Comparative accuracy and cost-effectiveness of dynamic contrast-enhanced CT and positron emission tomography in the characterisation of solitary pulmonary nodules
| Autor: | Gilbert, Fiona J., Harris, Scott, Miles, K.A., Weir-McCall, Jonathan, Qureshi, N.R., Rintoul, R.C., Dizdarevic, S., Pike, L, Sinclair, Donald, Shah, Andrew, Eaton, Rosemary, Jones, Jeremy, Clegg, A.J., Vitiello, Benedetto, Hill, James, Cook, Andrew, Tzelis, D, Vale, Luke, Brindle, Lucy, Madden, J., Cozens, Kelly, Little, LA, Eichhorst, Kathrin, Moate, P., McClement, C., Peebles, Charles, Bannerjee, A, Han, S., Poon, F.W., Groves, A.M., Kurban, L., Roderick, Paul, Frew, Anthony, Callister, Matthew, Crosbie, P., Gleeson, F.V., Karunasaagarar, K, Kankam, O., George, Steve |
|---|---|
| Přispěvatelé: | Gilbert, Fiona J [0000-0002-0124-9962], Weir-McCall, Jonathan R [0000-0001-5842-842X], Rintoul, Robert Campbell [0000-0003-3875-3780], Crosbie, Phil A [0000-0001-8941-4813], Apollo - University of Cambridge Repository |
| Rok vydání: | 2021 |
| Předmět: |
Male
Pulmonary and Respiratory Medicine Lung Neoplasms Manchester Cancer Research Centre ResearchInstitutes_Networks_Beacons/mcrc Cost-Benefit Analysis Solitary Pulmonary Nodule imaging/CT MRI etc A300 Sensitivity and Specificity lung cancer Fluorodeoxyglucose F18 Positron Emission Tomography Computed Tomography Positron-Emission Tomography Humans Female Prospective Studies Radiopharmaceuticals Tomography X-Ray Computed |
| Zdroj: | Gilbert, F J, Harris, S, Miles, K A, Weir-McCall, J R, Qureshi, N R, Rintoul, R C, Dizdarevic, S, Pike, L, Sinclair, D, Shah, A, Eaton, R, Jones, J, Clegg, A, Benedetto, V, Hill, J, Cook, A, Tzelis, D, Vale, L, Brindle, L, Madden, J, Cozens, K, Little, L, Eichhorst, K, Moate, P, McClement, C, Peebles, C, Banerjee, A, Han, S, Poon, F-W, Groves, A M, Kurban, L, Frew, A, Callister, M E J, Crosbie, P A, Gleeson, F V, Karunasaagarar, K, Kankam, O & George, S 2021, ' Comparative accuracy and cost-effectiveness of dynamic contrast-enhanced CT and positron emission tomography in the characterisation of solitary pulmonary nodules ', Thorax, pp. thoraxjnl-2021-216948 . https://doi.org/10.1136/thoraxjnl-2021-216948 |
| ISSN: | 1468-3296 0040-6376 |
| Popis: | Introduction Dynamic contrast-enhanced CT (DCE-CT) and positron emission tomography/CT (PET/CT) have a high reported accuracy for the diagnosis of malignancy in solitary pulmonary nodules (SPNs). The aim of this study was to compare the accuracy and cost-effectiveness of these. Methods In this prospective multicentre trial, 380 participants with an SPN (8–30 mm) and no recent history of malignancy underwent DCE-CT and PET/CT. All patients underwent either biopsy with histological diagnosis or completed CT follow-up. Primary outcome measures were sensitivity, specificity and overall diagnostic accuracy for PET/CT and DCE-CT. Costs and cost-effectiveness were estimated from a healthcare provider perspective using a decision-model. Results 312 participants (47% female, 68.1±9.0 years) completed the study, with 61% rate of malignancy at 2 years. The sensitivity, specificity, positive predictive value and negative predictive values for DCE-CT were 95.3% (95% CI 91.3 to 97.5), 29.8% (95% CI 22.3 to 38.4), 68.2% (95% CI 62.4% to 73.5%) and 80.0% (95% CI 66.2 to 89.1), respectively, and for PET/CT were 79.1% (95% CI 72.7 to 84.2), 81.8% (95% CI 74.0 to 87.7), 87.3% (95% CI 81.5 to 91.5) and 71.2% (95% CI 63.2 to 78.1). The area under the receiver operator characteristic curve (AUROC) for DCE-CT and PET/CT was 0.62 (95% CI 0.58 to 0.67) and 0.80 (95% CI 0.76 to 0.85), respectively (p Conclusions PET/CT has a superior diagnostic accuracy to DCE-CT for the diagnosis of SPNs. Combining both techniques improves the diagnostic accuracy over either test alone and could be cost-effective. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|