This title appears in the Scientific Report :
2022
Please use the identifier:
http://dx.doi.org/10.2967/jnumed.122.263790 in citations.
Please use the identifier: http://hdl.handle.net/2128/32775 in citations.
Cost-effectiveness of 18 F-FET PET for early treatment response assessment in glioma patients following adjuvant temozolomide chemotherapy
Cost-effectiveness of 18 F-FET PET for early treatment response assessment in glioma patients following adjuvant temozolomide chemotherapy
Rationale: In light of increasing healthcare costs, higher medical expenses should be justified socio-economically. Therefore, we calculated the effectiveness and cost-effectiveness of positron emission tomography (PET) using the radiolabeled amino acid O-(2-[18F]-fluoroethyl)-L-tyrosine (18F-FET) c...
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Personal Name(s): | Rosen, Jurij |
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Ceccon, Garry / Bauer, Elena Katharina / Werner, Jan Michael / Tscherpel, Caroline / Dunkl, Veronika / Rapp, Marion / Sabel, Michael / Herrlinger, Ulrich / Heinzel, Alexander / Schaefer, Niklas / Ruge, Maximilian / Goldbrunner, Roland / Stoffels, Gabriele / Kabbasch, Christoph / Fink, Gereon Rudolf / Langen, Karl-Josef / Galldiks, Norbert (Corresponding author) | |
Contributing Institute: |
Physik der Medizinischen Bildgebung; INM-4 Kognitive Neurowissenschaften; INM-3 |
Published in: | Journal of nuclear medicine, 63 (2022) 10, S. 1677-1682 |
Imprint: |
New York, NY
Soc.
2022
|
DOI: |
10.2967/jnumed.122.263790 |
Document Type: |
Journal Article |
Research Program: |
Neuroimaging |
Link: |
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Publikationsportal JuSER |
Please use the identifier: http://hdl.handle.net/2128/32775 in citations.
Rationale: In light of increasing healthcare costs, higher medical expenses should be justified socio-economically. Therefore, we calculated the effectiveness and cost-effectiveness of positron emission tomography (PET) using the radiolabeled amino acid O-(2-[18F]-fluoroethyl)-L-tyrosine (18F-FET) compared to conventional magnetic resonance imaging (MRI) for early identification of responders to adjuvant temozolomide chemotherapy. A recently published study in isocitrate dehydrogenase-wildtype glioma patients suggested that 18F-FET PET parameter changes predicted a significantly longer survival already after two cycles while MRI changes were not significant. Methods: To determine the effectiveness and cost-effectiveness of serial 18F-FET PET imaging, we analyzed published clinical data and calculated the associated costs from the perspective of the German Statutory Health Insurance system. Based on a decision-tree model, the effectiveness of 18F-FET PET and MRI was calculated, i.e., the probability to correctly identify a responder as defined by an overall survival ≥15 months. To determine the cost-effectiveness, the incremental cost-effectiveness ratio (ICER) was calculated, i.e., the cost for each additionally identified responder by 18F-FET PET who would have remained undetected by MRI. The robustness of the results was tested by deterministic and probabilistic Monte Carlo sensitivity analyses. Results: Compared to MRI, 18F-FET PET increased the rate of correctly identified responders to chemotherapy by 26%; thus, four patients needed to be examined by 18F-FET PET to identify one additional responder. Considering the respective cost for serial 18F-FET PET and MRI, the ICER resulted in €4,396.83 for each additional correctly identified responder by 18F-FET PET. Sensitivity analyses confirmed the robustness of the results. Conclusion: In contrast to conventional MRI, the model suggests that 18F-FET PET is cost-effective in terms of ICER values. Considering the high cost of temozolomide, the integration of 18F-FET PET has the potential to avoid premature chemotherapy discontinuation at reasonable cost. |