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Abstract #0222

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

An Tang1,2, Boyan Fan1, Joshua Bérubé1, Milena Cerny1, Damien Olivié1, Jeanne-Marie Giard3, Luigi Lepanto1,4, 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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