RT Journal Article
SR Electronic
T1 Is Long–Axial-Field-of-View PET/CT Cost-Effective? An International Health–Economic Analysis
JF Journal of Nuclear Medicine
JO J Nucl Med
FD Society of Nuclear Medicine
SP jnumed.124.269203
DO 10.2967/jnumed.124.269203
A1 Alberts, Ian
A1 More, Stuart
A1 Knapp, Karen
A1 Mei, Riccardo
A1 Fanti, Stefano
A1 Mingels, Clemens
A1 Nardo, Lorenzo
A1 Hammond, Nii Boye
A1 Nagaraj, Harish
A1 Rominger, Axel
A1 Cook, Gary J.R.
A1 Wilson, Don
YR 2025
UL http://jnm.snmjournals.org/content/early/2025/04/17/jnumed.124.269203.abstract
AB Our aim is to assess the cost-effectiveness of long–axial-field-of-view (LAFOV) versus short–axial FOV (SAFOV) PET/CT systems using international data. Methods: Our model compares equipment and operational costs for a PET/CT center and investigates the effect of camera choice (SAFOV vs. LAFOV) and operational models. Variables include scanner, personnel, radiopharmaceuticals, and operational costs. Economic performance was measured as cost per scan per patient, the total maximum number of scans possible, and the incremental cost-effectiveness ratio. The willingness-to-pay threshold (WTPT) was taken as the cost of a PET/CT scan using the baseline scenario. Radiopharmaceutical requirements, radiation dose to staff and patients, and patient time were modeled. Results: An LAFOV system can examine as many patients per day (n = 36) as 2 SAFOV systems but requires fewer technologists (4.5 LAFOV vs. 6.8 SAFOV full-time equivalents) and lower activity (12.5 vs. 35.6 GBq/d), resulting in lower personnel doses (0.9 vs. 2.0 mSv/y). For all countries, LAFOV resulted in lowest per-patient scan costs. The most cost-ineffective method was the use of extended hours. Incremental cost-effectiveness ratio analysis strongly favored LAFOV for all countries, including low-income economies, with WTPT met for all jurisdictions. Net monetary benefit was highest for LAFOV. The minimum number of patients needed to meet WTPT for LAFOV was lowest in lower-income countries, suggesting that high throughput or high per-procedure income is not a prerequisite for cost-effective LAFOV usage. Conclusion: LAFOV was shown to facilitate higher patient throughput at lower per-patient and total lifetime operational costs and with lower radiopharmaceutical requirements. These data suggest that LAFOV systems are not just suited to well-resourced academic centers but also are an economically attractive solution for community and resource-limited settings.