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000137550 1001_ $$0P:(DE-Juel1)132315$$aHeinzel, A.$$b0$$eCorresponding author$$ufzj
000137550 245__ $$aThe Use of O-(2-18F-Fluoroethyl)-L-Tyrosine PET for Treatment Management of Bevacizumab and Irinotecan in Patients with Recurrent High-Grade Glioma: A Cost-Effectiveness Analysis.
000137550 260__ $$aReston, Va.$$bSNM84042$$c2013
000137550 264_1 $$2Crossref$$3online$$bSociety of Nuclear Medicine$$c2013-06-19
000137550 264_1 $$2Crossref$$3print$$bSociety of Nuclear Medicine$$c2013-08-01
000137550 264_1 $$2Crossref$$3print$$bSociety of Nuclear Medicine$$c2013-08-01
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000137550 520__ $$aTo date, the use of structural MR imaging (including contrast-enhanced and T2-weighted or fluid-attenuated inversion recovery-weighted images) is the standard method to diagnose tumor progression and to assess antiangiogenic treatment effects. However, several studies have suggested that O-(2-(18)F-fluoroethyl)-l-tyrosine ((18)F-FET) PET adds valuable clinical information to the information derived from structural MR imaging alone. We evaluated the effectiveness and cost-effectiveness of the addition of (18)F-FET PET to structural MR imaging for the management of treatment with bevacizumab and irinotecan (BEV/IR) in patients with recurrent high-grade glioma compared with MR imaging alone from the perspective of the German Statutory Health Insurance.To evaluate the incremental cost-effectiveness of the additional use of (18)F-FET PET, a decision tree model was used. Effectiveness of (18)F-FET PET was defined as correct identification of both tumor progression before BEV/IR treatment initiation and BEV/IR treatment response and was evaluated for the combination of (18)F-FET PET and MR imaging compared with MR imaging alone. Costs were estimated for a baseline scenario and for a more expensive scenario. The robustness of the results was tested using deterministic and probabilistic sensitivity analyses.The use of (18)F-FET PET resulted in a number needed to diagnose of 2.4, that is, 3 additional patients have to be diagnosed to avoid 1 wrong diagnosis. The incremental cost-effectiveness ratio of (18)F-FET PET/MR imaging compared with MR imaging alone was €5,725 (€1 ≈ $1.30) for the baseline scenario and €8,145 for the more expensive scenario per additional correct diagnosis. The probabilistic sensitivity analysis confirmed the robustness of the results.The model suggests that the additional use of (18)F-FET PET in the management of patients with recurrent high-grade glioma treated with BEV/IR may be cost-effective. Integration of (18)F-FET PET has the potential to avoid overtreatment and corresponding costs, as well as unnecessary side effects to the patient.
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000137550 7001_ $$0P:(DE-HGF)0$$aMüller, Dirk$$b1
000137550 7001_ $$0P:(DE-Juel1)131777$$aLangen, Karl-Josef$$b2$$ufzj
000137550 7001_ $$0P:(DE-HGF)0$$aBlaum, Marcus$$b3
000137550 7001_ $$0P:(DE-HGF)0$$aVerburg, Frederik Anton$$b4
000137550 7001_ $$0P:(DE-Juel1)132318$$aMottaghy, Felix M$$b5$$ufzj
000137550 7001_ $$0P:(DE-Juel1)143792$$aGalldiks, Norbert$$b6$$ufzj
000137550 77318 $$2Crossref$$3journal-article$$a10.2967/jnumed.113.120089$$b : Society of Nuclear Medicine, 2013-06-19$$n8$$p1217-1222$$tJournal of Nuclear Medicine$$v54$$x0161-5505$$y2013
000137550 773__ $$0PERI:(DE-600)2040222-3$$a10.2967/jnumed.113.120089$$gVol. 54, no. 8, p. 1217 - 1222$$n8$$p1217-1222$$tJournal of nuclear medicine$$v54$$x0161-5505$$y2013
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