Accuracy and Cost Comparison of Ultrasound Versus Alternative Imaging Modalities,Including CT,MR,PET,and Angiography

Abstract

Ultrasound (US) has become widely used in clinical medicine for the diagnosis of a variety of disease processes. The unique ability of US to provide accurate information through an efficacious, painless, portable, and nonionizing method has expanded its role and application in diverse medical settings. Given the current economic environment and the related interest in creating the greatest value for health care expenditures, US has been evaluated to compare its clinical accuracy/efficacy and cost-effectiveness versus other imaging modalities. The following literature review reports the results of research studies aimed at comparing the accuracy/efficacy and cost of US versus alternative imaging modalities, including magnetic resonance imaging, computed tomography, contrast angiography, and single-photon emission computed tomography.

Keywords

ultrasound sonography ultrasonography cost-effective accuracy

References

Wild J. , Reid J. : Diagnostic use of ultrasound. Br J Phys Med 1956;19:248-257.

Wild J. , Reid J. : Echographic visualization of lesions of the living intact human breast . Cancer Res 1954;14:277-282.

Edler I. , Hertz CH : The early work of ultrasound in medicine at the University of Lund . J Clin Ultrasound 1977;5:352-356.

Hertz Ch ultrasonic heart investigation. Med Electron Biol Eng 1964;101:39-45.

Cole K. : Sonography's expansion into space. J Diagn Med Sonography 2008;24:380-387.

Levy JA , Bachur RG : Bedside ultrasound in the pediatric emergency department. Curr Opin Pediatr 2008; 20:235-242.

Körner M. , Krötz MM , Degenhart C. , Pfeifer KJ , Reiser MF , Linsenmaier U. : Current role of emergency US in patients with major trauma. Radiographics 2008;28:225-242.

Isenhour JL , Marx J. : Advances in abdominal trauma. Emerg Med Clin North Am 2007;25:713-733.

Ma OJ , Norvell JG , Subramanian S. : Ultrasound applications in mass casualties and extreme environments . Crit Care Med 2007;35(suppl):S275-S279.

10.

Pearlman AS , Ryan T. , Picard MH , Douglas PS : Evolving trends in the use of echocardiography: a study of Medicare beneficiaries. J Am Coll Cardiol 2007;49:2283-2291.

11.

GAO-08-1102R, Medicare imaging payments. Medicare: trends in fees, utilization, and expenditures for imaging services before and after implementation of the Deficit Reduction Act of 2005. September 26, 2008.

12.

Old JL , Dusing RW , Yap W. , Dirks J. : Imaging for suspected appendicitis. Am Fam Physician 2005;71:71-78.

13.

Porter ME , Teisberg EO : Redefining Health Care. Cambridge, MA, Harvard Business School Press, 2006.

14.

Miller M. : MedPAC recommendations on imaging services. Testimony March 17, 2005, before the House Ways and Means Subcommittee on Health.

15.

GAO-07-734, Medicare ultrasound procedures: consideration of payment reforms and technician qualification requirements. June 2007.

16.

Andrist LS , Schroedter WB : Standards for assurance of minimum entry-level competence for the diagnostic ultrasound professional. J Diagn Med Sonography 2001;17:307-311.

17.

Bierig SM , Ehler D. , Knoll ML , Waggoner AD : American Society of Echocardiography minimum standards for the cardiac sonographer: a position paper. J Am Soc Echocardiogr 2006 ;19:471-474.

18.

Reddy UM , Filly RA , Copel JA : Prenatal imaging: ultrasonography and magnetic resonance imaging. Obstet Gynecol 2008;112:145-157.

19.

Schauberger CW , Mathiason MA , Rooney BL : Ultrasound assessment of first-trimester bleeding. Obstet Gynecol 2005;105:333-338.

20.

Oepkes D. , Seaward PG , Vandenbussche FP , et al; DIAMOND Study Group : Doppler ultrasonography versus amniocentesis to predict fetal anemia. N Engl J Med 2006;355:156-164.

21.

