Economic evaluation of 18F-FDG PET/CT, MRI and CE-CT in selection of colorectal liver metastases eligible for ablation – A cost-effectiveness analysis

Schnitzer, Moritz L.; Buchner, Janine; Biechele, Gloria; Grawe, Freba; Münchhausen, Niklas von; Kaiser, Ch.; Kunz, Wolfgang G.; Froelich, Matthias F.; Schmid-Tannwald, Christine; Rübenthaler, Johannes

doi:10.1016/j.ejrad.2023.110803

Cited by 5 publications

(3 citation statements)

References 39 publications

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“…Previous studies have also demonstrated that liver MRI is cost-effective when compared with other imaging modalities. 43 , 44 Despite the potential benefits of liver MRI, it is important to emphasize that liver MRI as a first-line imaging without CT is currently not recommended since a thoracoabdominal CT is still needed for adequate staging of extrahepatic disease.…”

Section: Discussionmentioning

confidence: 99%

Added Value of Liver MRI in Patients Eligible for Surgical Resection or Ablation of Colorectal Liver Metastases Based on CT: A Systematic Review and Meta-Analysis

Görgec,

Verpalen,

Sijberden

et al. 2024

Annals of Surgery Open

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Background: Abdominal computed tomography (CT) is the standard imaging modality for detection and staging in patients with colorectal liver metastases (CRLM). Although liver magnetic resonance imaging (MRI) is superior to CT in detecting small lesions, guidelines are ambiguous regarding the added value of an additional liver MRI in the surgical workup of patients with CRLM. Therefore, this systematic review and meta-analysis aimed to evaluate the clinical added value of liver MRI in patients eligible for resection or ablation of CRLM based on CT. Methods: A systematic search was performed in the PubMed, Embase, and Cochrane Library databases through June 23, 2023. Studies investigating the impact of additional MRI on local treatment plan following CT in patients with CRLM were included. Risk of bias was assessed using the QUADAS-2 tool. The pooled weighted proportions for the primary outcome were calculated using random effect meta-analysis. Results: Overall, 11 studies with 1440 patients were included, of whom 468 patients (32.5%) were assessed for change in local treatment plan. Contrast-enhanced liver MRI was used in 10 studies, including gadoxetic acid in 9 studies. Liver MRI with diffusion-weighted imaging was used in 8 studies. Pooling of data found a 24.12% (95% confidence interval, 15.58%–32.65%) change in the local treatment plan based on the added findings of liver MRI following CT. Sensitivity analysis including 5 studies (268 patients) focusing on monophasic portal venous CT followed by gadoxetic acid-enhanced liver MRI with diffusion-weighted imaging showed a change of local treatment plan of 17.88% (95% confidence interval, 5.14%–30.62%). Conclusions: This systematic review and meta-analysis found that liver MRI changed the preinterventional local treatment plan in approximately one-fifth of patients eligible for surgical resection or ablation of CRLM based on CT. These findings suggest a clinically relevant added value of routine liver MRI in the preinterventional workup of CRLM, which should be confirmed by large prospective studies.

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Section: Discussionmentioning

confidence: 99%

Added Value of Liver MRI in Patients Eligible for Surgical Resection or Ablation of Colorectal Liver Metastases Based on CT: A Systematic Review and Meta-Analysis

Görgec,

Verpalen,

Sijberden

et al. 2024

Annals of Surgery Open

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“…In this subgroup, 26 (9%) had disease deemed too extensive and 8 (3%) were found to have benign lesions on liver contrast-enhanced MRI. Lastly, in an economic evaluation study that compared MRI, FDG PET/CT, and CE-CT for the selection of CLM eligible for ablation, the authors found that MRI was the most cost-effective modality [30].…”

Section: Baseline Imaging Prior To Locoregional Treatmentmentioning

confidence: 99%

Imaging Considerations before and after Liver-Directed Locoregional Treatments for Metastatic Colorectal Cancer

Chlorogiannis,

Moussa,

Zhao

et al. 2024

Diagnostics

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Colorectal cancer is a leading cause of cancer-related death. Liver metastases will develop in over one-third of patients with colorectal cancer and are a major cause of morbidity and mortality. Even though surgical resection has been considered the mainstay of treatment, only approximately 20% of the patients are surgical candidates. Liver-directed locoregional therapies such as thermal ablation, Yttrium-90 transarterial radioembolization, and stereotactic body radiation therapy are pivotal in managing colorectal liver metastatic disease. Comprehensive pre- and post-intervention imaging, encompassing both anatomic and metabolic assessments, is invaluable for precise treatment planning, staging, treatment response assessment, and the prompt identification of local or distant tumor progression. This review outlines the value of imaging for colorectal liver metastatic disease and offers insights into imaging follow-up after locoregional liver-directed therapy.

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“…4) [10,30]. Beispielsweise konnte bei CRC nachgewiesen werden, dass die FDG-PET/CT für die Detektion von Lebermetastasen zwar der Ultraschalldiagnostik und CT-Bildgebung überlegen ist, die MRT-Bildgebung jedoch dennoch als Goldstandard gilt und kosteneffizienter ist [31,32,33,34,35]. Der Vorteil der FDG-PET zeigt sich bei CRC daher auch im Rahmen der Detektion lymphogener bzw.…”

Section: Gaunclassified

Primäre und sekundäre Lebertumore – aus Sicht der Nuklearmedizin

Holzgreve,

Ilhan,

Unterrainer

et al. 2023

Angewandte Nuklearmedizin

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ZusammenfassungKonventionelle, radiologische Modalitäten wie die Ultraschalldiagnostik, CT- und MRT-Bildgebung sind der klinische Standard in der onkologischen Bildgebung primärer und sekundärer Lebertumore. In den letzten Jahrzehnten konnten nuklearmedizinische Verfahren, darunter insbesondere die PET/CT-Bildgebung, zusätzliche, molekulare Informationen liefern, die maßgeblich zur weiteren Optimierung der Stadieneinteilung und Risikostratifizierung beigetragen haben. Neben FDG als „Standard“-Radiopharmakon der PET/CT-Bildgebung werden in diesem Artikel weitere, spezifischere Radiopharmaka und neue Entwicklungen beschrieben.

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Economic evaluation of 18F-FDG PET/CT, MRI and CE-CT in selection of colorectal liver metastases eligible for ablation – A cost-effectiveness analysis

Cited by 5 publications

References 39 publications

Added Value of Liver MRI in Patients Eligible for Surgical Resection or Ablation of Colorectal Liver Metastases Based on CT: A Systematic Review and Meta-Analysis

Added Value of Liver MRI in Patients Eligible for Surgical Resection or Ablation of Colorectal Liver Metastases Based on CT: A Systematic Review and Meta-Analysis

Imaging Considerations before and after Liver-Directed Locoregional Treatments for Metastatic Colorectal Cancer

Primäre und sekundäre Lebertumore – aus Sicht der Nuklearmedizin

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