MP53-14 COST EFFECTIVENESS OF MAGNETIC RESONANCE/ULTRASOUND FUSION PROSTATE BIOPSY VS STANDARD OF CARE (TRANSRECTAL ULTRASOUND (TRUS)-GUIDED BIOPSY) (2016)

You have accessJournal of UrologyProstate Cancer: Detection & Screening VII1 Apr 2016MP53-14 COST EFFECTIVENESS OF MAGNETIC RESONANCE/ULTRASOUND FUSION PROSTATE BIOPSY VS STANDARD OF CARE (TRANSRECTAL ULTRASOUND (TRUS)-GUIDED BIOPSY) Kaitlan Cobb, Amichai Kilchevsky, John Michael DiBianco, Daniel Su, Thomas Frye, Vikram Sabarwal, Baris Turkbey, Peter Choyke, Bradford Wood, and Peter Pinto Kaitlan CobbKaitlan Cobb More articles by this author , Amichai KilchevskyAmichai Kilchevsky More articles by this author , John Michael DiBiancoJohn Michael DiBianco More articles by this author , Daniel SuDaniel Su More articles by this author , Thomas FryeThomas Frye More articles by this author , Vikram SabarwalVikram Sabarwal More articles by this author , Baris TurkbeyBaris Turkbey More articles by this author , Peter ChoykePeter Choyke More articles by this author , Bradford WoodBradford Wood More articles by this author , and Peter PintoPeter Pinto More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.511AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Studies have shown magnetic resonance imaging / ultrasound (MR/US) fusion prostate biopsies to be to be comparable and superior to standard TRUS-guided biopsy in diagnosing prostate cancer (PCa). MRI of the prostate as a possible initial diagnostic tool has been postulated. We sought to explore the cost-effectiveness of prostate MRI as an initial diagnostic tool as compared to TRUS-guided biopsy. METHODS Using a cost analysis model, the total cost and outcomes for biopsy naïve men presenting with an elevated PSA >4.0 ng/ml was compared. A theoretical cohort was subdivided into those undergoing TRUS prostate biopsy and those undergoing prostate MRI with subsequent MR/US fusion biopsy only if when a target lesion is present. A cancer incidence of 28%, additional 32% non-infectious complication rate cost, 1.73% infectious complication cost, sensitivities and specificities for TRUS-guided biopsy at 53% and 66% respectively, prostate MRI set at 75% and 88% respectively and MR/US fusion biopsy set at 77% and 68% respectively, were based off current literature. Cost of TRUS biopsy, prostate MRI and MR/US fusion biopsy were based of the current AUA recommended CPT and Medicare reimbursement. Added cost for the MR/US fusion cohort included the system cost, determined by the average cost of the commercially available system. RESULTS Using a total cost for 1 patient undergoing TRUS prostate biopsy of $1,410.35, a contrast enhanced prostate MR of $633.36 and MRI fusion biopsy of $2,138.95, TRUS guided biopsy in 100 men would cost $141,035, and would be falsely negative in 13.16 men and falsely positive 24.48 men. The total cost of obtaining initial prostate MRI in 100 men with only patients with target lesion(s) undergoing MR/US fusion biopsy, was determined to be $107,961.69 given that 70.36 men would undergo prostate MRI alone, and 29. 64 men would have a subsequent MR/US fusion biopsy. Within the group of men only undergoing prostate MRI, 7 men would have falsely negative results and 8.64 would have falsely positive results. If MR/US fusion biopsy were performed without the addition of the standard 12-core template, false positivity would occur in 0.521 men, and false negativity in 6.44 men. CONCLUSIONS 100 men with PSA elevation who undergo prostate MRI with MR/US fusion biopsy if indicated, would cost ~25% less than undergoing an initial standard TRUS guided biopsy. Prostate MRI alone would result in fewer biopsies performed, thereby decreasing the cost of diagnosing PCa and reducing biopsy associated complications. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e702-e703 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Kaitlan Cobb More articles by this author Amichai Kilchevsky More articles by this author John Michael DiBianco More articles by this author Daniel Su More articles by this author Thomas Frye More articles by this author Vikram Sabarwal More articles by this author Baris Turkbey More articles by this author Peter Choyke More articles by this author Bradford Wood More articles by this author Peter Pinto More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...