Universität zu Köln

Rosen, Jurij ORCID: 0000-0003-4469-6962, Werner, Jan-Michael ORCID: 0000-0001-7147-4594, Ceccon, Garry S. ORCID: 0009-0007-0510-4457, Rosen, Elena K., Wollring, Michael M. ORCID: 0000-0003-2177-6708, Stetter, Isabelle ORCID: 0009-0007-1732-5759, Lohmann, Philipp ORCID: 0000-0002-5360-046X, Mottaghy, Felix M. ORCID: 0000-0002-7212-6521, Marner, Lisbeth, Law, Ian, Fink, Gereon R. ORCID: 0000-0002-8230-1856, Langen, Karl-Josef ORCID: 0000-0003-1101-5075 and Galldiks, Norbert ORCID: 0000-0002-2485-1796 (2025). Diagnosis of treatment-related changes in children and adolescents with brain and spinal tumors: a cost-effectiveness analysis using MRI and [18 F]FET PET. European Journal of Nuclear Medicine and Molecular Imaging, 52 (12). pp. 4616-4626. Springer Nature. ISSN 1619-7070

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Abstract

Purpose: PET using the radiolabeled amino acid O -(2-[ 18 F]-fluoroethyl)-L-tyrosine ([ 18 F]FET) has considerable clinical value for follow-up evaluation of central nervous system tumors in children and adolescents. As medical procedures must be justified socio-economically, we determined cost-effectiveness of [ 18 F]FET PET for identification of treatment-related changes. Methods: We analyzed clinical data from two different studies that assessed the value of FET PET to differentiate between brain and spinal tumor relapse and treatment-related changes in children and adolescents. Cost calculation was based on the German statutory health insurance system perspective. Due to subtle differences in the diagnostic approach of the studies, two separate clinical scenarios including 80 patients with 105 lesions were considered: Decision tree model 1 determined cost-effectiveness of simultaneous [ 18 F]FET PET and MRI in comparison to MRI alone to identify treatment-related changes. Decision tree model 2 determined cost-effectiveness of [ 18 F]FET PET alone to identify treatment-related changes when routine MRI findings were suspicious for tumor relapse. Deterministic and probabilistic sensitivity analyses tested the robustness of the results. Results: Model 1 revealed that the rate of identified treatment-related changes increased by 52% when adding [ 18 F]FET PET to MRI, resulting in costs of €3,314.51 for each additional correctly identified lesion with treatment-related changes by [ 18 F]FET PET that MRI would have misclassified. Model 2 revealed that [ 18 F]FET PET correctly identified treatment-related changes in 90% of lesions when routine MRI findings were suspicious for tumor relapse, resulting in costs of €1,740.37 for each lesion. Conclusion: Integrating [ 18 F]FET PET in the follow-up of in children and adolescents with brain and spinal tumor may help improving patient care at acceptable costs.

Item Type:	Article
Creators:	Creators Email ORCID ORCID Put Code Rosen, Jurij UNSPECIFIED https://orcid.org/0000-0003-4469-6962 UNSPECIFIED Werner, Jan-Michael UNSPECIFIED https://orcid.org/0000-0001-7147-4594 UNSPECIFIED Ceccon, Garry S. UNSPECIFIED https://orcid.org/0009-0007-0510-4457 UNSPECIFIED Rosen, Elena K. UNSPECIFIED UNSPECIFIED UNSPECIFIED Wollring, Michael M. UNSPECIFIED https://orcid.org/0000-0003-2177-6708 UNSPECIFIED Stetter, Isabelle UNSPECIFIED https://orcid.org/0009-0007-1732-5759 UNSPECIFIED Lohmann, Philipp UNSPECIFIED https://orcid.org/0000-0002-5360-046X UNSPECIFIED Mottaghy, Felix M. UNSPECIFIED https://orcid.org/0000-0002-7212-6521 UNSPECIFIED Marner, Lisbeth UNSPECIFIED UNSPECIFIED UNSPECIFIED Law, Ian UNSPECIFIED UNSPECIFIED UNSPECIFIED Fink, Gereon R. UNSPECIFIED https://orcid.org/0000-0002-8230-1856 UNSPECIFIED Langen, Karl-Josef UNSPECIFIED https://orcid.org/0000-0003-1101-5075 UNSPECIFIED Galldiks, Norbert UNSPECIFIED https://orcid.org/0000-0002-2485-1796 UNSPECIFIED
URN:	urn:nbn:de:hbz:38-802399
Identification Number:	10.1007/s00259-025-07377-x
Journal or Publication Title:	European Journal of Nuclear Medicine and Molecular Imaging
Volume:	52
Number:	12
Page Range:	pp. 4616-4626
Number of Pages:	11
Date:	4 October 2025
Publisher:	Springer Nature
ISSN:	1619-7070
Language:	English
Faculty:	External institution Faculty of Medicine
Divisions:	Außeruniversitäre Forschungseinrichtungen > Forschungszentrum Jülich Faculty of Medicine > Neurologie > Klinik und Poliklinik für Neurologie Faculty of Medicine > Psychiatrie und Psychotherapie > Klinik und Poliklinik für Psychiatrie und Psychotherapie Faculty of Medicine > Weitere > Centrum für integrierte Onkologie (CIO)
Subjects:	Medical sciences Medicine
Uncontrolled Keywords:	Keywords Language Amino acid PET ; Economic evaluation ; Treatment monitoring ; Tumor relapse English
['eprint_fieldname_oa_funders' not defined]:	Publikationsfonds UzK
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/80239