Added value of positron emission tomography imaging in the surgical treatment of colorectal liver metastases.
Fulltext:
87934.pdf
Embargo:
until further notice
Size:
230.2Kb
Format:
PDF
Description:
Publisher’s version
Publication year
2010Source
Nuclear Medicine Communications, 31, 11, (2010), pp. 938-44ISSN
Annotation
01 november 2010
Publication type
Article / Letter to editor
Display more detailsDisplay less details
Organization
Surgery
Health Evidence
IQ Healthcare
Radiology
Nuclear Medicine
Former Organization
Epidemiology, Biostatistics & HTA
Journal title
Nuclear Medicine Communications
Volume
vol. 31
Issue
iss. 11
Page start
p. 938
Page end
p. 44
Subject
NCEBP 1: Molecular epidemiology; NCEBP 2: Evaluation of complex medical interventions; ONCOL 3: Translational research; ONCOL 4: Quality of Care; ONCOL 5: Aetiology, screening and detectionAbstract
OBJECTIVE: [F-18]-Fluorodeoxyglucose-positron emission tomography (FDG-PET) is used increasingly in the work-up to surgery for patients with potentially resectable colorectal liver metastases. This study evaluates the clinical effectiveness, impact on health care resources and cost-effectiveness of adding FDG-PET to the diagnostic algorithm alongside a randomized clinical trial from a health care perspective. METHODS: In a randomized clinical trial, the net monetary benefit (NMB) of FDG-PET added to conventional diagnostic work-up (CWU) was determined in patients with colorectal liver metastases. Seventy-five patients were included in each arm. Change in clinical management, futile laparotomies, preoperative findings and all relevant health care consumption were prospectively documented during 3 years. To assess health-related quality of life European Quality of Life-5 Dimensions was administered at the time of randomization, 3 and 6 weeks postoperatively, and every 3 months postoperatively for 3 years. Quality-adjusted life years (QALYs) were calculated based on European Quality of Life-5 Dimensions outcomes. RESULTS: In adding FDG-PET, diagnostic performance increased and futile laparotomies were reduced by 38%. Both health-related quality of life and QALYs showed no significant difference between the CWU and PET groups. For CWU and PET groups costs were euro 92,836 and euro 81,776, respectively, accumulated in 3 years after randomization. NMB ranged from euro 1004 to euro 11,060 depending on the monetary value given to a QALY. When costs for chemotherapy were disregarded, costs amounted to euro 15,874 for CWU and euro 18,664 for PET group. CONCLUSION: Additional costs of FDG-PET in the diagnostic work-up of patients with potentially resectable colorectal liver metastases were compensated by a reduction in futile laparotomies. The NMB analysis showed savings over a relevant range of willingness to pay for a QALY.
This item appears in the following Collection(s)
- Academic publications [238441]
- Electronic publications [122508]
- Faculty of Medical Sciences [90373]
Upload full text
Use your RU credentials (u/z-number and password) to log in with SURFconext to upload a file for processing by the repository team.