[Decision tree sensitivity analysis for cost-effectiveness of chest FDG-PET in patients with a pulmonary tumor (non-small cell carcinoma)].
Decision tree analysis was used to assess cost-effectiveness of chest FDG-PET in patients with a pulmonary tumor (non-small cell carcinoma, < or = Stage IIIB), based on the data of the current decision tree. Decision tree models were constructed with two competing strategies (CT alone and CT plus chest FDG-PET) in 1,000 patient population with 71.4% prevalence. Baselines of FDG-PET sensitivity and specificity on detection of lung cancer and lymph node metastasis, and mortality and life expectancy were available from references. Chest CT plus chest FDG-PET strategy increased a total cost by 10.5% when a chest FDG-PET study costs 0.1 million yen, since it increased the number of mediastinoscopy and curative thoracotomy despite reducing the number of bronchofiberscopy to half. However, the strategy resulted in a remarkable increase by 115 patients with curable thoracotomy and decrease by 51 patients with non-curable thoracotomy. In addition, an average life expectancy increased by 0.607 year/patient, which means increase in medical cost is approximately 218,080 yen/year/patient when a chest FDG-PET study costs 0.1 million yen. In conclusion, chest CT plus chest FDG-PET strategy might not be cost-effective in Japan, but we are convinced that the strategy is useful in cost-benefit analysis.
Kosuda
S
S
Department of Radiology, National Defense Medical College.
Ichihara
K
K
Watanabe
M
M
Kobayashi
H
H
Kusano
S
S
D000328:Adult; D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000000981:diagnostic imaging* / Q000191:economics; D003362:Cost-Benefit Analysis; D003663:Decision Trees; D019788:Fluorodeoxyglucose F18; D006760:Hospitalization / Q000191:economics; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000191:economics; D008875:Middle Aged; D019275:Radiopharmaceuticals; D012680:Sensitivity and Specificity; D013909:Thorax / Q000000981:diagnostic imaging*; D014055:Tomography, Emission-Computed / Q000191:economics*
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18