title: Cost comparison of 111In-DTPA-octreotide scintigraphy and 68Ga-DOTATOC PET/CT for staging enteropancreatic neuroendocrine tumours.
abstract: OBJECTIVE
  Although somatostatin receptor positron emission tomography (PET)/CT is gaining increasing popularity and has shown its diagnostic superiority in several studies, (111)In-diethylenetriaminepentaacetic acid (DTPA)-octreotide is still the current standard for diagnosis of neuroendocrine tumours (NET). The aim of this study was to compare the costs for the two diagnostic tests and the respective consequential costs.
  
  
  METHODS
  From January 2009 to July 2009, 51 consecutive patients with enteropancreatic NET who underwent contrast-enhanced (68)Ga-DOTATOC PET/CT (n = 29) or (111)In-DTPA-octreotide (mean 3 whole-body scans plus 1.6 low-dose single photon emission computed tomography/CT; n = 22) were included. For cost analysis, direct costs (equipment) and variable costs (material, labour) per examination were calculated. Additionally required CT and/or MRI examinations within the staging process were assessed as consequential costs. An additional deterministic sensitivity analysis was performed.
  
  
  RESULTS
  A (68)Ga-DOTATOC PET/CT examination yielded total costs (equipment, personnel and material costs) of 548 euro. On the other hand, an (111)In-DTPA-octreotide examination resulted in 827 euro total costs. Costs for equipment and material had a share of 460 euro/720 euro for (68)Ga-DOTATOC/(111)In-DTPA-octreotide and labour costs of 89 euro/106 euro. With (68)Ga-DOTATOC additional MRI had to be performed in 7% of the patients resulting in a mean of 20 euro for supplementary imaging per patient; 82% of patients with (111)In-DTPA-octreotide needed additional MRI and/or CT resulting in mean additional costs of 161 euro per patient.
  
  
  CONCLUSIONS
  (68)Ga-DOTATOC PET/CT was considerably cheaper than (111)In-DTPA-octreotide with respect to both material and personnel costs. Furthermore, by using (68)Ga-DOTATOC PET/CT considerably fewer additional examinations were needed reducing the consequential costs significantly.
authors.affiliation: Department of Nuclear Medicine, Charité-Universitätsmedizin Berlin, Berlin, Germany. nils.schreiter@charite.de
authors.forename: Nils F
authors.initials: NF
authors.lastname: Schreiter
authors.forename: Winfried
authors.initials: W
authors.lastname: Brenner
authors.forename: Munenobu
authors.initials: M
authors.lastname: Nogami
authors.forename: Ralph
authors.initials: R
authors.lastname: Buchert
authors.forename: Alexander
authors.initials: A
authors.lastname: Huppertz
authors.forename: Ulrich-Frank
authors.initials: UF
authors.lastname: Pape
authors.forename: Vikas
authors.initials: V
authors.lastname: Prasad
authors.forename: Bernd
authors.initials: B
authors.lastname: Hamm
authors.forename: Martin H
authors.initials: MH
authors.lastname: Maurer
mesh_terms: D000328:Adult; D000368:Aged; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging / Q000191:economics*; D009367:Neoplasm Staging; D018358:Neuroendocrine Tumors / Q000000981:diagnostic imaging* / Q000473:pathology*; D015282:Octreotide / Q000031:analogs & derivatives* / Q000191:economics; D009942:Organometallic Compounds / Q000191:economics; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*; D004369:Pentetic Acid / Q000031:analogs & derivatives* / Q000191:economics; D049268:Positron-Emission Tomography; D014057:Tomography, X-Ray Computed
chemical_list: C497824:111In-octreotide, DTPA(0)-; C499142:Ga(III)-DOTATOC; D009942:Organometallic Compounds; D004369:Pentetic Acid; D015282:Octreotide