Universität zu Köln

Rosen, Jurij, Ceccon, Garry, Bauer, Elena K., Werner, Jan-Michael ORCID: 0000-0001-7147-4594, Tscherpel, Caroline, Dunkl, Veronika ORCID: 0000-0001-6885-7666, Rapp, Marion, Sabel, Michael ORCID: 0009-0000-1485-7820, Herrlinger, Ulrich, Heinzel, Alexander, Schaefer, Niklas, Ruge, Maximilian, Goldbrunner, Roland, Stoffels, Gabriele, Kabbasch, Christoph, Fink, Gereon R., Langen, Karl-Josef and Galldiks, Norbert (2022). Cost Effectiveness of F-18-FET PET for Early Treatment Response Assessment in Glioma Patients After Adjuvant Temozolomide Chemotherapy. J. Nucl. Med., 63 (11). S. 1677 - 1683. RESTON: SOC NUCLEAR MEDICINE INC. ISSN 1535-5667

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Abstract

In light of increasing health-care costs, higher medical expenses should be justified socioeconomically. Therefore, we calculated the effectiveness and cost effectiveness of PET using the radiolabeled amino acid O-(2-18F-fluoroethyl)-L-tyrosine (F-18-FET) compared with conventional MRI for early identification of responders to adjuvant temozolomide chemotherapy. A recently published study in isocitrate dehydrogenase wild-type glioma patients suggested that F-18-FET PET parameter changes predicted a significantly longer survival already after 2 cycles whereasMRI changes were not significant. Methods: To determine the effectiveness and cost effectiveness of serial F-18-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 F-18-FET PET and MRI was calculated-that is, the probability to correctly identify a responder as defined by an overall survival of at least 15 mo. To determine the cost effectiveness, the incremental cost effectiveness ratio (ICER) was calculated-that is, the cost for each additionally identified responder by F-18-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 with MRI, F-18-FET PET increased the rate of correctly identified responders to chemotherapy by 26%; thus, 4 patients needed to be examined by F-18-FET PET to identify 1 additional responder. Considering the respective costs for serial F-18-FET PET and MRI, the ICER resulted in (sic)4,396.83 for each additional correctly identified responder by F-18-FET PET. Sensitivity analyses confirmed the robustness of the results. Conclusion: In contrast to conventional MRI, the model suggests that F-18-FET PET is cost-effective in terms of ICER values. Considering the high cost of temozolomide, the integration of F-18-FET PET has the potential to avoid premature chemotherapy discontinuation at reasonable cost.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Rosen, Jurij UNSPECIFIED UNSPECIFIED UNSPECIFIED Ceccon, Garry UNSPECIFIED UNSPECIFIED UNSPECIFIED Bauer, Elena K. UNSPECIFIED UNSPECIFIED UNSPECIFIED Werner, Jan-Michael UNSPECIFIED orcid.org/0000-0001-7147-4594 UNSPECIFIED Tscherpel, Caroline UNSPECIFIED UNSPECIFIED UNSPECIFIED Dunkl, Veronika UNSPECIFIED orcid.org/0000-0001-6885-7666 UNSPECIFIED Rapp, Marion UNSPECIFIED UNSPECIFIED UNSPECIFIED Sabel, Michael UNSPECIFIED orcid.org/0009-0000-1485-7820 UNSPECIFIED Herrlinger, Ulrich UNSPECIFIED UNSPECIFIED UNSPECIFIED Heinzel, Alexander UNSPECIFIED UNSPECIFIED UNSPECIFIED Schaefer, Niklas UNSPECIFIED UNSPECIFIED UNSPECIFIED Ruge, Maximilian UNSPECIFIED UNSPECIFIED UNSPECIFIED Goldbrunner, Roland UNSPECIFIED UNSPECIFIED UNSPECIFIED Stoffels, Gabriele UNSPECIFIED UNSPECIFIED UNSPECIFIED Kabbasch, Christoph UNSPECIFIED UNSPECIFIED UNSPECIFIED Fink, Gereon R. UNSPECIFIED UNSPECIFIED UNSPECIFIED Langen, Karl-Josef UNSPECIFIED UNSPECIFIED UNSPECIFIED Galldiks, Norbert UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-687463
DOI:	10.2967/jnumed.122.263790
Journal or Publication Title:	J. Nucl. Med.
Volume:	63
Number:	11
Page Range:	S. 1677 - 1683
Date:	2022
Publisher:	SOC NUCLEAR MEDICINE INC
Place of Publication:	RESTON
ISSN:	1535-5667
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language AMINO-ACID PET; O-(2-F-18-FLUOROETHYL)-L-TYROSINE PET; CONVENTIONAL MRI; GLIOBLASTOMA; BRAIN; PSEUDOPROGRESSION; RADIOTHERAPY; THERAPY Multiple languages Radiology, Nuclear Medicine & Medical Imaging Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/68746