Functional MR Imaging versus Wada Test for Evaluation of Language Lateralization: Cost Analysis

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Abstract
To compare the total direct costs (fixed and variable costs) of functional magnetic resonance (MR) imaging and of the Wada test for evaluation of language lateralization. The direct fixed and variable costs of functional MR imaging (performed in 21 patients with mean age +/- SD of 15.5 years +/- 8.9) and of the Wada test (performed in 18 patients aged 19.2 years +/- 5.4) were determined prospectively with time and motion analyses. The labor of all personnel involved in evaluations of language lateralization was tracked, and involvement times were recorded to the nearest minute. All material items used in the studies were recorded. Costs of labor and of materials were determined from personnel reimbursement data and from vendor pricing, respectively. Direct fixed costs were determined from hospital accounting department records. Means (+/- SDs) were calculated for all direct fixed and variable costs. Total direct costs were determined for each procedure and compared by using the Student t test. The total direct costs of the Wada test (US dollars 1130.01 +/- US dollars 138.40) and of functional MR imaging (US dollars 301.82 +/- US dollars 10.65) were significantly different (P <.001). The cost of the Wada test was 3.7 times higher than that of functional MR imaging. Substantial savings are achievable with the use of functional MR imaging instead of the Wada test to evaluate language lateralization.