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13N-ammonia myocardial perfusion imaging with hybrid PET/CT: impact on clinical decision-making and cost-effectiveness


Knabenhans, M A. 13N-ammonia myocardial perfusion imaging with hybrid PET/CT: impact on clinical decision-making and cost-effectiveness. 2007, University of Zurich, Faculty of Medicine.

Abstract

To determine the impact of 13N-ammonia myocardial perfusion positron emission tomography-computed tomography (PET/CT) hybrid imaging on clinical decision-making and its cost-effectiveness.
Methods: One hundred consecutive patients (28 women, 72 men; mean age 60.9�12.0 years; range 24-85 years) underwent 13N-ammonia PET/CT (CT was only used for attenuation correction) scanning to assess myocardial perfusion in patients with known (n=79) or suspected (n=8) coronary artery disease (CAD), or for suspected small vessel disease (SVD)(n=13). Prior to PET/CT the referring physician was asked to determine patient treatment if PET/CT would not be available. Four weeks after PET/CT patient management was re-assessed for each patient individually.
Results: Prior to PET/CT management strategies would have been: diagnostic angiography (62/100 patients), percutaneous coronary intervention (PCI) (6/100), coronary artery bypass grafting (CABG) (3/100), transplantation (1/100), or conservative medical treatment (28/100). After PET/CT scanning treatment strategies were altered in 78 patients leading to: diagnostic angiography (0/100), PCI (20/100), CABG (3/100), transplantation (1/100), or conservative medical treatment (76/100). Patient management followed the recommendations of PET/CT findings in 97% of the cases. Cost-effectiveness analysis revealed lower costs of $273/patient as a result of PET/CT scanning.
Conclusion: In a population with a high prevalence of CAD, PET/CT is cost-effective and has an important impact on patient management.

To determine the impact of 13N-ammonia myocardial perfusion positron emission tomography-computed tomography (PET/CT) hybrid imaging on clinical decision-making and its cost-effectiveness.
Methods: One hundred consecutive patients (28 women, 72 men; mean age 60.9�12.0 years; range 24-85 years) underwent 13N-ammonia PET/CT (CT was only used for attenuation correction) scanning to assess myocardial perfusion in patients with known (n=79) or suspected (n=8) coronary artery disease (CAD), or for suspected small vessel disease (SVD)(n=13). Prior to PET/CT the referring physician was asked to determine patient treatment if PET/CT would not be available. Four weeks after PET/CT patient management was re-assessed for each patient individually.
Results: Prior to PET/CT management strategies would have been: diagnostic angiography (62/100 patients), percutaneous coronary intervention (PCI) (6/100), coronary artery bypass grafting (CABG) (3/100), transplantation (1/100), or conservative medical treatment (28/100). After PET/CT scanning treatment strategies were altered in 78 patients leading to: diagnostic angiography (0/100), PCI (20/100), CABG (3/100), transplantation (1/100), or conservative medical treatment (76/100). Patient management followed the recommendations of PET/CT findings in 97% of the cases. Cost-effectiveness analysis revealed lower costs of $273/patient as a result of PET/CT scanning.
Conclusion: In a population with a high prevalence of CAD, PET/CT is cost-effective and has an important impact on patient management.

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Additional indexing

Item Type:Dissertation
Referees:Kaufmann P A
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Nuclear Medicine
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:2007
Deposited On:18 Mar 2009 12:55
Last Modified:05 Apr 2016 13:04
Number of Pages:26
Related URLs:http://opac.nebis.ch/F/?local_base=NEBIS&con_lng=GER&func=find-b&find_code=SYS&request=005521611
Permanent URL: http://doi.org/10.5167/uzh-15938

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