肺癌~(18)F-氟脱氧葡萄糖正电子发射型计算机断层显像检查的卫生经济学
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摘要
~(18)F-氟脱氧葡萄糖正电子发射型计算机断层显像(~(18)F-f luorodeoxyglucose positron-emission tomography comparedwith computed tomography,~(18)F-FDG PET-CT,简称PET-CT)用于孤立性肺结节(solitary pulmonary nodule,SPN)及肺癌诊断的敏感性和特异性较常规影像检查显著提高。从卫生经济学角度而言,PET-CT用于恶性肿瘤风险偏中的SPN最具成本效果性,且对于肺癌的术前分期诊断及放射治疗、化学治疗后的随访都具有较好的卫生经济学价值。PET-CT用于肺癌诊疗的卫生经济学研究大多采用的评价方法、效果指标及比较方法分别为成本效果分析、生命年和计算增量成本效果比。病例追踪和随访是早期PET-CT卫生经济学研究的一种手段,而近年来大多数研究所采用的都是模型法。
Compared with conventional imaging, 18 F-fluorodeoxyglucose positron-emission tomography compared with computed tomography(18 F-FDG PET/CT) possesses higher sensitivity and specificity in the diagnosis of solitary pulmonary nodule(SPN) and lung cancer. From the perspective of healtheconomics, PET/CT is more suitable strategy for diagnose of SPN with intermediate probability of malignancy, and has good healtheconomics value in preoperative staging diagnosis and follow-up aft er radiotherapy and chemotherapy of lung cancer. Th e evaluation meth od, effect index and comparison meth od used in the healtheconomics research of PET/CT for lung cancer diagnosis and treatment are cost-effect analysis, life year and incremental cost-effect ratio, respectively. Case tracking and follow-up was a means of early studies on PET/CT healtheconomics, and in recent years mathematical models are used in most studies.
Compared with conventional imaging, 18 F-fluorodeoxyglucose positron-emission tomography compared with computed tomography(18 F-FDG PET/CT) possesses higher sensitivity and specificity in the diagnosis of solitary pulmonary nodule(SPN) and lung cancer. From the perspective of healtheconomics, PET/CT is more suitable strategy for diagnose of SPN with intermediate probability of malignancy, and has good healtheconomics value in preoperative staging diagnosis and follow-up aft er radiotherapy and chemotherapy of lung cancer. Th e evaluation meth od, effect index and comparison meth od used in the healtheconomics research of PET/CT for lung cancer diagnosis and treatment are cost-effect analysis, life year and incremental cost-effect ratio, respectively. Case tracking and follow-up was a means of early studies on PET/CT healtheconomics, and in recent years mathematical models are used in most studies.
引文
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[16]李亚明,陈英茂,田嘉禾.全国PET/CT(PET)配置与使用情况调查简报[J].中华核医学杂志, 2009, 29(4):282-283.LI Yaming, CHEN Yingmao, TIAN Jiahe. Investigation briefing onallocation and utilization of PET/CT(PET)in China[J]. ChineseJournal of Nuclear Medicine, 2009, 29(4):282-283.
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[19]Han Y, Xiao H, Zhou Z, et al. Cost-e?ectiveness analysis of strategiesintroducingintegrated18F-FDGPET/CTintothemediastinallymph node staging of non-small-cell lung cancer[J]. Nucl MedComm, 2015, 36(3):234-241.
[20]ComberLA,Keith CJ,Griffith sM,etal.Solitarypulmonarynodules:impact of quantitative contrast-enhanced CT on the cost-e?ectiveness of FDG-PET[J]. Clin Radiol, 2003, 58(9):706-711.
[21]GouldMK,SandersGD,BarnettPG,etal.Cost-effectivenessofalternativemanagementstrategiesforpatientswith solitarypulmonary nodules[J]. Ann Intern Med, 2003, 138(9):724-735.
[22]vanLoonJ,GruttersJP,WandersR,etal.18FDG-PET-CTinthe follow-up of non-small cell lung cancer patients after radicalradiotherapyw ith orw ith outchemotherapy:aneconomicevaluation[J]. Eur J Cancer, 2010, 46(1):110-119.
