Thyroid nodules with indeterminate cytology: molecular imaging with ⁹⁹mTc-methoxyisobutylisonitrile (MIBI) is more cost-effective than the Afirma gene expression classifier.
OBJECTIVE
To compare the cost-effectiveness of (99m)Tc-methoxyisobutylisonitrile (MIBI) thyroid scintigraphy and the Afirma gene expression classifier for the assessment of cytologically indeterminate thyroid nodules.


METHODS
A decision tree model was used. Costs were calculated from the perspective of the German health insurance system. The robustness of the results was assessed with probabilistic sensitivity analyses using a Monte Carlo simulation.


RESULTS
Life expectancy was 34.3 years (estimated costs per patient €1,459 - €2,224) for the MIBI scan and 34.1 years (estimated costs €3,560 - €4,071) for the molecular test. These results were confirmed by the Monte Carlo simulation.


CONCLUSIONS
MIBI thyroid scintigraphy is more cost-effective than the gene expression classifier.
Department of Nuclear Medicine, RWTH Aachen University Hospital, 52074, Aachen, Pauwelsstrasse 30, Germany, aheinzel@ukaachen.de.
Alexander
A
Heinzel
Dirk
D
Müller
Florian F
FF
Behrendt
Luca
L
Giovanella
Felix M
FM
Mottaghy
Frederik A
FA
Verburg
D014408:Biomarkers, Tumor / Q000191:economics*; D044963:Biopsy, Fine-Needle / Q000191:economics*; D003362:Cost-Benefit Analysis; D006801:Humans; D049268:Positron-Emission Tomography / Q000191:economics*; D019275:Radiopharmaceuticals; D017256:Technetium Tc 99m Sestamibi; D016606:Thyroid Nodule / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000473:pathology
D014408:Biomarkers, Tumor; D019275:Radiopharmaceuticals; D017256:Technetium Tc 99m Sestamibi