Solitary pulmonary nodules: accuracy and cost-effectiveness of sodium iodide FDG-PET using Australian data

被引:32
作者
Keith, CJ
Miles, KA
Griffiths, MR
Wong, D
Pitman, AG
Hicks, RJ
机构
[1] Wesley Hosp, So Xray Clin, Auchenflower, Qld 4006, Australia
[2] Wesley Res Inst, Brisbane, Qld, Australia
[3] Queensland Univ Technol, Ctr Med Hlth & Environm Phys, Brisbane, Qld 4001, Australia
[4] Peter MacCallum Canc Inst, Melbourne, Vic 3000, Australia
关键词
positron emission tomography; cost-effectiveness; decision tree analysis;
D O I
10.1007/s00259-002-0833-2
中图分类号
R8 [特种医学]; R445 [影像诊断学];
学科分类号
1002 ; 100207 ; 1009 ;
摘要
This study uses Australian data to confirm the accuracy of dedicated sodium iodide (NaI) fluorine-18 fluorodeoxyglucose positron emission tomography (FDG-PET) in evaluating indeterminate solitary pulmonary nodules (SPNs) and to determine the conditions under which PET could play a cost-effective role in this evaluation. Ninety-two patients from two Australian hospitals in different states underwent FDG-PET for evaluation of an SPN. Observed values for prior probability of malignancy and diagnostic accuracy of PET were applied to previously published decision tree models using published Australian health care costs. The accuracy of FDG-PET was 93% with a sensitivity of 92% and a specificity of 95%. The prior probability of malignancy (0.54), PET sensitivity and PET specificity indicated cost savings per patient of up to EUR 455 (A$ 774) based on a PET cost of EUR 706 (A$ 1,200). PET would remain cost-effective for levels of prior probability up to 0.8-0.9 and a PET cost of EUR 736-1,161 (A$ 1,252-A$ 1,974). It is concluded that Nal PET is accurate, cost saving and cost-effective for the characterisation of indeterminate pulmonary nodules in Australia. Comparison with previous reports from the United States confirms that FDG-PET can remain cost-effective despite population differences in medical costs, disease prevalence and PET diagnostic performance.
引用
收藏
页码:1016 / 1023
页数:8
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