Added value of positron emission tomography imaging in the surgical treatment of colorectal liver metastases

Wiering, B., Adang, E. M. M., van der Sijp, J. R. M., Roumen, R. M., de Jong, K. P., Comans, E. F. I., Pruim, J., Dekker, H. M., Ruers, T. J. M., Krabbe, P. F. M. & Oyen, W. J. G., Nov-2010, In : Nuclear Medicine Communications. 31, 11, p. 938-944 7 p.

Research output: Contribution to journalArticleAcademicpeer-review

Objective [F-18]-Fluorodeoxyglucose-positron emission tomography (FDG-PET) is used increasingly in the work-up to surgery for patients with potentially resectable colorectal liver metastases. This study evaluates the clinical effectiveness, impact on health care resources and cost-effectiveness of adding FDG-PET to the diagnostic algorithm alongside a randomized clinical trial from a health care perspective.

Methods In a randomized clinical trial, the net monetary benefit (NMB) of FDG-PET added to conventional diagnostic work-up (CWU) was determined in patients with colorectal liver metastases. Seventy-five patients were included in each arm. Change in clinical management, futile laparotomies, preoperative findings and all relevant health care consumption were prospectively documented during 3 years. To assess health-related quality of life European Quality of Life-5 Dimensions was administered at the time of randomization, 3 and 6 weeks postoperatively, and every 3 months postoperatively for 3 years. Quality-adjusted life years (QALYs) were calculated based on European Quality of Life-5 Dimensions outcomes.

Results In adding FDG-PET, diagnostic performance increased and futile laparotomies were reduced by 38%. Both health-related quality of life and QALYs showed no significant difference between the CWU and PET groups. For CWU and PET groups costs were (sic)92 836 and (sic)81776, respectively, accumulated in 3 years after randomization. NMB ranged from (sic)1004 to (sic)11 060 depending on the monetary value given to a QALY. When costs for chemotherapy were disregarded, costs amounted to (sic)15 874 for CWU and (sic)18 664 for PET group.

Conclusion Additional costs of FDG-PET in the diagnostic work-up of patients with potentially resectable colorectal liver metastases were compensated by a reduction in futile laparotomies. The NMB analysis showed savings over a relevant range of willingness to pay for a QALY. Nucl Med Commun 31: 938-944 (C) 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins.

Original languageEnglish
Pages (from-to)938-944
Number of pages7
JournalNuclear Medicine Communications
Issue number11
Publication statusPublished - Nov-2010


  • colorectal cancer, cost-utility analysis, [F-18]-fluorodeoxyglucose-positron emission tomography, metastases, LOCAL ABLATIVE THERAPY, HEPATIC METASTASES, COST-EFFECTIVENESS, DECISION-ANALYSIS, CARCINOMA METASTASES, CURATIVE RESECTION, F-18-FDG PET, FDG-PET, CANCER, RECURRENCE

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