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Huo J , Chu Y , Chamie K , Smaldone MC , Boorjian SA , Baillargeon JG , Kuo YF , Kerr P , O'Malley P , Orihuela E , Tyler DS , Freedland SJ , Giordano SH , Vikram R , Kamat AM , Williams SB
Increased Utilization of Positron Emission Tomography/Computed Tomography (PET/CT) Imaging and Its Economic Impact for Patients Diagnosed With Bladder Cancer
Clin Genitourin Cancer. 2017 Jul 26
PMID: 28826932    PMCID: PMC5878135    URL: https://www.ncbi.nlm.nih.gov/pubmed/28826932
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Abstract
BACKGROUND: The purpose of this study was to examine temporal nationwide utilization patterns and predictors for use of positron emission tomography/computed tomography (PET/CT) in comparison with magnetic resonance imaging (MRI) and computed tomography (CT) among patients diagnosed with bladder cancer. MATERIALS AND METHODS: A total of 36,855 patients aged 66 years or older diagnosed with clinical stage TI-IV, N0M0 bladder cancer from 2004 to 2011 were analyzed. We used multivariable logistic regression analyses to discern factors associated with receipt of imaging within 12 months from diagnosis. The Cochran-Armitage test for trend was used to determine changes in the proportion of patients receiving imaging after cancer diagnosis. RESULTS: Independent of clinical stage, there was marked increase in use of PET/CT throughout the study period (2011 vs. 2004: odds ratio, 17.55; 95% confidence interval, 10.14-30.38; P < .001). Although use of CT imaging remained stable during the study period, there was significantly decreased utilization of MRI (odds ratio, 0.60; 95% confidence interval, 0.49-0.75; P < .001) in 2011 versus 2004. The mean incremental cost of PET/CT versus CT and MRI was $1040 and $612 (in 2016 dollars), respectively. Extrapolating these findings to the patients with bladder cancer in the United States results in excess spending of $11.6 million for PET/CT imaging. CONCLUSION: We identified rapid adoption of PET/CT imaging independent of clinical stage, resulting in excess national spending of $11.6 million for this imaging modality alone. Further value-based research discerning the clinical versus economic benefits of advanced imaging among patients with bladder cancer are needed.
Notes
1938-0682 Huo, Jinhai Chu, Yiyi Chamie, Karim Smaldone, Marc C Boorjian, Stephen A Baillargeon, Jacques G Kuo, Yong-Fang Kerr, Preston O'Malley, Padraic Orihuela, Eduardo Tyler, Douglas S Freedland, Stephen J Giordano, Sharon H Vikram, Raghu Kamat, Ashish M Williams, Stephen B Journal Article United States Clin Genitourin Cancer. 2017 Jul 26. pii: S1558-7673(17)30215-X. doi: 10.1016/j.clgc.2017.07.018.