Cost analysis of next-generation imaging in high-risk prostate cancer staging.

Autor: Szczesniewski JJ; Servicio de Urología, Hospital Universitario de Getafe, Getafe, Madrid, Spain; Departamento de Cirugía, Facultad de Medicina, Universidad de Salamanca, Salamanca, Spain., Tellez Fouz C; Servicio de Urología, Hospital Universitario de Getafe, Getafe, Madrid, Spain., García Tello A; Servicio de Urología, Hospital Universitario de Getafe, Getafe, Madrid, Spain., de la Rubia Marcos M; Servicio de Medicina Nuclear, Hospital Universitario de Getafe, Getafe, Madrid, Spain., García Alonso MP; Servicio de Medicina Nuclear, Hospital Universitario de Getafe, Getafe, Madrid, Spain., Llanes González L; Servicio de Urología, Hospital Universitario de Getafe, Getafe, Madrid, Spain; Universidad Francisco de Vitoria, Madrid, Spain. Electronic address: luis.llanes@salud.madrid.org.
Jazyk: English; Spanish; Castilian
Zdroj: Actas urologicas espanolas [Actas Urol Esp (Engl Ed)] 2024 May; Vol. 48 (4), pp. 328-334. Date of Electronic Publication: 2023 Dec 29.
DOI: 10.1016/j.acuroe.2023.12.003
Abstrakt: Introduction and Objective: Next-generation imaging (NGI) tests, such as choline PET/CT and PSMA PET, have shown to increase sensitivity in the detection of nodal and metastatic disease in prostate cancer. However, their use implies an increase in diagnostic costs compared to conventional imaging (CI) tests such as CT and bone scan. The aim of our study was to determine which diagnostic pathway is more cost-effective in high-risk prostate cancer.
Material and Method: Cost-effectiveness analysis of the available imaging tests (CI, Choline/PSMA PET) for the staging of high-risk prostate cancer. Sensitivity and specificity were estimated based on published evidence, and costs were collected from the Management Department. In order to carry out a cost-effectiveness analysis, five diagnostic pathways were proposed estimating the accurate diagnoses.
Results: PSMA PET was the most accurate diagnostic option. The CI diagnostic workup was the most economical and CI+PSMA the most expensive. Analyzing the diagnostic cost-effectiveness ratio, CI+PSMA proved to be the most expensive (€5627.30 per correct diagnosis) followed by PET PSMA (€4987.11), choline (€4599.84) and CI (€4444.22).
Conclusions: PSMA PET is the most accurate strategy in staging distant disease in patients with high-risk prostate cancer. Radiotracer uptake tests such as CI have been shown to be the most cost-effective option, followed by choline and PSMA.
(Copyright © 2024 AEU. Published by Elsevier España, S.L.U. All rights reserved.)
Databáze: MEDLINE
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