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Cost-effectiveness analysis of 68Ga DOTA-TATE PET/CT, 111In-pentetreotide SPECT/CT and CT for diagnostic workup of neuroendocrine tumors

Neuroendocrine tumors (NETs) are relatively rare neoplasms arising from the hormone-producing neuroendocrine system that can occur in various organs such as pancreas, small bowel, stomach and lung. As the majority of these tumors express somatostatin receptors (SSR) on their cell membrane, utilizati...

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Main Authors: Froelich, Matthias F. (Author) , Schnitzer, Moritz Ludwig (Author) , Holzgreve, Adrien (Author) , Gassert, Felix (Author) , Gresser, Eva Kristina (Author) , Overhoff, Daniel (Author) , Schwarze, Vincent (Author) , Fabritius, Matthias P. (Author) , Nörenberg, Dominik (Author) , Münchhausen, Niklas, Freiherr von (Author) , Große Hokamp, Nils (Author) , Auernhammer, Christoph (Author) , Ilhan, Harun (Author) , Todica, Andrei Stefan (Author) , Rübenthaler, Johannes (Author)
Format: Article (Journal)
Language:English
Published: 18 February 2021
In: Diagnostics
Year: 2021, Volume: 11, Issue: 2, Pages: 1-14
ISSN:2075-4418
DOI:10.3390/diagnostics11020334
Online Access:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.3390/diagnostics11020334
Verlag, lizenzpflichtig, Volltext: https://www.mdpi.com/2075-4418/11/2/334
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Author Notes:Matthias Frank Froelich, Moritz Ludwig Schnitzer, Adrien Holzgreve, Felix Gerhard Gassert, Eva Gresser, Daniel Overhoff, Vincent Schwarze, Matthias Philipp Fabritius, Dominik Nörenberg, Niklas von Münchhausen, Nils Große Hokamp, Christoph J. Auernhammer, Harun Ilhan, Andrei Todica andJohannes Rübenthaler
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Summary:Neuroendocrine tumors (NETs) are relatively rare neoplasms arising from the hormone-producing neuroendocrine system that can occur in various organs such as pancreas, small bowel, stomach and lung. As the majority of these tumors express somatostatin receptors (SSR) on their cell membrane, utilization of SSR analogs in nuclear medicine is a promising, but relatively costly approach for detection and localization. The aim of this study was to analyze the cost-effectiveness of 68Ga-DOTA-TATE PET/CT (Gallium-68 DOTA-TATE Positron emission tomography/computed tomography) compared to 111In-pentetreotide SPECT/CT (Indium-111 pentetreotide Single Photon emission computed tomography/computed tomography) and to CT (computed tomography) alone in detection of NETs. A decision model on the basis of Markov simulations evaluated lifetime costs and quality-adjusted life years (QALYs) related to either a CT, SPECT/CT or PET/CT. Model input parameters were obtained from publicized research projects. The analysis is grounded on the US healthcare system. Deterministic sensitivity analysis of diagnostic parameters and probabilistic sensitivity analysis predicated on a Monte Carlo simulation with 30,000 reiterations was executed. The willingness-to-pay (WTP) was determined to be $ 100,000/QALY. In the base-case investigation, PET/CT ended up with total costs of $88,003.07 with an efficacy of 4.179, whereas CT ended up with total costs of $88,894.71 with an efficacy of 4.165. SPECT/CT ended up with total costs of $89,973.34 with an efficacy of 4.158. Therefore, the strategies CT and SPECT/CT were dominated by PET/CT in the base-case scenario. In the sensitivity analyses, PET/CT remained a cost-effective strategy. This result was due to reduced therapy costs of timely detection. The additional costs of 68Ga-DOTA-TATE PET/CT when compared to CT alone are justified in the light of potential savings in therapy costs and better outcomes.
Item Description:Im Titel sind die Zahlen 68 und 111 jeweils hochgestellt
Gesehen am 28.04.2021
Physical Description:Online Resource
ISSN:2075-4418
DOI:10.3390/diagnostics11020334

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