Early health technology assessment of magnetic resonance-guided high intensity focused ultrasound ablation for the treatment of early-stage breast cancer

• Published in: Journal of therapeutic ultrasound 2017-08, Vol.5 (1), p.23-23, Article 23
• Main Authors: Knuttel, Floortje M, Huijsse, Sèvrin E M, Feenstra, Talitha L, Moonen, Chrit T W, van den Bosch, Maurice A A J, Buskens, Erik, Greuter, Marcel J W, de Bock, Geertruida H
• Format: Article
• Language: English
• Subjects: Ablation; Ablation (Surgery); Accuracy; Anesthesia; Biopsy; Breast cancer; Breathing; Cancer; Cancer therapies; Care and treatment; Cooling; Cost analysis; Costs; Diagnosis; Feasibility studies; Lumpectomy; Lymphatic system; Magnetic resonance; Magnetic resonance imaging; Mastectomy; Medical prognosis; Metastasis; NMR; Nuclear magnetic resonance; Oncology; Patients; Radiation therapy; Surgery; Technology assessment; Temperature; Tumors; Ultrasonic imaging; Ultrasound; Womens health
• ISSN: 2050-5736; 2050-5736
• DOI: 10.1186/s40349-017-0101-3

Magnetic resonance-guided high intensity focused ultrasound (MR-HIFU) ablation is in development for minimally invasive treatment of breast cancer. Cost-effectiveness has not been assessed yet. An early health technology assessment was performed to estimate costs of MR-HIFU ablation, compared to breast conserving treatment (BCT). An MR-HIFU treatment model using the dedicated MR-HIFU breast system (Sonalleve, Philips Healthcare) was developed. Input parameters (treatment steps and duration) were based on the analysis of questionnaire data from an expert panel. MR-HIFU experts assessed face validity of the model. Data collected by questionnaires were compared to published data of an MR-HIFU breast feasibility study. Treatment costs for tumours of 1 to 3 cm were calculated. The model structure was considered of acceptable face validity by consulted experts, and questionnaire data and published data were comparable. Costs of MR-HIFU ablation were higher than BCT costs. MR-HIFU best-case scenario costs exceeded BCT costs with approximately €1000. Cooling times and breathing correction contributed most to treatment costs. MR-HIFU ablation is currently not a cost-effective alternative for BCT. MR-HIFU experience is limited, increasing uncertainty of estimations. The potential for cost-effectiveness increases if future research reduces treatment durations and might substantiate equal or improved results.