Supplemental 18F-FDG-PET/CT for detection of malignant transformation of IPMN: a model-based cost-effectiveness analysis

Accurate detection of malignant transformation and risk-stratification of intraductal papillary mucinous neoplasms (IPMN) has remained a diagnostic challenge. Preliminary findings have indicated a promising role of positron emission tomography combined with computed tomography and 18F-fluorodeoxyglu...

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Main Authors: Bicu, Felix (Author) , Rink, Johann (Author) , Froelich, Matthias F. (Author) , Cyran, Clemens Christian Joachim (Author) , Rübenthaler, Johannes (Author) , Birgin, Emrullah (Author) , Röhrich, Manuel (Author) , Tollens, Fabian (Author)
Format: Article (Journal)
Language:English
Published: 18 March 2021
In: Cancers
Year: 2021, Volume: 13, Issue: 6, Pages: 1-12
ISSN:2072-6694
DOI:10.3390/cancers13061365
Online Access:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.3390/cancers13061365
Verlag, lizenzpflichtig, Volltext: https://www.mdpi.com/2072-6694/13/6/1365
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Author Notes:Felix Bicu, Johann S. Rink, Matthias F. Froelich, Clemens C. Cyran, Johannes Rübenthaler, Emrullah Birgin, Manuel Röhrich and Fabian Tollens
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Summary:Accurate detection of malignant transformation and risk-stratification of intraductal papillary mucinous neoplasms (IPMN) has remained a diagnostic challenge. Preliminary findings have indicated a promising role of positron emission tomography combined with computed tomography and 18F-fluorodeoxyglucose (18F-FDG-PET/CT) in detecting malignant IPMN. Therefore, the aim of this model-based economic evaluation was to analyze whether supplemental FDG-PET/CT could be cost-effective in patients with IPMN. Decision analysis and Markov modeling were applied to simulate patients’ health states across a time frame of 15 years. CT/MRI based imaging was compared to a strategy with supplemental 18F-FDG-PET/CT. Cumulative costs in US-$ and outcomes in quality-adjusted life years (QALY) were computed based on input parameters extracted from recent literature. The stability of the model was evaluated by deterministic sensitivity analyses. In the base-case scenario, the CT/MRI-strategy resulted in cumulative discounted costs of USD $106,424 and 8.37 QALYs, while the strategy with supplemental FDG-PET/CT resulted in costs of USD $104,842 and a cumulative effectiveness of 8.48 QALYs and hence was cost-saving. A minimum specificity of FDG-PET/CT of 71.5% was required for the model to yield superior net monetary benefits compared to CT/MRI. This model-based economic evaluation indicates that supplemental 18F-FDG-PET/CT could have a favorable economic value in the management of IPMN and could be cost-saving in the chosen setting. Prospective studies with standardized protocols for FDG-PET/CT could help to better determine the value of FDG-PET/CT.
Item Description:Im Titel ist "18" hochgestellt
Gesehen am 31.05.2021
Physical Description:Online Resource
ISSN:2072-6694
DOI:10.3390/cancers13061365