Cost comparison of 111In-DTPA-octreotide scintigraphy and 68Ga-DOTATOC PET/CT for staging enteropancreatic neuroendocrine tumours

• Published in: European journal of nuclear medicine and molecular imaging 2012, Vol.39 (1), p.72-82
• Main Authors: Schreiter, Nils F., Brenner, Winfried, Nogami, Munenobu, Buchert, Ralph, Huppertz, Alexander, Pape, Ulrich-Frank, Prasad, Vikas, Hamm, Bernd, Maurer, Martin H.
• Format: Article
• Language: English
• Subjects: Adult; Aged; Cardiology; Cost-Benefit Analysis; Female; Humans; Imaging; Magnetic Resonance Imaging; Male; Medicine; Medicine & Public Health; Middle Aged; Multimodal Imaging - economics; Neoplasm Staging; Neuroendocrine Tumors - diagnostic imaging; Neuroendocrine Tumors - pathology; Nuclear Medicine; Octreotide - analogs & derivatives; Octreotide - economics; Oncology; Organometallic Compounds - economics; Original Article; Orthopedics; Pancreatic Neoplasms - diagnostic imaging; Pancreatic Neoplasms - pathology; Pentetic Acid - analogs & derivatives; Pentetic Acid - economics; Positron-Emission Tomography; Radiology; Tomography, X-Ray Computed
• ISSN: 1619-7070; 1619-7089
• DOI: 10.1007/s00259-011-1935-5

Purpose Although somatostatin receptor positron emission tomography (PET)/CT is gaining increasing popularity and has shown its diagnostic superiority in several studies, 111 In-diethylenetriaminepentaacetic acid (DTPA)-octreotide is still the current standard for diagnosis of neuroendocrine tumours (NET). The aim of this study was to compare the costs for the two diagnostic tests and the respective consequential costs. Methods From January 2009 to July 2009, 51 consecutive patients with enteropancreatic NET who underwent contrast-enhanced 68 Ga-DOTATOC PET/CT ( n  = 29) or 111 In-DTPA-octreotide (mean 3 whole-body scans plus 1.6 low-dose single photon emission computed tomography/CT; n  = 22) were included. For cost analysis, direct costs (equipment) and variable costs (material, labour) per examination were calculated. Additionally required CT and/or MRI examinations within the staging process were assessed as consequential costs. An additional deterministic sensitivity analysis was performed. Results A 68 Ga-DOTATOC PET/CT examination yielded total costs (equipment, personnel and material costs) of 548 €. On the other hand, an 111 In-DTPA-octreotide examination resulted in 827 € total costs. Costs for equipment and material had a share of 460 €/720 € for 68 Ga-DOTATOC/ 111 In-DTPA-octreotide and labour costs of 89 €/106 €. With 68 Ga-DOTATOC additional MRI had to be performed in 7% of the patients resulting in a mean of 20 € for supplementary imaging per patient; 82% of patients with 111 In-DTPA-octreotide needed additional MRI and/or CT resulting in mean additional costs of 161 € per patient. Conclusion 68 Ga-DOTATOC PET/CT was considerably cheaper than 111 In-DTPA-octreotide with respect to both material and personnel costs. Furthermore, by using 68 Ga-DOTATOC PET/CT considerably fewer additional examinations were needed reducing the consequential costs significantly.