18F FDG PET/MRI with hepatocyte-specific contrast agent for M staging of rectal cancer: a primary economic evaluation

Gassert FG, Rubenthaler J, Cyran CC, Rink JS, Schwarze V, Luitjens J, Gassert FT, Makowski MR, Schoenberg SO, Mayerhoefer ME, Tamandl D, Froelich MF (2021)


Publication Type: Journal article

Publication year: 2021

Journal

Book Volume: 48

Pages Range: 3268-3276

Journal Issue: 10

DOI: 10.1007/s00259-021-05193-7

Abstract

Purpose: Rectal cancer is one of the most frequent causes of cancer-related morbidity and mortality in the world. Correct identification of the TNM state in primary staging of rectal cancer has critical implications on patient management. Initial evaluations revealed a high sensitivity and specificity for whole-body PET/MRI in the detection of metastases allowing for metastasis-directed therapy regimens. Nevertheless, its cost-effectiveness compared with that of standard-of-care imaging (SCI) using pelvic MRI + chest and abdominopelvic CT is yet to be investigated. Therefore, the aim of this study was to analyze the cost-effectiveness of whole-body 18F FDG PET/MRI as an alternative imaging method to standard diagnostic workup for initial staging of rectal cancer. Methods: For estimation of quality-adjusted life years (QALYs) and lifetime costs of diagnostic modalities, a decision model including whole-body 18F FDG PET/MRI with a hepatocyte-specific contrast agent and pelvic MRI + chest and abdominopelvic CT was created based on Markov simulations. For obtaining model input parameters, review of recent literature was performed. Willingness to pay (WTP) was set to $100,000/QALY. Deterministic sensitivity analysis of diagnostic parameters and costs was applied, and probabilistic sensitivity was determined using Monte Carlo modeling. Results: In the base-case scenario, the strategy whole-body 18F FDG PET/MRI resulted in total costs of $52,186 whereas total costs of SCI were at $51,672. Whole-body 18F FDG PET/MRI resulted in an expected effectiveness of 3.542 QALYs versus 3.535 QALYs for SCI. This resulted in an incremental cost-effectiveness ratio of $70,291 per QALY for PET/MRI. Thus, from an economic point of view, whole-body 18F FDG PET/MRI was identified as an adequate diagnostic alternative to SCI with high robustness of results to variation of input parameters. Conclusion: Based on the results of the analysis, use of whole-body 18F FDG PET/MRI was identified as a feasible diagnostic strategy for initial staging of rectal cancer from a cost-effectiveness perspective.

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How to cite

APA:

Gassert, F.G., Rubenthaler, J., Cyran, C.C., Rink, J.S., Schwarze, V., Luitjens, J.,... Froelich, M.F. (2021). 18F FDG PET/MRI with hepatocyte-specific contrast agent for M staging of rectal cancer: a primary economic evaluation. European Journal of Nuclear Medicine and Molecular Imaging, 48(10), 3268-3276. https://doi.org/10.1007/s00259-021-05193-7

MLA:

Gassert, Felix G., et al. "18F FDG PET/MRI with hepatocyte-specific contrast agent for M staging of rectal cancer: a primary economic evaluation." European Journal of Nuclear Medicine and Molecular Imaging 48.10 (2021): 3268-3276.

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