Davidson KG , Dubinsky TJ : Ultrasonographic evaluation of the endometrium in postmenopausal vaginal bleeding . Radiol Clin North Am 2003;41:769-780.

22.

Evans P. , Brunsell S. : Uterine fibroid tumors: diagnosis and treatment. Am Fam Physician 2007;75:1503-1508.

23.

Ghi T. , Casadio P. , Kuleva M. , et al: Accuracy of three-dimensional ultrasound in diagnosis and classification of congenital uterine anomalies. Fertil Steril 2008;8:1-6.

24.

Kim LG , Scott RA , Ashton HA , Thompson SG ; Multicentre Aneurysm Screening Study Group : A sustained mortality benefit from screening for abdominal aortic aneurysm . Ann Intern Med 2007;146:699-706.

25.

Vidakovic R. , Feringa HH , Kuiper RJ , et al: Comparison with computed tomography of two ultrasound devices for diagnosis of abdominal aortic aneurysm. Am J Cardiol 2007;100:1786-1791.

26.

Alhayaf N. , Lalor E. , Bain V. , McKaigney J. , Sandha GS : The clinical impact and cost implication of endoscopic ultrasound on use of endoscopic retrograde cholangiopancreatography in a Canadian university hospital . Can J Gastroenterol 2008;22:138-142.

27.

Romagnuolo J. , Currie G. ; Calgary Advanced Therapeutic Endoscopy Center Study Group : Noninvasive vs. selective invasive biliary imaging for acute biliary pancreatitis: an economic evaluation by using decision tree analysis. Gastrointest Endosc. 2005;61:86-97.

28.

Park MS , Yu JS , Kim YH , et al: Acute cholecystitis: comparison of MR cholangiography and US in patients with acute cholecystitis. Radiology 1998;209:781-785.

29.

Friedrich-Rust M. , Schneider G. , Bohle RM , et al: Contrast-enhanced sonography of adrenal masses: differentiation of adenomas and nonadenomatous lesions. AJR Am J Roentgenol 2008;191:1852-1860.

30.

Loftus WK , Metreweli C. , Sung JJ , Yang WT , Leung VK , Set PA : Ultrasound, CT and colonoscopy of colonic cancer. Br J Radiol 1999;72:144-148.

31.

Horsthuis K. , Bipat S. , Bennink RJ , Stoker J. : Inflammatory bowel disease diagnosed with US, MR, scintigraphy, and CT: meta-analysis of prospective studies. Radiology 2008;247:64-79.

32.

Goodman LR , Stein PD , Matta F. , et al: CT venography and compression sonography are diagnostically equivalent: data from PIOPED II. AJR Am J Roentgenol 2007;189:1071-1076.

33.

Goodacre S. , Sampson F. , Stevenson M. , et al: Measurement of the clinical and cost-effectiveness of non-invasive diagnostic testing strategies for deep vein thrombosis. Health Technol Assess 2006;10:1-168, iii-iv.

34.

Orbell JH , Smith A. , Burnand KG , Waltham M. : Imaging of deep vein thrombosis. Br J Surg 2008;95:137-146.

35.

Weber TM , Lockhart ME , Robbin ML : Upper extremity venous Doppler ultrasound. Radiol Clin North Am 2007;45:513-524, viii-ix.

36.

Calvert N. , Hind D. , McWilliams R. , Davidson A. , Beverley CA , Thomas SM : Ultrasound for central venous cannulation: economic evaluation of cost-effectiveness . Anaesthesia 2004;59:1116-1120.

37.

Collins R. , Cranny G. , Burch J. , et al: A systematic review of duplex ultrasound, magnetic resonance angiography and computed tomography angiography for the diagnosis and assessment of symptomatic, lower limb peripheral arterial disease. Health Technol Assess 2007;11:iii-iv, xi-xiii, 1-184.

38.

Coffi SB , Ubbink DT , Dijkgraaf MG , Reekers JA , Legemate DA : Cost-effectiveness of identifying aortoiliac and femoropopliteal arterial disease with angiography or duplex scanning. Eur J Radiol 2008;66:142-148.

