Under Dr. Chi's direction, Matthew Hudnall and his colleagues compared cost factors associated with ultrasound (in 33 patients) and fluoroscopic guidance (in 40 patients) for percutaneous nephrolithotomy (PCNL). They have found that ultrasound-guided PCNL had significantly shorter mean operative time (99.8 vs. 144.9 minutes). Including capital equipment costs, the mean total cost per case of ultrasound-guided PCNL was approximately 30% less than fluoroscopy-guided PCNL (simulated costs with a uniform multiplier; $5,258.90 vs. $7,508.60). Postoperative clinical outcomes were comparable between the two groups.

The authors concluded that "including capital costs, ultrasound-guided PCNL can produce comparable clinical outcomes to fluoroscopy-guided procedures at a lower cost to the institution." Using ultrasound imaging during PCNL may be more cost-effective compared to fluoroscopy and warrants further study. This study was published in Urology on December 2016.  

Ultrasound Guidance Reduces Percutaneous Nephrolithotomy Cost Compared to Fluoroscopy. Hudnall M, Usawachintachit M, Metzlet I, Tzou DT, Harrison B, Lobo E, Chi T. Urology. 2016 Dec 23. pii: S0090-4295(16)31017-2. doi: 10.1016/j.urology.2016.12.030.   Read more...