[23]Gambhir SS, Shepherd JE, Shah BD, et al. Analytical decision modelfor the cost-e?ective management of solitary pulmonary nodules[J].J Clin Oncol, 1998, 16(6):2113-2125.
[24]LejeuneC,AlZahouriK,Woronoff-LemsiMC,etal.Useofadecision analysis model to assess the medicoeconomic implicationsof FDG PET imaging in diagnosing a solitary pulmonary nodule[J].Eur J Health Econ, 2005, 6(3):203-214.
[25]王荣福.PET/CT新技术应用[J].CT理论与应用研究,2009,18(4):9-14.WANG Rongfu. Application on new technology of PET/CT[J]. CTTheory and Applications, 2009, 18(4):9-14.
[26]罗韶晖.从我国PET/CT装备现状看合理配置卫生资源的重要性[J].中国医院管理, 2007, 27(11):75-77.LUO Shaohui. Research on the present situation of PET/CT inChina and how to rational use resources of sanitation[J]. ChineseHospital Management, 2007, 27(11):75-77.
[27]Keith CJ, Miles KA, Gri?th s MR, et al. Solitary pulmonary nodules:accuracy and cost-effectiveness of sodium iodide FDG-PET usingAustralian data[J]. Eur J Nucl Med Mol Imaging, 2002, 29(8):1016-1023.
[2]王晓琴.肺内孤立性结节和早期肺癌的影像诊断和鉴别诊断[J].世界最新医学信息文摘, 2017, 17(16):105-106.WANGXiaoqin.Imaginganddifferentialdiagnosisofsolitarypulmonary nodule and lung cancer withearly stage[J]. World LatestMedicne Information, 2017, 17(16):105-106.
[3]Truong MT, Ko JP, Rossi SE, et al. Update in the evaluation of thesolitary pulmonary nodule[J]. Radio Graphics, 2014, 34(6):1658-1679.
[4]Sahin E, Kara A, Elboga U. Contribution of nonattenuation-correctedimages on FDG-PET/CT in the assessment of solitary pulmonarynodules[J]. Radiol Med, 2016, 121(12):944-949.
[5]任云燕,李友财,吴湖炳,等.薄层CT与18F-FDG PET/CT联合运用可提高肺孤立性结节定性诊断的准确性[J].南方医科大学学报, 2017, 37(3):283-289.REN Yunyan, LI Youcai, WU Hubing, et al. Combined use of th in-section CT and 18F-FDG PET/CT for characterization of solitarypulmonary nodules[J]. Journal of South Medical University, 2017,37(3):283-289.
[6]Ceylan N, Dogan S, Kocacelebi K, et al. Contrast enhanced CTversus integrated PET-CT in pre-operative nodal staging of non-small cell lung cancer[J]. Diagn Interv Radiol, 2012, 18(5):435-440.
[7]Yang RM, Li L, Wei XH, et al. Di?erentiation of central lung cancerfrom atelectasis:comparison of di?usion-weighted MRI with PET/CT[J]. PLoS One, 2013, 8(4):e60279.
[8]GroheuxD,QuereG,BlancE,etal.FDGPET-CTforsolitarypulmonarynoduleandlungcancer:literaturereview[J].DiagnInterv Radiol, 2016, 97(10):1003-1017.
[9]Valk PE, Pounds TR, Tesar RD, et al. Cost-effectiveness of PETimaging in clinical oncology[J]. Nucl Med Biol, 1996, 23(6):737-743.
[10]S?gaard R, Fischer BMB, Mortensen J, et al. Preoperative staging oflung cancer with PET/CT:cost-e?ectiveness evaluation alongside arandomized controlled trial[J]. Eur J Nucl Med Mol Imaging, 2011,38(5):802-809.
[11]Schrey?gg J, Weller J, Stargardt T, et al. Cost-e?ectiveness of hybridPET/CT for staging of non–small cell lung cancer[J]. J Nucl Med,2010, 51(11):1668-1675.
[12]Scott WJ, Shepherd J, Gambhir SS. Cost-e?ectiveness of FDG-PETfor staging non–small cell lung cancer:a decision analysis[J]. AnnThorac Surg, 1998, 66(6):1876-1884.
