Positron Emission Tomography/Computed Tomography Influences on the Management of Resectable Pancreatic Cancer and Its Cost-Effectiveness

Abstract

PET/CT represents an important staging procedure prior to pancreatic resection for cancer, since it significantly improves patient selection and is cost-effective.

PET-PANC: multicentre prospective diagnostic accuracy and health economic analysis study of the impact of combined modality 18fluorine-2-fluoro-2-deoxy-d-glucose positron emission tomography with computed tomography scanning in the diagnosis and management of pancreatic cancer

“…One study of a series of 59 patients undergoing PET/CT for pancreatic cancer demonstrated a 16% change in management. 46 The use of PET/CT was found to be cost-effective in this limited study. The planned economic analysis in the PET-PANC study found evidence of cost-effectiveness for PET/CT in terms of management changes for patients.…”

“…42 PET and CT are acquired concurrently and co-registered, merging functional information from PET with the anatomical information from CT. Several studies/meta-analyses have demonstrated that FDG-PET/CT is more accurate than FDG-PET [43][44][45] in solid tumours, including pancreatic tumours. In pancreatic cancer, a study by Heinrich et al 46 found that FDG-PET/CT had a sensitivity of 89% for the detection of pancreatic cancer, altered treatment planning in 16% of 59 patients and was cost saving. Another study demonstrated that the sensitivity and specificity of FDG-PET/CT was 88% and 89%, respectively, in patients being assessed for pancreatic cancer and changed the management of six (11%) patients.…”

“…44,[46][47][48]78,79,84 The effect size with regard to change in management ranges from 41% to 10%. 44,[46][47][48]78,79,84 The largest study was a retrospective series of 285 patients over a period of 7 years. The addition of PET/CT changed management in 31 (10%) patients.…”

Cost-effectiveness of Fluorine-18-Fluorodeoxyglucose positron emission tomography in tumours other than lung cancer: A systematic review

“…Thirty-three articles were selected and retrieved in fulltext version (Figure 1). One study was found screening the references [6] and 18 articles were subsequently excluded [7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24] . Finally, 16 studies were included [6,[25][26][27][28][29][30][31][32][33][34][35][36][37][38][39] .…”

“…Germany Brain (glioma) Aminoacid PET Hetzel et al [21] 2003 Germany Bone (metastases) F18-Fluoride PET Tateishi et al [22] 2010 Japan Bone (metastases) F18-Fluoride PET Heinrich et al [23] 2005 Austria Pancreas (various)…”