The Cost-utility Analysis of 18-Fluoro-2-Deoxyglucose Positron Emission Tomography in the Diagnosis of Recurrent Nasopharyngeal Carcinoma

Ruoh Fang Yen, Ming Fang Yen, Ruey Long Hong, Kai Yuan Tzen, Chun Ru Chien, Tony Hsiu Hsi Chen

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

Rationale and Objectives: 18-Fluoro-2-deoxyglucose (18F-FDG) positron emission tomography (PET) is effective but costly in the early detection of recurrence for nasopharyngeal carcinoma (NPC) in patients after treatment. In this study, we developed a decision tree model to analyze the cost utility of 18F-FDG PET in detecting loco-regional recurrences for NPC patients after therapy. Materials and Methods: The analysis for cost utility is based on the decision-tree model for three different strategies: 1) magnetic resonance imaging (MRI)-only, 2) PET-only, and 3) MRI-PET (performing PET if MRI result is uncertain). Sensitivity analyses have been performed to examine changes in the cost ratio of PET/MRI and the probability of uncertain MRI. Results: After inputting the data for utilities and life expectancies into the decision tree model, the quality-adjusted life expectancies turn out to be 16.16 quality-adjusted life-years (QALYs) for strategy 1, 16.70 QALYs for strategy 2, and 17.35 QALYs for strategy 3. The additional cost per additional QALYs for strategy 3 relative to strategy 1 is calculated to be US $462. Strategy 3 dominates over strategy 2 because strategy 3 costs less and yields more QALYs than strategy 2. If the cost ratio of PET/MRI is less than 1.85 or the probability of uncertain MRI is greater than 73%, then the PET-only strategy becomes more cost-effective than the MRI-PET strategy. Conclusion: Our analysis shows that the MRI-PET strategy is the most cost-effective for now. It is likely the PET-only strategy will become the most cost-effective for recurrent NPC in patients in the near future as the cost of PET has decreased in a faster rate than the cost of MRI.

Original languageEnglish
Pages (from-to)54-60
Number of pages7
JournalAcademic Radiology
Volume16
Issue number1
DOIs
Publication statusPublished - Jan 2009
Externally publishedYes

Keywords

  • 18F-FDG PET
  • cost-utility analysis
  • decision tree model
  • Nasopharyngeal carcinoma
  • recurrence

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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