Abstract #0222

Cost-Utility Analysis of Ultrasound, Computed Tomography, Abbreviated and Standard MRI for Hepatocellular Carcinoma Surveillance

An Tang^1,2, Boyan Fan¹, Joshua Bérubé¹, Milena Cerny¹, Damien Olivié¹, Jeanne-Marie Giard³, Luigi Lepanto^1,4, and Jean Lachaine⁵

¹Radiology, University of Montreal, Montreal, QC, Canada, ²Centre de recherche du Centre hospitalier de l'Université de Montréal (CRCHUM), Montreal, QC, Canada, ³Gastroenterology and Hepatology, University of Montreal, Montreal, QC, Canada, ⁴Health Technology Assessment Unit, ⁵Faculty of Pharmacy and Pharmacoeconomics, University of Montreal, Montreal

Current clinical practice guidelines recommend ultrasound (US) every 6 months for surveillance of hepatocellular carcinoma (HCC) in at-risk patients. Despite higher sensitivity, there is uncertainty regarding the role of MRI for HCC surveillance, whether as an add-on or replacement test. Our results indicate that surveillance with standard MRI followed by CT if technically inconclusive provided the highest level of effectiveness. However, CT followed by MRI was more cost-effective than alternative surveillance strategies using a threshold of $50,000 per QALY gained. Further, lower cost of abbreviated MRI will be required to be used as a first-line imaging technique for surveillance.

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