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Rosen, Jurij [Author]; Ceccon, Garry [Author]; Schaefer, Niklas [Author]; Ruge, Maximilian [Author]; Goldbrunner, Roland [Author]; Stoffels, Gabriele [Author]; Kabbasch, Christoph [Author]; Fink, Gereon Rudolf [Author]; Langen, Karl-Josef [Author]; Galldiks, Norbert [Author]; Bauer, Elena Katharina [Author]; Werner, Jan Michael [Author]; Tscherpel, Caroline [Author]; Dunkl, Veronika [Author]; Rapp, Marion [Author]; Sabel, Michael [Author]; Herrlinger, Ulrich [Author]; Heinzel, Alexander [Author]

Cost-effectiveness of 18 F-FET PET for early treatment response assessment in glioma patients following adjuvant temozolomide chemotherapy

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  • Media type: E-Article
  • Title: Cost-effectiveness of 18 F-FET PET for early treatment response assessment in glioma patients following adjuvant temozolomide chemotherapy
  • Contributor: Rosen, Jurij [Author]; Ceccon, Garry [Author]; Schaefer, Niklas [Author]; Ruge, Maximilian [Author]; Goldbrunner, Roland [Author]; Stoffels, Gabriele [Author]; Kabbasch, Christoph [Author]; Fink, Gereon Rudolf [Author]; Langen, Karl-Josef [Author]; Galldiks, Norbert [Author]; Bauer, Elena Katharina [Author]; Werner, Jan Michael [Author]; Tscherpel, Caroline [Author]; Dunkl, Veronika [Author]; Rapp, Marion [Author]; Sabel, Michael [Author]; Herrlinger, Ulrich [Author]; Heinzel, Alexander [Author]
  • Published: Soc., 2022
  • Published in: Journal of nuclear medicine 63(10), 1677-1682 (2022). doi:10.2967/jnumed.122.263790
  • Language: English
  • DOI: https://doi.org/10.2967/jnumed.122.263790
  • ISSN: 0022-3123; 1535-5667; 0097-9058; 0161-5505; 2159-662X
  • Origination:
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  • Description: 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 ...
  • Access State: Open Access