39.

Ouwendijk R. , de Vries M. , Stijnen T. , et al; Program for the Assessment of Radiological Technology: Multicenter randomized controlled trial of the costs and effects of noninvasive diagnostic imaging in patients with peripheral arterial disease: the DIPAD trial. AJR Am J Roentgenol 2008;190:1349-1357.

40.

de Vries M. , Ouwendijk R. , Flobbe K. , et al: Peripheral arterial disease: clinical and cost comparisons between duplex US and contrast-enhanced MR angiography-a multicenter randomized trial. Radiology 2006 ;240:401-410.

41.

Lowery AJ , Hynes N. , Manning BJ , Mahendran M. , Tawfik S. , Sultan S. : A prospective feasibility study of duplex ultrasound arterial mapping, digital-subtraction angiography, and magnetic resonance angiography in management of critical lower limb ischemia by endovascular revascularization. Ann Vasc Surg 2007;21:443-451.

42.

Buskens E. , Nederkoorn PJ , Buijs-Van Der Woude T. , et al: Imaging of carotid arteries in symptomatic patients: cost-effectiveness of diagnostic strategies. Radiology 2004;233:101-112.

43.

Burnett MG , Stein SC , Sonnad SS , Zager EL : Cost-effectiveness of intraoperative imaging in carotid endarterectomy . Neurosurgery 2005;57:478-485.

44.

Khare RK , Courtney DM , Powell ES , Venkatesh AK , Lee TA : Sixty-four-slice computed tomography of the coronary arteries: cost-effectiveness analysis of patients presenting to the emergency department with low-risk chest pain. Acad Emerg Med 2008;15:623-632.

45.

Wyrick JJ , Kalvaitis S. , McConnell KJ , Rinkevich D. , Kaul S. , Wei K. : Cost-efficiency of myocardial contrast echocardiography in patients presenting to the emergency department with chest pain of suspected cardiac origin and a nondiagnostic electrocardiogram. Am J Cardiol 2008;102:649-652.

46.

Bedetti G. , Pasanisi EM , Pizzi C. , Turchetti G. , Loré C. : Economic analysis including long-term risks and costs of alternative diagnostic strategies to evaluate patients with chest pain. Cardiovasc Ultrasound 2008;6:21.

47.

Jeetley P. , Burden L. , Stoykova B. , Senior R. : Clinical and economic impact of stress echocardiography compared with exercise electrocardiography in patients with suspected acute coronary syndrome but negative troponin: a prospective randomized controlled study. Eur Heart J 2007;28:204-211.

48.

Nucifora G. , Badano LP , Sarraf-Zadegan N. , et al: Comparison of early dobutamine stress echocardiography and exercise electrocardiographic testing for management of patients presenting to the emergency department with chest pain. Am J Cardiol 2007;100:1068-1073.

49.

Shaw LJ , Marwick TH , Berman DS , et al: Incremental cost-effectiveness of exercise echocardiography vs. SPECT imaging for the evaluation of stable chest pain. Eur Heart J 2006;27:2448-2458.

50.

Hayashino Y. , Shimbo T. , Tsujii S. , et al: Cost-effectiveness of coronary artery disease screening in asymptomatic patients with type 2 diabetes and other atherogenic risk factors in Japan: factors influencing on international application of evidence-based guidelines. Int J Cardiol 2007;118:88-96.

51.

Sicari R. , Pasanisi E. , Venneri L. , Landi P. , Cortigiani L. , Picano E. ; Echo Persantine International Cooperative (EPIC) Study Group ; Echo Dobutamine International Cooperative (EDIC) Study Group: Stress echo results predict mortality: a large-scale multicenter prospective international study. J Am Coll Cardiol 2003 ;41:589-595.

52.

Kertai MD , Boersma E. , Bax JJ , et al: A meta-analysis comparing the prognostic accuracy of six diagnostic tests for predicting perioperative cardiac risk in patients undergoing major vascular surgery. Heart 2003;89:1327-1334.

53.

