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@ARTICLE{Heinzel:137550,
      author       = {Heinzel, A. and Müller, Dirk and Langen, Karl-Josef and
                      Blaum, Marcus and Verburg, Frederik Anton and Mottaghy,
                      Felix M and Galldiks, Norbert},
      title        = {{T}he {U}se of {O}-(2-18{F}-{F}luoroethyl)-{L}-{T}yrosine
                      {PET} for {T}reatment {M}anagement of {B}evacizumab and
                      {I}rinotecan in {P}atients with {R}ecurrent {H}igh-{G}rade
                      {G}lioma: {A} {C}ost-{E}ffectiveness {A}nalysis.},
      journal      = {Journal of nuclear medicine},
      volume       = {54},
      number       = {8},
      issn         = {0161-5505},
      address      = {Reston, Va.},
      publisher    = {SNM84042},
      reportid     = {FZJ-2013-03983},
      pages        = {1217-1222},
      year         = {2013},
      abstract     = {To 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.},
      cin          = {INM-3 / INM-4},
      ddc          = {610},
      cid          = {I:(DE-Juel1)INM-3-20090406 / I:(DE-Juel1)INM-4-20090406},
      pnm          = {332 - Imaging the Living Brain (POF2-332)},
      pid          = {G:(DE-HGF)POF2-332},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:23785172},
      UT           = {WOS:000322692400026},
      doi          = {10.2967/jnumed.113.120089},
      url          = {https://juser.fz-juelich.de/record/137550},
}