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

Autor: Schnitzer ML; Klinik und Poliklinik für Radiologie, Klinikum der Universität München, Ludwig-Maximilians-Universität München, Germany., Buchner J; Klinik und Poliklinik für Radiologie, Klinikum der Universität München, Ludwig-Maximilians-Universität München, Germany., Biechele G; Klinik und Poliklinik für Radiologie, Klinikum der Universität München, Ludwig-Maximilians-Universität München, Germany., Grawe F; Klinik und Poliklinik für Radiologie, Klinikum der Universität München, Ludwig-Maximilians-Universität München, Germany., Ingenerf M; Klinik und Poliklinik für Radiologie, Klinikum der Universität München, Ludwig-Maximilians-Universität München, Germany., von Münchhausen N; Klinik für Radiologie und Nuklearmedizin, Universitätsmedizin Mannheim, Medizinische Fakultät der Universität Heidelberg, Germanyv., Kaiser CG; Klinik für Radiologie und Nuklearmedizin, Universitätsmedizin Mannheim, Medizinische Fakultät der Universität Heidelberg, Germanyv., Kunz WG; Klinik und Poliklinik für Radiologie, Klinikum der Universität München, Ludwig-Maximilians-Universität München, Germany., Froelich MF; Klinik für Radiologie und Nuklearmedizin, Universitätsmedizin Mannheim, Medizinische Fakultät der Universität Heidelberg, Germanyv., Schmid-Tannwald C; Klinik und Poliklinik für Radiologie, Klinikum der Universität München, Ludwig-Maximilians-Universität München, Germany., Rübenthaler J; Klinik und Poliklinik für Radiologie, Klinikum der Universität München, Ludwig-Maximilians-Universität München, Germany. Electronic address: johannes.ruebenthaler@med.uni-muenchen.de.
Jazyk: angličtina
Zdroj: European journal of radiology [Eur J Radiol] 2023 Jun; Vol. 163, pp. 110803. Date of Electronic Publication: 2023 Mar 30.
DOI: 10.1016/j.ejrad.2023.110803
Abstrakt: Objectives: Colorectal cancers (CRC) are among the world's most prevailing cancer entities. In a third of all cases, the patients have already developed distant metastases - mainly in the liver - at the time of detection. Colorectal liver metastases (CRLM) can be treated by surgical resection or, as is possible in most cases, by percutaneous ablation. For selecting the liver metastases eligible for radiofrequency ablation (RFA) or microwave ablation (MWA), the common imaging modalities are magnetic resonance imaging (MRI), positron emission tomography/computed tomography (PET/CT), and contrast-enhanced computed tomography (CE-CT). This study aims to evaluate those imaging modalities for selecting liver lesions eligible for ablation according to their long-term cost-effectiveness.
Materials and Methods: A Markov model was applied, calculating quality-adjusted life years (QALYs) and accumulative costs for every diagnostic strategy, according to predefined input parameters obtained from published research. Further, sensitivity analyses were executed to prove the certainty of the calculations by running Monte-Carlo simulations with 30,000 reiterations. The Willingness-to-pay (WTP) is at $ 100,000. All calculations are based on the U.S. healthcare system.
Results: CE-CT caused cumulative costs of $ 31,940.98 and 8,99 QALYs, whereas MRI caused $ 32,070.83 and 9,01 QALYs. PET/CT caused cumulative costs of $ 33,013.21 and 8,99 QALYs.
Conclusion: In conclusion, according to our analysis, MRI is the most cost-effective strategy for detecting liver metastases eligible for ablation and therefore should be seen as the gold standard.
Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2023. Published by Elsevier B.V.)
Databáze: MEDLINE
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