Procedural Micro-Costing of Single-Room Transcatheter CT Hepatic Angiography for Microwave Liver Ablation

PURPOSE: To quantify the resource use and procedural costs attributable to transcatheter CT hepatic angiography during single-room computed tomography-guided microwave ablation of liver tumours. MATERIALS AND METHODS: A prospective bottom-up micro-costing analysis was conducted from the UK National Health Service perspective. Resource utilisation data were collected from 35 consecutive patients undergoing hepatic angiography-assisted microwave ablation in a single-room equipped with a standard computed tomography scanner and a mobile C-arm. Unit costs were identified using National Health Service reference costs and the Personal Social Services Research Unit databases. Per-procedure costs incorporated staff time, equipment and consumables, and imaging-related capital costs. RESULTS: Median costs were £4,499 (£2,361-8,001) for the ablation component and £1,142 (£929-1,584) for hepatic angiography, with a median combined procedure cost, calculated independently, of £5,689 (£3,533-9,296). The hepatic angiography component was equivalent to 25.4% of the median ablation-component cost. Among the sensitivity scenarios tested, angiography duration had the greatest influence on its incremental cost, producing estimates of £929-1,584. CONCLUSION: Hepatic angiography adds a measurable incremental cost to computed tomography-guided microwave ablation. These results provide a foundation for prospective studies evaluating whether improved intraprocedural assessment translates into reduced re-intervention and improved cost-effectiveness. LEVEL OF EVIDENCE: Level 4, case series.