Cost-effectiveness of 18F-FET PET for early treatment response assessment in glioma patients following adjuvant temozolomide chemotherapy

• DOI: 10.2967/jnumed.122.263790
• Publication Date: 2022-04-14T20:55:15Z
• Authors: Jurij Rosen; Garry Ceccon; Elena Katharina B...; Jan Michael Werner; Caroline Tscherpel; Veronika Dunkl; Marion Rapp; Michael Sabel; Ulrich Herrlinger; Alexander Heinzel; Niklas Schaefer; Maximilian Ruge; Roland Goldbrunner; Gabriele Stoffels; Christoph Kabbasch; Gereon Rudolf Fink; Karl-Josef Langen; Norbert Galldiks
• Keywords: Temozolomide

In light of increasing health-care costs, higher medical expenses should be justified socioeconomically. Therefore, we calculated the effectiveness and cost PET using radiolabeled amino acid O-(2-18F-fluoroethyl)-l-tyrosine (18F-FET) compared with conventional MRI for early identification responders to adjuvant temozolomide chemotherapy. A recently published study in isocitrate dehydrogenase wild-type glioma patients suggested that 18F-FET parameter changes predicted a significantly longer survival already after 2 cycles whereas were not significant. Methods: To determine serial imaging, analyzed clinical data associated costs from perspective German Statutory Health Insurance system. Based on decision-tree model, was calculated-that is, probability correctly identify responder as defined by an overall at least 15 mo. effectiveness, incremental ratio (ICER) each additionally identified who would have remained undetected MRI. The robustness results tested deterministic probabilistic Monte Carlo sensitivity analyses. Results: Compared MRI, increased rate chemotherapy 26%; thus, 4 needed examined 1 additional responder. Considering respective ICER resulted €4,396.83 PET. Sensitivity analyses confirmed results. Conclusion: contrast model suggests is cost-effective terms values. high temozolomide, integration has potential avoid premature discontinuation reasonable cost.