The economic impact of 18FDG positron emission tomography in the surgical management of colorectal cancer with hepatic metastases.
BACKGROUND
(18)F-fluorodeoxyglucose positron emission tomography (FDG-PET) is recognized as a powerful tool in the management of patients with recurrent and/or metastatic colorectal cancer. The aim of this was was to analyze costs from the payer's perspective, of adding FDG-PET to a computed tomography (CT) scan preoperatively in colorectal cancer patients with resectable hepatic metastases.


METHODS
CT with and without FDG-PET were compared among patients with colorectal cancer in staging for surgical resection of hepatic metastases. Outcomes included uncomplicated surgery, complicated surgery, or death. Extrahepatic disease occurrence rates and diagnostic accuracy of CT and FDG-PET were obtained from published sources. Complication rates and costs for CT, FDG-PET, and surgical procedures were obtained from Healthcare Finance Administration data.


RESULTS
The average expected surgical cost per patient when FDG-PET was used to determine the presence of extrahepatic disease was 16,278 dollars compared to 21,547 dollars for conventional management-a net savings of 5,269 dollars.


CONCLUSIONS
Integration of FDG-PET into the presurgical evaluation of patients with hepatic metastases could substantially reduce overall costs and patients' morbidity. This substantial net saving results from the unique ability of FDG-PET in excluding patients with extrahepatic disease, and avoiding unnecessary surgical expenses.
Zubeldia
Jose M
JM
School of Medicine and Biomedical Sciences, Department of Nuclear Medicine, University at Buffalo, State University of New York, Buffalo, New York 14214-3007, USA.
Bednarczyk
Edward M
EM
Baker
John G
JG
Nabi
Hani A
HA
D015179:Colorectal Neoplasms / Q000473:pathology / Q000601:surgery* / Q000628:therapy; D003362:Cost-Benefit Analysis; D003663:Decision Trees; D019788:Fluorodeoxyglucose F18 / Q000627:therapeutic use*; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary* / Q000601:surgery*; D009362:Neoplasm Metastasis; D049268:Positron-Emission Tomography / Q000295:instrumentation / Q000379:methods*; D019275:Radiopharmaceuticals / Q000627:therapeutic use*; D011878:Radiotherapy / Q000191:economics*; D014057:Tomography, X-Ray Computed / Q000191:economics
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18