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

Medientyp: E-Artikel

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

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

Erschienen: Soc., 2022

Sprache: Englisch

DOI: https://doi.org/10.2967/jnumed.122.263790

ISSN: 0022-3123; 1535-5667; 0097-9058; 0161-5505; 2159-662X

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Beschreibung: 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 ...

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