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The purpose of this paper was to compare the costs of three noninvasive diagnostic investigations as the initial tests in peripheral artery disease management in Romania. A cost analysis of three imaging diagnostic tests was performed at the university hospital in Timișoara, Romania. The tests were as follows: arterial Duplex Ultrasound Scanning, Computed Tomography Angiography, and Contrast-enhanced Magnetic Resonance Angiography. The evaluation of the diagnostic test performance was performed together with the calculation of the real costs of each investigation. Finally, an economic evaluation of different diagnostic tests was done. A number of 46 patients (36 male and 10 female) were included in the study. The selected patients have been subjected to a total number of 61 diagnostic tests prior to the therapeutic decision. Both in terms of sensitivity and specificity, Duplex Ultrasound Scanning and Computed Tomography Angiography showed little difference in our study. The cost analysis results showed a net economic advantage if Duplex Ultrasound Scanning is applied as a diagnostic method under conditions of obtaining a similar effect. In conclusion, Duplex Ultrasound Scanning is accurate, safe, and cost-effective in designing the final therapeutic plan in peripheral artery disease (PAD), especially in the femoropopliteal segment. [ABSTRACT FROM AUTHOR]