### 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 language | English |
---|---|

Pages (from-to) | 54-60 |

Number of pages | 7 |

Journal | Academic Radiology |

Volume | 16 |

Issue number | 1 |

DOIs | |

Publication status | Published - Jan 2009 |

Externally published | Yes |

### Fingerprint

### Keywords

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

### ASJC Scopus subject areas

- Radiology Nuclear Medicine and imaging

### Cite this

*Academic Radiology*,

*16*(1), 54-60. https://doi.org/10.1016/j.acra.2008.06.012

**The Cost-utility Analysis of 18-Fluoro-2-Deoxyglucose Positron Emission Tomography in the Diagnosis of Recurrent Nasopharyngeal Carcinoma.** / Yen, Ruoh Fang; Yen, Ming Fang; Hong, Ruey Long; Tzen, Kai Yuan; Chien, Chun Ru; Chen, Tony Hsiu Hsi.

Research output: Contribution to journal › Article

*Academic Radiology*, vol. 16, no. 1, pp. 54-60. https://doi.org/10.1016/j.acra.2008.06.012

}

TY - JOUR

T1 - The Cost-utility Analysis of 18-Fluoro-2-Deoxyglucose Positron Emission Tomography in the Diagnosis of Recurrent Nasopharyngeal Carcinoma

AU - Yen, Ruoh Fang

AU - Yen, Ming Fang

AU - Hong, Ruey Long

AU - Tzen, Kai Yuan

AU - Chien, Chun Ru

AU - Chen, Tony Hsiu Hsi

PY - 2009/1

Y1 - 2009/1

N2 - 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.

AB - 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.

KW - 18F-FDG PET

KW - cost-utility analysis

KW - decision tree model

KW - Nasopharyngeal carcinoma

KW - recurrence

UR - http://www.scopus.com/inward/record.url?scp=57049084026&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=57049084026&partnerID=8YFLogxK

U2 - 10.1016/j.acra.2008.06.012

DO - 10.1016/j.acra.2008.06.012

M3 - Article

C2 - 19064212

AN - SCOPUS:57049084026

VL - 16

SP - 54

EP - 60

JO - Academic Radiology

JF - Academic Radiology

SN - 1076-6332

IS - 1

ER -