title: (18)F-fluorodeoxyglucose positron emission tomography/computed tomography accuracy in the staging of non-small cell lung cancer: review and cost-effectiveness.
abstract: Aim of the performed clinical study was to compare the accuracy and cost-effectiveness of PET/CT in the staging of non-small cell lung cancer (NSCLC). Material and Methods. Cross-sectional and prospective study including 103 patients with histologically confirmed NSCLC. All patients were examined using PET/CT with intravenous contrast medium. Those with disease stage ≤IIB underwent surgery (n = 40). Disease stage was confirmed based on histology results, which were compared with those of PET/CT and positron emission tomography (PET) and computed tomography (CT) separately. 63 patients classified with ≥IIIA disease stage by PET/CT did not undergo surgery. The cost-effectiveness of PET/CT for disease classification was examined using a decision tree analysis. Results. Compared with histology, the accuracy of PET/CT for disease staging has a positive predictive value of 80%, a negative predictive value of 95%, a sensitivity of 94%, and a specificity of 82%. For PET alone, these values are 53%, 66%, 60%, and 50%, whereas for CT alone they are 68%, 86%, 76%, and 72%, respectively. Incremental cost-effectiveness of PET/CT over CT alone was €17,412 quality-adjusted life-year (QALY). Conclusion. In our clinical study, PET/CT using intravenous contrast medium was an accurate and cost-effective method for staging of patients with NSCLC.
authors.affiliation: Department of Radiology, Research Institute La Princesa, La Princesa University Hospital, C/Diego de León 62, 28006 Madrid, Spain.
authors.forename: Nieves
authors.initials: N
authors.lastname: Gómez León
authors.affiliation: Health Technology Assessment Unit, Lain Entralgo Agency, C/Gran Vía 27, 28013 Madrid, Spain.
authors.forename: Sofía
authors.initials: S
authors.lastname: Escalona
authors.affiliation: Department of Radiology, Research Institute La Princesa, La Princesa University Hospital, C/Diego de León 62, 28006 Madrid, Spain.
authors.forename: Beatriz
authors.initials: B
authors.lastname: Bandrés
authors.affiliation: National School of Health, Sinesio Delgado 4, 28029 Madrid, Spain.
authors.forename: Cristobal
authors.initials: C
authors.lastname: Belda
authors.affiliation: Health Technology Assessment Unit, Lain Entralgo Agency, C/Gran Vía 27, 28013 Madrid, Spain.
authors.forename: Daniel
authors.initials: D
authors.lastname: Callejo
authors.affiliation: Health Technology Assessment Unit, Lain Entralgo Agency, C/Gran Vía 27, 28013 Madrid, Spain ; Institute for Health and Consumer Protection, Joint Research Centre, European Commission, Via E. Fermi 2749, 21027 Ispra, Italy.
authors.forename: Juan Antonio
authors.initials: JA
authors.lastname: Blasco