[18FDG-PET/CT cost-effectiveness compared to CT at the end of treatment in pediatric Hodgkin's lymphoma patients].
OBJECTIVE
Estimating the cost-effectiveness of 18FDG-PET/CT (positron emission tomography) compared to computer tomography (CT) followed by 18FDG-PET/CT as a confirmatory test for a positive case at the end of treatment in Hodgkin's lymphoma (HL) patients under 18 years-old.


METHODS
A decision tree was built for comparing 18FDG-PET/CT to CT followed by 18FDG-PET/CT as a confirmatory test for a positive case in detecting residual lesions; outcome was measured in life years gained (LYG). The cost-effectiveness ratio was calculated; the threshold was 3 times the per capita GDP per LYG. Values were expressed in Colombian pesos for 2010 (1 US dollar=$ 1,897.89) and submitted to deterministic and probabilistic sensitivity analysis.


RESULTS
Assuming a difference of 13 months in true positives' life expectancy compared to that for false negatives, the cost of an additional LYG with 18FDG-PET/CT compared to CT followed by 18FDG-PET/CT as a confirmatory test for a positive case when evaluating the end of pediatric HL patients' treatment was $ 34,508,590 (COP).


CONCLUSIONS
If differential life-expectancy between true positives and false negatives is at least 1.03 years, then using 18FDG-PET/CT for evaluating the end of HL pediatric patients' therapy is a cost-effective strategy for Colombia.
Universidad Nacional de Colombia, Bogotá, Colombia, mgarciamo@unal.edu.co.
Mario
M
García-Molina
Universidad Nacional de Colombia, Bogotá, Colombia, mgarciamo@unal.edu.co.
Liliana
L
Chicaíza-Becerra
Universidad Nacional de Colombia, Bogotá, Colombia, mgarciamo@unal.edu.co.
Alexander
A
Moreno-Calderon
Universidad Nacional de Colombia, Bogotá, Colombia, mgarciamo@unal.edu.co.
Víctor
V
Prieto-Martínez
Fundación Hospital La Misericordia, Bogotá, Colombia.
Isabel
I
Sarmiento-Urbina
Universidad Nacional de Colombia, Bogotá, Colombia, mgarciamo@unal.edu.co.
Adriana
A
Linares-Ballesteros
D000293:Adolescent; D002648:Child; D003105:Colombia; D003362:Cost-Benefit Analysis; D003663:Decision Trees; D005188:False Negative Reactions; D005189:False Positive Reactions; D005260:Female; D005462:Fluorine Radioisotopes / Q000191:economics; D019788:Fluorodeoxyglucose F18 / Q000191:economics; D006689:Hodgkin Disease / Q000000981:diagnostic imaging / Q000191:economics* / Q000473:pathology; D006801:Humans; D008017:Life Expectancy; D008297:Male; D064847:Multimodal Imaging / Q000191:economics*; D018365:Neoplasm, Residual / Q000175:diagnosis / Q000191:economics; D049268:Positron-Emission Tomography / Q000191:economics*; D011379:Prognosis; D019275:Radiopharmaceuticals / Q000191:economics; D014057:Tomography, X-Ray Computed / Q000191:economics*
D005462:Fluorine Radioisotopes; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18