Integrating CEUS in Diagnostic Pathways: Evidence of Economic and Organizational Sustainability From the Italian Healthcare System
Author(s)
Lucrezia Bianca Ferrario, mecon1, FABRIZIO SCHETTINI, MEng1, Daniele Bellavia, MEng1, Carla Serra, MD2, Esterita Accogli, MD3, Andrea Domanico, MD3, Alice Brighenti, MD2, Andrea Boccatonda, MD2, Emanuela Foglia, PhD1.
1HD LAB – Healthcare Datascience LAB – Università Carlo Cattaneo – LIUC, Castellanza, Italy, 2IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy, 3Maggiore Hospital, Bologna, Italy.
1HD LAB – Healthcare Datascience LAB – Università Carlo Cattaneo – LIUC, Castellanza, Italy, 2IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy, 3Maggiore Hospital, Bologna, Italy.
OBJECTIVES: To investigate the potential benefits of integrated contrast-enhanced ultrasound (CEUS) on organizational and economic sustainability when utilized for incidental focal liver lesions (FLLs) characterization in patients without symptoms and/or laboratory findings suggestive of liver disease referred for non-contrast abdominal ultrasound.
METHODS: An economic and organizational analysis was conducted, using real-life data collected in two Italian hospitals, currently using CEUS. Three different AS IS Scenarios (not including the routine use of CEUS in clinical practice, following the performance of an abdominal ultrasound and utilizing CT or MRI diagnostic techniques for the proper characterization of incidental FLL, thereby not adhering to an optimized pathway and using CEUS as a third-line diagnostic option) were compared to a BEST-CASE Scenario, where CEUS is systematically used as a second-line investigation, following inconclusive ultrasound. Costs and time data were analyzed assuming the Italian NHS perspective over a 12-month time horizon, incorporating Bayesian sensitivity analysis to account for uncertainty.
RESULTS: Adopting CEUS as a second-line procedure resulted in significant economic savings, ranging from 38% to 51%, for the management of 688,811 individuals with potential incidental FLLs. Similar advantages emerged from an organizational perspective: procedure execution time was reduced by 12-23 minutes per patient, freeing up healthcare professional time and generating organizational savings between €19.11 and €36.27. CEUS also enabled faster diagnosis, reducing time to lesion characterization by up to 87% compared to traditional MRI or CT pathways. Sensitivity analyses confirmed the robustness of these findings across all scenarios.
CONCLUSIONS: CEUS represents a valid diagnostic strategy for incidental FLLs characterization, capable to ensure economic and organizational sustainability, offering tangible benefits for healthcare systems seeking to optimize resource allocation and improve diagnostic timelines.
METHODS: An economic and organizational analysis was conducted, using real-life data collected in two Italian hospitals, currently using CEUS. Three different AS IS Scenarios (not including the routine use of CEUS in clinical practice, following the performance of an abdominal ultrasound and utilizing CT or MRI diagnostic techniques for the proper characterization of incidental FLL, thereby not adhering to an optimized pathway and using CEUS as a third-line diagnostic option) were compared to a BEST-CASE Scenario, where CEUS is systematically used as a second-line investigation, following inconclusive ultrasound. Costs and time data were analyzed assuming the Italian NHS perspective over a 12-month time horizon, incorporating Bayesian sensitivity analysis to account for uncertainty.
RESULTS: Adopting CEUS as a second-line procedure resulted in significant economic savings, ranging from 38% to 51%, for the management of 688,811 individuals with potential incidental FLLs. Similar advantages emerged from an organizational perspective: procedure execution time was reduced by 12-23 minutes per patient, freeing up healthcare professional time and generating organizational savings between €19.11 and €36.27. CEUS also enabled faster diagnosis, reducing time to lesion characterization by up to 87% compared to traditional MRI or CT pathways. Sensitivity analyses confirmed the robustness of these findings across all scenarios.
CONCLUSIONS: CEUS represents a valid diagnostic strategy for incidental FLLs characterization, capable to ensure economic and organizational sustainability, offering tangible benefits for healthcare systems seeking to optimize resource allocation and improve diagnostic timelines.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
HSD64
Topic
Health Service Delivery & Process of Care, Medical Technologies
Disease
No Additional Disease & Conditions/Specialized Treatment Areas