HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:
Guest Access | Sign In via User Name/Password

This Article Full Text Free Full Text (PDF) Free Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Add to My Personal Article Archive Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via ISI Web of Science (23) Citing Articles via Google Scholar Google Scholar Articles by Kosuda, S. Articles by Kusano, S. Search for Related Content PubMed PubMed Citation Articles by Kosuda, S. Articles by Kusano, S.

Decision-Tree Sensitivity Analysis for Cost-Effectiveness of Chest 2-Fluoro-2-D-[¹⁸F]Fluorodeoxyglucose Positron Emission Tomography in Patients With Pulmonary Nodules (Non-small Cell Lung Carcinoma) in Japan^*

^* From the Department of Radiology (Dr. Kosuda), Department of Surgery (Dr. Watanabe), and Department of Internal Medicine (Dr. Kobayashi), National Defense Medical College, Tokorozawa, Japan; and the Department of Diagnosis (Dr. Ichihara), Kawasaki Medical College, Kurashiki, Japan. Partially supported by funding from the Working Group Project of the Japanese Society of Nuclear Medicine.

Correspondence to: Shigeru Kosuda, MD, Department of Radiology, National Defense Medical College, 3–2 Namiki Tokorozawa 359-8513, Japan; e-mail: nucleark{at}infokanto.ne.jp

Context: Recent studies have demonstrated the potential cost-effectiveness of using 2-fluoro-2-D-[¹⁸F]fluorodeoxyglucose (FDG) positron emission tomography (PET) in the management of non-small cell lung carcinoma (NSCLC), but because of differences in health-care systems, those findings may not hold true in a Japanese hospital.

Objective: To assess the cost-effectiveness of the chest CT plus chest FDG-PET strategy in Japan.

Design: Decision-tree sensitivity analysis based on the two competing strategies of chest CT–alone vs chest CT plus chest FDG-PET.

Study selection: A simulation of 1,000 patients in whom NSCLC, stage IIIB or less, was suspected was created using baselines of other relevant variables in regard to sensitivity, specificity, mortality, life expectancy, and cost from published data.

Methods: We surveyed the relevant literature for the choice of variables.

Main outcome measures: Expected marginal cost and expected life expectancy gain for NSCLC patients.

Results: The chest CT plus chest FDG-PET strategy yielded an expected life expectancy gain of 0.607 years (7.3 months) per patient, compared with the alternative strategy of chest CT–alone. Using an FDG-PET examination cost of 1.0 x 10⁵ yen (around $700 US) per study, the cost increment was 2.18 x 10⁵ yen/yr/patient.

Conclusions: The chest CT plus chest FDG-PET strategy in patients with NSCLC is unlikely to be cost-effective in Japan. However, patient life expectancy gain would increase as a result of improved staging of NSCLC. These preliminary results should be confirmed by further studies for specific environments.

Key Words: cost-effectiveness • 2-fluoro-2-D-[¹⁸F]fluorodeoxyglucose positron emission tomography • life expectancy • non-small cell lung carcinoma

This article has been cited by other articles:

				C. C. Earle Outcomes Research in Lung Cancer J Natl Cancer Inst Monographs, October 1, 2004; 2004(33): 56 - 77. [Abstract] [Full Text] [PDF]

				M. Berger, M. K. Gould, and P. G. Barnett The Cost of Positron Emission Tomography in Six United States Veterans Affairs Hospitals and Two Academic Medical Centers Am. J. Roentgenol., August 1, 2003; 181(2): 359 - 365. [Abstract] [Full Text] [PDF]

				J.F. Vansteenkiste and S.G. Stroobants The role of positron emission tomography with 18F-fluoro-2-deoxy-D-glucose in respiratory oncology Eur. Respir. J., April 1, 2001; 17(4): 802 - 820. [Abstract] [Full Text] [PDF]