Lim TK , Dwivedi G. , Hayat S. , Collinson PO , Senior R. : Cost effectiveness of the B type natriuretic peptide, electrocardiography, and portable echocardiography for the assessment of patients from the community with suspected heart failure. Echocardiography 2007;24:228-236.

54.

Shiga T. , Wajima Z. , Apfel CC , Inoue T. , Ohe Y. : Diagnostic accuracy of transesophageal echocardiography, helical computed tomography, and magnetic resonance imaging for suspected thoracic aortic dissection: systematic review and meta-analysis. Arch Intern Med 2006;166:1350-1356.

55.

Soldati G. , Testa A. , Silva FR , Carbone L. , Portale G. , Silveri NG : Chest ultrasonography in lung contusion. Chest 2006;130:533-538.

56.

Soldati G. , Testa A. , Sher S. , Pignataro G. , La Sala M. , Silveri NG : Occult traumatic pneumothorax: diagnostic accuracy of lung ultrasonography in the emergency department. Chest 2008;133:204-211.

57.

Park GY , Kim JM , Lee SM , Lee MY : The value of ultrasonography in the detection of meniscal tears diagnosed by magnetic resonance imaging. Am J Phys Med Rehabil 2008;87:14-20.

58.

Parker L. , Nazarian LN , Carrino JA , et al: Musculoskeletal imaging: Medicare use, costs, and potential for cost substitution. J Am Coll Radiol 2008 ;5:182-188.

59.

Shahabpour M. , Kichouh M. , Laridon E. , Gielen JL , De Mey J. : The effectiveness of diagnostic imaging methods for the assessment of soft tissue and articular disorders of the shoulder and elbow. Eur J Radiol 2008;65:194-200.

60.

Weiner SM , Jurenz S. , Uhl M. , et al: Ultrasonography in the assessment of peripheral joint involvement in psoriatic arthritis: a comparison with radiography, MRI and scintigraphy . Clin Rheumatol 2008;27:983-989.

61.

Gray A. , Elbourne D. , Dezateux C. , King A. , Quinn A. , Gardner F. : Economic evaluation of ultrasonography in the diagnosis and management of developmental hip dysplasia in the United Kingdom and Ireland. J Bone Joint Surg Am 2005;87:2472-2479.

62.

Ruda JM , Stack BCJr , Hollenbeak CS : The cost-effectiveness of additional preoperative ultrasonography or sestamibi-SPECT in patients with primary hyperparathyroidism and negative findings on sestamibi scans. Arch Otolaryngol Head Neck Surg 2006 ;132:46-53.

63.

Khalid AN , Hollenbeak CS , Quraishi SA , Fan CY , Stack BC Jr : The cost-effectiveness of iodine 131 scintigraphy, ultrasonography, and fine-needle aspiration biopsy in the initial diagnosis of solitary thyroid nodules. Arch Otolaryngol Head Neck Surg 2006;132:244-250.

64.

Savelli L. , Ceccarini M. , Ludovisi M. , et al: Preoperative local staging of endometrial cancer: transvaginal sonography vs. magnetic resonance imaging. Ultrasound Obstet Gynecol 2008;31:560-566.

65.

Cappelli C. , Pirola I. , De Martino E. , et al: The role of imaging in Graves' disease: a cost-effectiveness analysis. Eur J Radiol 2008;65:99-103.

66.

Michl P. , Pauls S. , Gress TM : Evidence-based diagnosis and staging of pancreatic cancer. Best Pract Res Clin Gastroenterol 2006;20:227-251.

67.

Soriano A. , Castells A. , Ayuso C. , et al: Preoperative staging and tumor resectability assessment of pancreatic cancer: prospective study comparing endoscopic ultrasonography, helical computed tomography, magnetic resonance imaging, and angiography. Am J Gastroenterol 2004;99:492-501.

68.

Bipat S. , Glas AS , Slors FJ , Zwinderman AH , Bossuyt PM , Stoker J. : Rectal cancer: local staging and assessment of lymph node involvement with endoluminal US, CT, and MR imaging-a meta-analysis. Radiology 2004;232:773-783.