(13)N-ammonia myocardial perfusion imaging with a PET/CT scanner: impact on clinical decision making and cost-effectiveness
| Autor: | Martina Knabenhans, Ines Valenta, Hatem Alkadhi, Oliver Gaemperli, Philipp A. Kaufmann, Patrick T. Siegrist, Hans Scheffel, Lars Husmann, Tobias Hoefflinghaus, Paul Stolzmann |
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| Přispěvatelé: | University of Zurich |
| Rok vydání: | 2008 |
| Předmět: |
Adult
Male medicine.medical_specialty Cost effectiveness Cost-Benefit Analysis medicine.medical_treatment Population 610 Medicine & health Coronary Artery Disease Coronary artery disease Myocardial perfusion imaging Ammonia Prevalence Humans 2741 Radiology Nuclear Medicine and Imaging Medicine Radiology Nuclear Medicine and imaging education Aged Aged 80 and over PET-CT education.field_of_study Nitrogen Isotopes medicine.diagnostic_test 10042 Clinic for Diagnostic and Interventional Radiology business.industry Percutaneous coronary intervention Health Care Costs 10181 Clinic for Nuclear Medicine General Medicine Middle Aged Decision Support Systems Clinical medicine.disease Transplantation Positron-Emission Tomography Subtraction Technique 10076 Center for Integrative Human Physiology Conventional PCI 570 Life sciences biology Female Radiology Radiopharmaceuticals Tomography X-Ray Computed business Switzerland |
| DOI: | 10.5167/uzh-3622 |
| Popis: | Purpose: The purpose of the study is to determine the impact of 13N-ammonia positron emission tomography (PET) myocardial perfusion imaging (MPI) on clinical decision making and its cost-effectiveness. Materials and methods: One hundred consecutive patients (28 women, 72 men; mean age 60.9 ± 12.0years; range 24-85years) underwent 13N-ammonia PET scanning (and computed tomography, used only for attenuation correction) to assess myocardial perfusion in patients with known (n = 79) or suspected (n = 8) coronary artery disease (CAD), or for suspected small-vessel disease (SVD; n = 13). Before PET, the referring physician was asked to determine patient treatment if PET would not be available. Four weeks later, PET patient management was reassessed for each patient individually. Results: Before PET management strategies would have been: diagnostic angiography (62 of 100 patients), diagnostic angiography and percutaneous coronary intervention (PCI; 6 of 100), coronary artery bypass grafting (CABG; 3 of 100), transplantation (1 of 100), or conservative medical treatment (28 of 100). After PET scanning, treatment strategies were altered in 78 patients leading to: diagnostic angiography (0 of 100), PCI (20 of 100), CABG (3 of 100), transplantation (1 of 100), or conservative medical treatment (76 of 100). Patient management followed the recommendations of PET findings in 97% of the cases. Cost-effectiveness analysis revealed lower costs of €206/patient as a result of PET scanning. Conclusion: In a population with a high prevalence of known CAD, PET is cost-effective and has an important impact on patient management |
| Databáze: | OpenAIRE |
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