Martin Helmut Maurer MD, Presenter: Nothing to Disclose

Malte Schmidt, Abstract Co-Author: Nothing to Disclose

Moritz Wagner MD, Abstract Co-Author: Nothing to Disclose

Olaf Püttcher MD, Abstract Co-Author: Nothing to Disclose

Patrick Asbach MD, Abstract Co-Author: Speakers Bureau, Siemens AG, Erlangen, Germany Investigator, Copenhagen Malmo Contrast AB, Lund, Sweden

Joachim Strassburg MD, Abstract Co-Author: Nothing to Disclose

Fritz Stöckmann, Abstract Co-Author: Nothing to Disclose

Oliver Schöffski PhD, Abstract Co-Author: Nothing to Disclose

Bernd K. Hamm MD, Abstract Co-Author: Research Consultant, Bayer AG Research Consultant, Toshiba Corporation Stockholder, Siemens AG Stockholder, General Electric Company Stockholder, Biomed Research grant, Toshiba Corporation Research grant, Koninklijke Philips Electronics NV Research grant, Siemens AG Research grant, General Electric Company Research grant, Elbit Medical Imaging Ltd Research grant, Bayer AG Research grant, Guerbet AG Research grant, Bracco Group Research grant, B. Braun Research grant, Knauth Research grant, Boston Group Equipment support, Elbit Medical Imaging Ltd Investigator, Copenhagen Malmo Contrast AB, Lund, Sweden

Alexander Huppertz MD, Abstract Co-Author: Employee, Siemens AG

To compare the total direct costs of whole-body MRI versus established sequential, multi-modal diagnostic algorithm for pretherapeutic TNM staging of rectal cancer.

In a study including 33 patients (25 male, 8 female; mean age, 62.5 years) the direct fixed and variable costs of a sequential, multimodal diagnostic algorithm (rectoscopy, endoscopic and abdominal ultrasound, chest X-ray, combined thoracic/abdominal computed tomography) were compared with those of a novel algorithm of rectoscopy followed by MR imaging using a whole-body scanner. MR imaging included T2-weighted sequences of the rectum, 3D T1-weighted sequences of the liver and chest after bolus injection of gadoxetic acid (Primovist®, Bayer Schering Pharma, Berlin, Germany), and delayed phases of the liver. On the basis of expert interviews of process drivers (two surgeons, two radiologists) the labor of personnel involved was tracked, involvement times were documented to the nearest minute, all material items were recorded. Costs of labor and materials were determined from personnel reimbursement data and hospital accounting records. Direct fixed costs were determined from vendor pricing.

Mean MR imaging time was 55 min. Computed tomography was performed in 19/33 patients (58%) causing an additional day of hospitalization (costs 367 EUR). Costs for equipment and material were higher for MR imaging (equipment 116 vs. 30 EUR; material 159 vs. 60 EUR per patient). Personnel costs were markedly lower for MR imaging (436 vs. 732 EUR per patient). Altogether, the absolute cost advantage of MR imaging was 31.3% (711 vs. 1035 EUR).

Substantial savings are achievable with the use of whole-body MR imaging in the preoperative TNM staging of patients with rectal cancer.

In the pretherapeutic TNM staging of rectal cancer whole-body MR imaging is a cost-effective alternative and may replace the established sequential, multi-modal diagnostic algorithm.

Maurer, M, Schmidt, M, Wagner, M, Püttcher, O, Asbach, P, Strassburg, J, Stöckmann, F, Schöffski, O, Hamm, B, Huppertz, A, Whole-body MRI versus Established Sequential, Multimodal Diagnostic Algorithm for Staging of Patients with Rectal Carcinoma: Cost Analysis.  Radiological Society of North America 2010 Scientific Assembly and Annual Meeting, November 28 - December 3, 2010 ,Chicago IL. http://archive.rsna.org/2010/9005044.html