Economic Evaluation of PET and PET/CT in Oncology: Evidence and Methodologic Approaches

Abstract

PET and PET/CT have changed the diagnostic algorithm in oncology. Health care systems worldwide have recently approved reimbursement for PET and PET/CT for staging of non-small cell lung cancer and differential diagnosis of solitary pulmonary nodules because PET and PET/CT have been found to be cost-effective for those uses. Additional indications that are covered by health care systems in the United States and several European countries include staging of gastrointestinal tract cancers, breast cancer, malignant lymphoma, melanoma, and head and neck cancers. Regarding these indications, diagnostic effectiveness and superiority over conventional imaging modalities have been shown, whereas cost-effectiveness has been demonstrated only in part. This article reports on the current knowledge of economic evaluations of PET and PET/CT in oncologic applications. Because more economic evaluations are needed for several clinical indications, we also report on the methodologies for conducting economic evaluations of diagnostic tests and suggest an approach toward the implementation of these tests in future clinical studies.

Whole-body FDG PET/CT is more accurate than conventional imaging for staging primary breast cancer patients

“…This has consequences for treatment decision making (e.g. resection of single distant metastases, decision on systemic chemotherapy or not) and, therefore, survival [29,44,45]. FDG PET imaging has been reported to have only fair accuracy for detecting osteoblastic lesions, but to be more accurate than bone scintigraphy for detecting osteolytic lesions [46].…”

Plant-PET Scans: In Vivo Mapping of Xylem and Phloem Functioning

“…Plant-PET may play an important role in this quest, in particular when quantitative analysis of PET data is pursued. To date, PET scanners are not readily available for plant scientists, but plant researchers can profit from the advances that have been made in medical imaging, and can use, as temporary solution, clinical PET scanners [68]. Access to custom-built, plant-dedicated PET scanners, with a configuration that is better suited for plants than the horizontal orientated medical scanners, is expected to rapidly develop ( Figure 1B,C).…”

Limited Positron Emission Tomography-Computed Tomography for Restaging of Lymphoma: A Strategy for Reducing Radiation Exposure among Patients with Early-Stage Curable Lymphoma

“…For example, in Germany the cost of a single PET-CT examination is reported to be in the range of EUR 600-1,000 [16]. In the USA the mean total cost of a PET scan was previously estimated at USD 1,900 [17].…”