Journal Article

FZJ-2022-03685

http://join2-wiki.gsi.de/foswiki/pub/Main/Artwork/join2_logo100x88.png Cost-effectiveness of 18 F-FET PET for early treatment response assessment in glioma patients following adjuvant temozolomide chemotherapy

Rosen, J. ; Ceccon, G. ; Bauer, E. K. ; Werner, J. M. ; Tscherpel, C. ; Dunkl, V. ; Rapp, M. ; Sabel, M. ; Herrlinger, U. ; Heinzel, A.FZJ* ; Schaefer, N. ; Ruge, M. ; Goldbrunner, R. ; Stoffels, G.FZJ* ; Kabbasch, C. ; Fink, G. R.FZJ* ; Langen, K.-J.FZJ* ; Galldiks, N. (Corresponding author)FZJ*

2022
Soc. New York, NY

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Please use a persistent id in citations: http://hdl.handle.net/2128/32775  doi:10.2967/jnumed.122.263790

Abstract: Rationale: In light of increasing healthcare costs, higher medical expenses should be justified socio-economically. Therefore, we calculated the effectiveness and cost-effectiveness of positron emission tomography (PET) using the radiolabeled amino acid O-(2-[18F]-fluoroethyl)-L-tyrosine (18F-FET) compared to conventional magnetic resonance imaging (MRI) for early identification of responders to adjuvant temozolomide chemotherapy. A recently published study in isocitrate dehydrogenase-wildtype glioma patients suggested that 18F-FET PET parameter changes predicted a significantly longer survival already after two cycles while MRI changes were not significant. Methods: To determine the effectiveness and cost-effectiveness of serial 18F-FET PET imaging, we analyzed published clinical data and calculated the associated costs from the perspective of the German Statutory Health Insurance system. Based on a decision-tree model, the effectiveness of 18F-FET PET and MRI was calculated, i.e., the probability to correctly identify a responder as defined by an overall survival ≥15 months. To determine the cost-effectiveness, the incremental cost-effectiveness ratio (ICER) was calculated, i.e., the cost for each additionally identified responder by 18F-FET PET who would have remained undetected by MRI. The robustness of the results was tested by deterministic and probabilistic Monte Carlo sensitivity analyses. Results: Compared to MRI, 18F-FET PET increased the rate of correctly identified responders to chemotherapy by 26%; thus, four patients needed to be examined by 18F-FET PET to identify one additional responder. Considering the respective cost for serial 18F-FET PET and MRI, the ICER resulted in €4,396.83 for each additional correctly identified responder by 18F-FET PET. Sensitivity analyses confirmed the robustness of the results. Conclusion: In contrast to conventional MRI, the model suggests that 18F-FET PET is cost-effective in terms of ICER values. Considering the high cost of temozolomide, the integration of 18F-FET PET has the potential to avoid premature chemotherapy discontinuation at reasonable cost.

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Contributing Institute(s):

1. Physik der Medizinischen Bildgebung (INM-4)
2. Kognitive Neurowissenschaften (INM-3)

Research Program(s):

1. 5253 - Neuroimaging (POF4-525) (POF4-525)

Appears in the scientific report 2022

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Database coverage:
; ; BIOSIS Previews ; Biological Abstracts ; Clarivate Analytics Master Journal List ; Current Contents - Clinical Medicine ; Current Contents - Life Sciences ; Essential Science Indicators ; IF >= 10 ; JCR ; SCOPUS ; Science Citation Index Expanded ; Web of Science Core Collection

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