COST-EFFECTIVENESS OF MR-ANGIOGRAPHY IN CASES OF LIMB-THREATENING PERIPHERAL VASCULAR-DISEASE

PURPOSE: To evaluate the cost-effectiveness of magnetic resonance (MR) angiography in the preoperative planning of treatment in patients wit h limb-threatening peripheral vascular disease (PVD). MATERIALS AND ME THODS: A decision model was developed to study the effects of MR angio graphy on the outcome and cost of treatment. The authors calculated th e incremental cost per quality-adjusted life-years gained(ie, cost-eff ectiveness ratio) when conventional angiography was replaced or supple mented with MR angiography. Previously reported data regarding the acc uracies of MR and conventional angiography were used in the analysis. RESULTS: The cost-effectiveness ratio of MR angiography ranged from ne gative (cost-reducing) values to $78,000. For the base case in which t he sensitivity and specificity of MR angiography for the evaluation of inflow vessels were 92% and 88% and those of conventional angiography were 97% and 97%, respectively, the cost-effectiveness ratio was $25, 895. CONCLUSION: MR angiography may be a cost-effective alternative to conventional angiography in patients with limb-threatening PVD if its accuracy for the inflow evaluation reaches certain thresholds. Furthe r prospective investigation is warranted.