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- Title
PET/MRI versus PET/CT in oncology: a prospective single-center study of 330 examinations focusing on implications for patient management and cost considerations.
- Authors
Mayerhoefer, Marius E.; Prosch, Helmut; Beer, Lucian; Tamandl, Dietmar; Beyer, Thomas; Hoeller, Christoph; Berzaczy, Dominik; Raderer, Markus; Preusser, Matthias; Hochmair, Maximilian; Kiesewetter, Barbara; Scheuba, Christian; Ba-Ssalamah, Ahmed; Karanikas, Georgios; Kesselbacher, Julia; Prager, Gerald; Dieckmann, Karin; Polterauer, Stephan; Weber, Michael; Rausch, Ivo
- Abstract
Purpose: PET/MRI has recently been introduced into clinical practice. We prospectively investigated the clinical impact of PET/MRI compared with PET/CT, in a mixed population of cancer patients, and performed an economic evaluation of PET/MRI. Methods: Cancer patients referred for routine staging or follow-up by PET/CT underwent consecutive PET/CT and PET/MRI, using single applications of [18F]FDG, [68Ga]Ga-DOTANOC, or [18F]FDOPA, depending on tumor histology. PET/MRI and PET/CT were rated separately, and lesions were assessed per anatomic region; based on regions, per-examination and per-patient accuracies were determined. A simulated, multidisciplinary team meeting served as reference standard and determined whether differences between PET/CT and PET/MRI affected patient management. The McNemar tests were used to compare accuracies, and incremental cost-effectiveness ratios (ICERs) for PET/MRI were calculated. Results: Two hundred sixty-three patients (330 same-day PET/CT and PET/MRI examinations) were included. PET/MRI was accurate in 319/330 examinations and PET/CT in 277/330 examinations; the respective accuracies of 97.3% and 83.9% differed significantly (P < 0.001). The additional findings on PET/MRI—mainly liver and brain metastases—had implications for patient management in 21/263 patients (8.0%). The per-examination cost was 596.97 EUR for PET/MRI and 405.95 EUR for PET/CT. ICERs for PET/MRI were 14.26 EUR per percent of diagnostic accuracy and 23.88 EUR per percent of correctly managed patients. Conclusions: PET/MRI enables more appropriate management than PET/CT in a nonnegligible fraction of cancer patients. Since the per-examination cost is about 50% higher for PET/MRI than for PET/CT, a histology-based triage of patients to either PET/MRI or PET/CT may be meaningful.
- Subjects
POSITRON emission tomography computed tomography; COST control; LONGITUDINAL method; LIVER metastasis; BRAIN metastasis; ONCOLOGY; HOSPITAL central service departments
- Publication
European Journal of Nuclear Medicine & Molecular Imaging, 2020, Vol 47, Issue 1, p51
- ISSN
1619-7070
- Publication type
Article
- DOI
10.1007/s00259-019-04452-y