PT  - JOURNAL ARTICLE
AU  - Jonas Schreyögg
AU  - Julia Weller
AU  - Tom Stargardt
AU  - Ken Herrmann
AU  - Christina Bluemel
AU  - Tobias Dechow
AU  - Gerhard Glatting
AU  - Bernd J. Krause
AU  - Felix Mottaghy
AU  - Sven N. Reske
AU  - Andreas K. Buck
TI  - Cost-Effectiveness of Hybrid PET/CT for Staging of Non–Small Cell Lung Cancer
AID  - 10.2967/jnumed.109.072090
DP  - 2010 Nov 01
TA  - Journal of Nuclear Medicine
PG  - 1668--1675
VI  - 51
IP  - 11
4099  - http://jnm.snmjournals.org/content/51/11/1668.short
4100  - http://jnm.snmjournals.org/content/51/11/1668.full
SO  - J Nucl Med2010 Nov 01; 51
AB  - Although the diagnostic effectiveness of integrated PET/CT for staging of non–small cell lung cancer (NSCLC) has already been proven, it remains to be determined if tumor staging with combined metabolic and anatomic imaging is also cost-effective. The objective of this study was to evaluate from a payers’ perspective the cost-effectiveness of staging NSCLC with CT alone (representing the mainstay diagnostic test) and with integrated PET/CT. Methods: The study is based on 172 NSCLC patients from a prospective clinical study who underwent diagnostic, contrast-enhanced helical CT and integrated PET/CT. Imaging was performed at the University Hospital Ulm between May 2002 and December 2004. To calculate treatment costs, we differentiated among cost for diagnosis, cost for nonsurgical treatment according to the clinical diagnosis, and cost for surgical procedures according to the clinical tumor stage. Results: The diagnostic effectiveness in terms of correct TNM staging was 40% (31/77) for CT alone and 60% (46/77) for PET/CT. For the assessment of resectability (tumor stages Ia–IIIa vs. IIIb–IV), 65 of 77 patients (84%) were staged correctly by PET/CT (CT alone, 70% [54/77]). The incremental cost-effectiveness ratios per correctly staged patient were $3,508 for PET/CT versus CT alone. The incremental cost-effectiveness ratios per quality-adjusted life year gained were $79,878 for PET/CT vs. CT alone, decreasing to $69,563 assuming a reduced loss of utility (0.10 quality-adjusted life years) due to surgical morbidity. Conclusion: Cost-effectiveness analyses showed that costs for PET/CT are within the commonly accepted range for diagnostic tests or therapies. Therefore, reimbursement of PET/CT for NSCLC staging can be also recommended from an economic point of view.