Cost-effectiveness of PET and PET/Computed Tomography

Gerke, Oke; Hermansson, Ronnie; Hess, Søren; Schifter, Søren; Vach, Werner; Høilund‐Carlsen, Poul Flemming

doi:10.1016/j.cpet.2014.09.008

Cited by 13 publications

(12 citation statements)

References 59 publications

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“…This would be expected to improve the clinical management of a large proportion of patients and to provide more accurate assessment of prognosis. Because similar advantages have been demonstrated in several other cancers (26), it is also relevant for health-care providers and policy-makers to consider PET/CT as a possibly more cost-effective approach than conventional imaging modalities.…”

Section: Discussionmentioning

confidence: 82%

Head-to-Head Comparison of Chest X-Ray/Head and Neck MRI, Chest CT/Head and Neck MRI, and ¹⁸F-FDG PET/CT for Detection of Distant Metastases and Synchronous Cancer in Oral, Pharyngeal, and Laryngeal Cancer

et al. 2017

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The purpose of this study was to determine the detection rate of distant metastasis and synchronous cancer, comparing clinically used imaging strategies based on chest x-ray + head and neck MRI (CXR/MRI) and chest CT + head and neck MRI (CHCT/MRI) with F-FDG PET/CT upfront in the diagnostic workup of patients with oral, pharyngeal, or laryngeal cancer. This was a prospective cohort study based on paired data. Consecutive patients with histologically verified primary head and squamous cell carcinoma at Odense University Hospital from September 2013 to March 2016 were considered for the study. Included patients underwent CXR/MRI and CHCT/MRI as well as PET/CT on the same day and before biopsy. Scans were read masked by separate teams of experienced nuclear physicians or radiologists. The true detection rate of distant metastasis and synchronous cancer was assessed for CXR/MRI, CHCT/MRI, and PET/CT. A total of 307 patients were included. CXR/MRI correctly detected 3 (1%) patients with distant metastasis, CHCT/MRI detected 11 (4%) patients, and PET/CT detected 18 (6%) patients. The absolute differences of 5% and 2%, respectively, were statistically significant in favor of PET/CT. Also, PET/CT correctly detected 25 (8%) synchronous cancers, which was significantly more than CXR/MRI (3 patients, 1%) and CHCT/MRI (6 patients, 2%). The true detection rate of distant metastasis or synchronous cancer with PET/CT was 13% (40 patients), which was significantly higher than 2% (6 patients) for CXR/MRI and 6% (17 patients) for CHCT/MRI. A clinical imaging strategy based on PET/CT demonstrated a significantly higher detection rate of distant metastasis or synchronous cancer than strategies in current clinical imaging guidelines, of which European ones primarily recommend CXR/MRI, whereas U.S. guidelines preferably point to CHCT/MRI in patients with head and neck squamous cell carcinoma.

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Section: Discussionmentioning

confidence: 82%

Head-to-Head Comparison of Chest X-Ray/Head and Neck MRI, Chest CT/Head and Neck MRI, and ¹⁸F-FDG PET/CT for Detection of Distant Metastases and Synchronous Cancer in Oral, Pharyngeal, and Laryngeal Cancer

et al. 2017

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“…Extensive clinical evidence has established the effectiveness and value of molecular imaging for cancer diagnosis and management [ 2 ]. Technologies are deemed a good value when their additional costs, if any, are acceptable when compared to their ability to improve health outcomes, as measured by increased longevity and/or better quality of life for patients.…”

Section: Clinical Evidencementioning

confidence: 99%

“…These measurements of health outcomes are compared to the lifetime costs of the intervention when assessing its value. Using this methodology, studies on the cost effectiveness of molecular imaging over the last 20 years have clearly demonstrated its value for several cancer indications, as well as cancer drug development [ 2 ].…”

Section: Clinical Evidencementioning

confidence: 99%

“…One of the most widely adopted applications of molecular imaging is the use of PET/CT for preoperative staging of both non-small-cell lung cancer (NSCLC) and solitary pulmonary nodules. Clinical trials and cost-effectiveness analyses together have established that PET/CT provides accurate preoperative staging of lung cancer [ 3 ], resulting in a decrease in unnecessary surgeries and treatment costs [ 2 ]. For example, cost-effectiveness analyses performed alongside a randomised clinical trial showed that preoperative staging with PET/CT reduced the number of futile thoracotomies by almost 20% for patients with highly suspected NSCLC — saving an average of EUR 19,314 for each futile thoracotomy that was avoided and significantly improving the patients’ quality of life [ 4 ].…”

Section: Clinical Evidencementioning

confidence: 99%

“…PET/CT also, cost-effectively, provides definitive diagnoses and staging for colorectal cancer [ 2 ]. Clinical trials have shown that PET/CT precisely localises and characterises malignant colorectal lesions, improving the overall accuracy of staging and restaging [ 7 ].…”

Section: Clinical Evidencementioning

confidence: 99%

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