OBJECTIVES:To compare the clinical and cost consequences of Gadoxetic Acidenhanced magnetic resonance imaging (PV-MRI) to extracellular contrast mediaenhanced MRI (ECCM-MRI) and Multidetector Computed Tomography (MD-CT) in patients with suspected hepatocellular carcinoma (HCC) in South Korea and Thailand. METHODS: The clinical pathway of patients with suspected HCC from the initial imaging procedure (PV-MRI, ECCM-MRI or MD-CT) to the confirmed treatment decision was presented in an economic decision-tree model. The model compared payer relevant costs of the three diagnostic procedures as first line imaging for suspected HCC and the subsequent costs to reach a confirmed treatment decision. The probabilities and resource consumptions were estimated and validated by clinical experts through a Delphi panel process. Costs for diagnostic and treatment options were derived from published sources. , respectively. The higher acquisition cost of PV-MRI are more than compensated by the cost saving achieved through the reduced need for confirmatory imaging procedures and the reduced need for changes in the surgical protocol during resection. CONCLUSIONS: Using PV-MRI compared to ECCM-MRI and MD-CT for the first imaging in patients with suspected HCC leads to relevant cost savings for the statutory health insurance in both countries. The impact on health outcomes (e.g. mortality, quality of life) and total cost needs to be shown in an extended study approach. OBJECTIVES:To compare Gadoxetic Acid-enhanced MRI (PV-MRI) with extracellular contrast media-enhanced MRI (ECCM-MRI) and 3-phase MD-CT (MD-CT) in the planning of surgery for patients with colorectal cancer liver metastases (CRCLM). METHODS:A decision-tree model was used. The probabilities were collected and validated by radiologists and liver surgeons in Germany, Italy and Sweden using a Delphi panel process. Cost was derived from published sources and the mean costs A350

Conflicts of interest: none.aBstRact objectives: To analyze the operative time, length of hospitalization and cost, as well as the bleeding and pain observed during the postoperative period, of thyroidectomy procedures using vessel sealing, harmonic scalpel or the conventional technique. methods: Retrospective analysis of thyroidectomies performed between 2007 and 2010 using either the conventional technique or minimally invasive techniques involving vessel sealing or a harmonic scalpel. Gender, age, primary diagnosis and procedure type were analyzed. The outcomes analyzed included the length of the procedure, length of hospital stay, need for blood product transfusions, pain and cost of hospitalization. The findings were based on a significance level of 5%, and statistical analyses were performed using the R software. Results: The use of the vessel sealing increased the duration of the surgery by approximately 47 minutes compared to the conventional technique (p<0.001), and the use of the harmonic scalpel decreased the duration of the surgery by approximately 32 minutes compared to the conventional technique (p<0.001). No statistically significant difference was found between the groups regarding the use of blood products and pain score. Procedures involving vessel sealing or a harmonic scalpel cost more than those using the conventional technique. conclusion: The use of harmonic scalpel was favorable in terms of reducing the surgical time, but there was no reduction in hospitalization time. The cost of the procedure was higher than that of the conventional technique. The use of vessel sealing offered no advantages in terms of the outcomes assessed, and the cost of the procedure was greater than that of the conventional technique.Keywords: Thyroidectomy; Health economics; Cost-effectiveness evaluation; Technology, high-cost ResUmo objetivos: Analisar tempo cirúrgico, tempo de internação, sangramento, escore de dor no período pós-operatório e custo referente aos procedimentos de tireoidectomia com utilização de pinça seladora ou bisturi harmônico, comparando-os à técnica convencional. métodos: Análise retrospectiva das tireoidectomias, realizadas entre 2007 e 2010, pela técnica convencional e com uso de pinça seladora ou bisturi harmônico. Foram analisados: gênero, idade, diagnóstico principal e tipo de procedimento. Os desfechos analisados foram: duração do procedimento, tempo de permanência hospitalar, necessidade de transfusão de hemoderivados, dor e custo da internação. As conclusões foram baseadas em um nível de significância de 5%, e as análises estatísticas foram realizadas utilizando o software R. Resultados: Para o desfecho "duração da cirurgia", o uso da pinça seladora resultou em aumento médio de, aproximadamente, 47 minutos, quando comparado à técnica convencional (p<0,001) e o uso do bisturi harmônico levou à redução média de, aproximadamente, 32 minutos, quando comparado à técnica convencional (p<0,001). Não houve diferença estatisticamente significativa entre os grupos quanto ao uso de hemoderivad...