dose studies. RESULTS A total of 3 craniotomies ($22,800 each) and 2 aggressive courses of radiation therapy ($1122 each) were avoided in 4 patients because of the additional lesions detected by the high-dose studies. This resulted in a treatment cost savings of $70,644. The extra expense for implementing the high-dose study is $9126 for a single injection in all 27 patients, $9295 for 2 separate injections completed in 1 visit in the 11 patients, and $11,154 for 2 separate injections completed in 2 separate visits. The cost savings in management (diagnosis and treatment) therefore ranged from $59,490 to $61,518 for all patients and from $2203 to $2278 per patient. CONCLUSION Based on our limited data, the high-dose study seems to impact positively on the cost-effectiveness in the management of brain metastases. However, because our study had limitations, our results need to be confirmed with a larger patient population and a more standardized treatment approach and fee schedule.