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Cost-effectiveness analysis of MRI, CE-CT and 18F-FDG PET/CT for detecting colorectal liver metastases eligible for hepatic resection

OBJECTIVES: Colorectal cancer (CRC) is a serious challenge for the health system. In 2022 CRC represented 8% of cancer diagnoses in the United States. 30% of patients already show metastases at the initial tumor staging. The majority of these metastases are sited in the liver. According to their ext...

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Autores principales: Schnitzer, Moritz L., von Münchhausen, Niklas, Biechele, Gloria, Runtemund, Jasmin, Grawe, Freba, Geyer, Thomas, Kaiser, Clemens G., Haag, Florian, Rübenthaler, Johannes, Froelich, Matthias F.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10405934/
https://www.ncbi.nlm.nih.gov/pubmed/37554160
http://dx.doi.org/10.3389/fonc.2023.1161738
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author Schnitzer, Moritz L.
von Münchhausen, Niklas
Biechele, Gloria
Runtemund, Jasmin
Grawe, Freba
Geyer, Thomas
Kaiser, Clemens G.
Haag, Florian
Rübenthaler, Johannes
Froelich, Matthias F.
author_facet Schnitzer, Moritz L.
von Münchhausen, Niklas
Biechele, Gloria
Runtemund, Jasmin
Grawe, Freba
Geyer, Thomas
Kaiser, Clemens G.
Haag, Florian
Rübenthaler, Johannes
Froelich, Matthias F.
author_sort Schnitzer, Moritz L.
collection PubMed
description OBJECTIVES: Colorectal cancer (CRC) is a serious challenge for the health system. In 2022 CRC represented 8% of cancer diagnoses in the United States. 30% of patients already show metastases at the initial tumor staging. The majority of these metastases are sited in the liver. According to their extension and the status of the tumor colorectal liver metastases can be treated in several ways, with hepatic resection being the gold-standard. Contrast-enhanced computed tomography (CE-CT), positron emission tomography/computed tomography (PET/CT) and magnetic resonance imaging (MRI) can be used for evaluation of resectability of these liver metastases. The aim of this study is to assess the most economic imaging modality for detecting liver metastases eligible for hepatic resection by analyzing their cost-effectiveness. MATERIALS AND METHODS: In our study, a Markov state transition model was built to calculate the quality-adjusted life years (QALYs) and overall costs for each diagnostic strategy in accord with the stated input values obtained from scientific research. Further, probabilistic sensitivity analyses by means of Monte Carlo simulations were performed to consider possible model uncertainties. For evaluation of the cost-effectiveness on an economic threshold, the Willingness-to-pay (WTP) was set at $ 100,000. The applied values and the calculated results are based on the U.S. healthcare system. RESULTS: CE-CT led to overall costs of $ 42,874.02 and 8.47 QALYs, whereas MRI led to $ 40,863.65 and 8.50 QALYs. PET/CT resulted in overall costs of $ 43,216.74 and 8.48 QALYs. Therefore, MRI was determined to be the dominant strategy in the model. According to the performed sensitivity analyses, MRI remained cost-effective over a wide range of WTPs. CONCLUSION: In conclusion, according to our analysis, MRI is the dominant strategy for detecting hepatic metastases eligible for hepatic resection in colorectal cancer.
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spelling pubmed-104059342023-08-08 Cost-effectiveness analysis of MRI, CE-CT and 18F-FDG PET/CT for detecting colorectal liver metastases eligible for hepatic resection Schnitzer, Moritz L. von Münchhausen, Niklas Biechele, Gloria Runtemund, Jasmin Grawe, Freba Geyer, Thomas Kaiser, Clemens G. Haag, Florian Rübenthaler, Johannes Froelich, Matthias F. Front Oncol Oncology OBJECTIVES: Colorectal cancer (CRC) is a serious challenge for the health system. In 2022 CRC represented 8% of cancer diagnoses in the United States. 30% of patients already show metastases at the initial tumor staging. The majority of these metastases are sited in the liver. According to their extension and the status of the tumor colorectal liver metastases can be treated in several ways, with hepatic resection being the gold-standard. Contrast-enhanced computed tomography (CE-CT), positron emission tomography/computed tomography (PET/CT) and magnetic resonance imaging (MRI) can be used for evaluation of resectability of these liver metastases. The aim of this study is to assess the most economic imaging modality for detecting liver metastases eligible for hepatic resection by analyzing their cost-effectiveness. MATERIALS AND METHODS: In our study, a Markov state transition model was built to calculate the quality-adjusted life years (QALYs) and overall costs for each diagnostic strategy in accord with the stated input values obtained from scientific research. Further, probabilistic sensitivity analyses by means of Monte Carlo simulations were performed to consider possible model uncertainties. For evaluation of the cost-effectiveness on an economic threshold, the Willingness-to-pay (WTP) was set at $ 100,000. The applied values and the calculated results are based on the U.S. healthcare system. RESULTS: CE-CT led to overall costs of $ 42,874.02 and 8.47 QALYs, whereas MRI led to $ 40,863.65 and 8.50 QALYs. PET/CT resulted in overall costs of $ 43,216.74 and 8.48 QALYs. Therefore, MRI was determined to be the dominant strategy in the model. According to the performed sensitivity analyses, MRI remained cost-effective over a wide range of WTPs. CONCLUSION: In conclusion, according to our analysis, MRI is the dominant strategy for detecting hepatic metastases eligible for hepatic resection in colorectal cancer. Frontiers Media S.A. 2023-07-24 /pmc/articles/PMC10405934/ /pubmed/37554160 http://dx.doi.org/10.3389/fonc.2023.1161738 Text en Copyright © 2023 Schnitzer, von Münchhausen, Biechele, Runtemund, Grawe, Geyer, Kaiser, Haag, Rübenthaler and Froelich https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Oncology
Schnitzer, Moritz L.
von Münchhausen, Niklas
Biechele, Gloria
Runtemund, Jasmin
Grawe, Freba
Geyer, Thomas
Kaiser, Clemens G.
Haag, Florian
Rübenthaler, Johannes
Froelich, Matthias F.
Cost-effectiveness analysis of MRI, CE-CT and 18F-FDG PET/CT for detecting colorectal liver metastases eligible for hepatic resection
title Cost-effectiveness analysis of MRI, CE-CT and 18F-FDG PET/CT for detecting colorectal liver metastases eligible for hepatic resection
title_full Cost-effectiveness analysis of MRI, CE-CT and 18F-FDG PET/CT for detecting colorectal liver metastases eligible for hepatic resection
title_fullStr Cost-effectiveness analysis of MRI, CE-CT and 18F-FDG PET/CT for detecting colorectal liver metastases eligible for hepatic resection
title_full_unstemmed Cost-effectiveness analysis of MRI, CE-CT and 18F-FDG PET/CT for detecting colorectal liver metastases eligible for hepatic resection
title_short Cost-effectiveness analysis of MRI, CE-CT and 18F-FDG PET/CT for detecting colorectal liver metastases eligible for hepatic resection
title_sort cost-effectiveness analysis of mri, ce-ct and 18f-fdg pet/ct for detecting colorectal liver metastases eligible for hepatic resection
topic Oncology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10405934/
https://www.ncbi.nlm.nih.gov/pubmed/37554160
http://dx.doi.org/10.3389/fonc.2023.1161738
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