[13]Dietlein M, Weber K, Gandjour A, et al. Cost-e?ectiveness of FDG-PET for the management of potentially operable non-small cell lungcancer:priority for a PET-based strategy after nodal-negative CTresults[J]. Eur J Nucl Med, 2000, 27(11):1598-1609.
[14]Gugiatti A, Grimaldi A, Rossetti C, et al. Economic analyses on theuse of positron emission tomography for the work-up of solitarypulmonary nodules and for staging patients with non-small-cell-lung-cancer in Italy[J]. Q J Nucl Med Mol Im, 2004, 48(1):49-61.
[15]BuckAK,HerrmannK,SchreyoggJ.PET/CTforstaginglungcancer:costly or cost-saving?[J]. Eur J Nucl Med Mol Imaging, 2011,38(5):799-801.
[16]李亚明,陈英茂,田嘉禾.全国PET/CT(PET)配置与使用情况调查简报[J].中华核医学杂志, 2009, 29(4):282-283.LI Yaming, CHEN Yingmao, TIAN Jiahe. Investigation briefing onallocation and utilization of PET/CT(PET)in China[J]. ChineseJournal of Nuclear Medicine, 2009, 29(4):282-283.
[17]张成琪,孟庆跃. PET-CT对肿瘤分期定性分期诊断的卫生经济学评价[J].中国卫生经济, 2008, 27(10):68-71.ZHANGChengqi,MENGQingyue.Economicanalysesontheuse of positron emission tomography-computed tomography fordiagnosing and staging patients with malignant tumor[J]. ChineseHealth Economics, 2008, 27(10):68-71.
[18]Wang YT, Huang G. Is FDG PET/CT cost-e?ective for pre-operationstaging of potentially operative non-small cell lung cancer?–FromChinese health care system perspective[J]. Eur J of Radiol, 2012,81(8):903-909.
[19]Han Y, Xiao H, Zhou Z, et al. Cost-e?ectiveness analysis of strategiesintroducingintegrated18F-FDGPET/CTintothemediastinallymph node staging of non-small-cell lung cancer[J]. Nucl MedComm, 2015, 36(3):234-241.
[20]ComberLA,Keith CJ,Griffith sM,etal.Solitarypulmonarynodules:impact of quantitative contrast-enhanced CT on the cost-e?ectiveness of FDG-PET[J]. Clin Radiol, 2003, 58(9):706-711.
[21]GouldMK,SandersGD,BarnettPG,etal.Cost-effectivenessofalternativemanagementstrategiesforpatientswith solitarypulmonary nodules[J]. Ann Intern Med, 2003, 138(9):724-735.
[22]vanLoonJ,GruttersJP,WandersR,etal.18FDG-PET-CTinthe follow-up of non-small cell lung cancer patients after radicalradiotherapyw ith orw ith outchemotherapy:aneconomicevaluation[J]. Eur J Cancer, 2010, 46(1):110-119.
[23]Gambhir SS, Shepherd JE, Shah BD, et al. Analytical decision modelfor the cost-e?ective management of solitary pulmonary nodules[J].J Clin Oncol, 1998, 16(6):2113-2125.
[24]LejeuneC,AlZahouriK,Woronoff-LemsiMC,etal.Useofadecision analysis model to assess the medicoeconomic implicationsof FDG PET imaging in diagnosing a solitary pulmonary nodule[J].Eur J Health Econ, 2005, 6(3):203-214.
[25]王荣福.PET/CT新技术应用[J].CT理论与应用研究,2009,18(4):9-14.WANG Rongfu. Application on new technology of PET/CT[J]. CTTheory and Applications, 2009, 18(4):9-14.
[26]罗韶晖.从我国PET/CT装备现状看合理配置卫生资源的重要性[J].中国医院管理, 2007, 27(11):75-77.LUO Shaohui. Research on the present situation of PET/CT inChina and how to rational use resources of sanitation[J]. ChineseHospital Management, 2007, 27(11):75-77.
[27]Keith CJ, Miles KA, Gri?th s MR, et al. Solitary pulmonary nodules:accuracy and cost-effectiveness of sodium iodide FDG-PET usingAustralian data[J]. Eur J Nucl Med Mol Imaging, 2002, 29(8):1016-1023.