Additional MRI for initial M-staging in pancreatic cancer: a cost-effectiveness analysis
Gassert FG, Ziegelmayer S, Luitjens J, Gassert FT, Tollens F, Rink J, Makowski MR, Ruebenthaler J, Froelich MF (2022)
Publication Type: Journal article
Publication year: 2022
Journal
Book Volume: 32
Pages Range: 2448-2456
Journal Issue: 4
DOI: 10.1007/s00330-021-08356-0
Abstract
Objective: Pancreatic cancer is portrayed to become the second leading cause of cancer-related death within the next years. Potentially complicating surgical resection emphasizes the importance of an accurate TNM classification. In particular, the failure to detect features for non-resectability has profound consequences on patient outcomes and economic costs due to incorrect indication for resection. In the detection of liver metastases, contrast-enhanced MRI showed high sensitivity and specificity; however, the cost-effectiveness compared to the standard of care imaging remains unclear. The aim of this study was to analyze whether additional MRI of the liver is a cost-effective approach compared to routinely acquired contrast-enhanced computed tomography (CE-CT) in the initial staging of pancreatic cancer. Methods: A decision model based on Markov simulation was developed to estimate the quality-adjusted life-years (QALYs) and lifetime costs of the diagnostic modalities. Model input parameters were assessed based on evidence from recent literature. The willingness-to-pay (WTP) was set to $100,000/QALY. To evaluate model uncertainty, deterministic and probabilistic sensitivity analyses were performed. Results: In the base-case analysis, the model yielded a total cost of $185,597 and an effectiveness of 2.347 QALYs for CE-MR/CT and $187,601 and 2.337 QALYs for CE-CT respectively. With a net monetary benefit (NMB) of $49,133, CE-MR/CT is shown to be dominant over CE-CT with a NMB of $46,117. Deterministic and probabilistic survival analysis showed model robustness for varying input parameters. Conclusion: Based on our results, combined CE-MR/CT can be regarded as a cost-effective imaging strategy for the staging of pancreatic cancer. Key Points: • Additional MRI of the liver for initial staging of pancreatic cancer results in lower total costs and higher effectiveness. • The economic model showed high robustness for varying input parameters.
Involved external institutions
Technische Universität München (TUM)
Germany (DE)
Ludwig-Maximilians-Universität (LMU)
Germany (DE)
Universitätsklinikum Mannheim
Germany (DE)
Germany (DE)
Ludwig-Maximilians-Universität (LMU)
Germany (DE)
Universitätsklinikum Mannheim
Germany (DE)
How to cite
APA:
Gassert, F.G., Ziegelmayer, S., Luitjens, J., Gassert, F.T., Tollens, F., Rink, J.,... Froelich, M.F. (2022). Additional MRI for initial M-staging in pancreatic cancer: a cost-effectiveness analysis. European Radiology, 32(4), 2448-2456. https://doi.org/10.1007/s00330-021-08356-0
MLA:
Gassert, Felix G., et al. "Additional MRI for initial M-staging in pancreatic cancer: a cost-effectiveness analysis." European Radiology 32.4 (2022): 2448-2456.
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