Abstract
BackgroundBased on prior studies spectral CT has shown a higher sensitivity for malignant lesions than conventional CT at the cost of lower specificity. For the radiologists, it also offers a higher degree of certainty in the diagnosis of benign lesions. The objective of this study was to evaluate the economic impact of spectral CT in patients suspected of occult cancer in a medical center in Denmark.MethodsThis study was a secondary analysis using de-identified data from a prospective study of patients receiving a contrast-enhanced spectral CT scan. Based on suggested follow-up examinations on both spectral CT and contrast-enhanced CT, costs from a payer’s perspective were determined using unit costs obtained from national databases.ResultsThe dataset contained 400 patients. Overall, 203 follow-up procedures were eliminated based on spectral data reading. The largest reduction in suggested follow-up procedures was found for the kidney (83%), followed by the liver (66%), adrenal glands (60%), and pancreas (42%). The total estimated costs for suggested follow-up procedures based on spectral data reading were €155,219, 25.2% (€52,384) less than that of conventional CT reading.ConclusionOur results provide support for spectral body imaging as an advanced imaging modality for suspected occult cancer. A substantial number of follow-up diagnostic procedures could be eliminated based on spectral data reading, which would result in significant cost savings.
Highlights
Based on prior studies spectral CT has shown a higher sensitivity for malignant lesions than conventional CT at the cost of lower specificity
In 2009, fast-track investigational courses for patients with suspected cancer were introduced in Denmark to streamline organ-specific cancer patient pathways (CPPs)
Patients referred from the general practitioner (GP) to the Non-specific cancer patient pathway (NS-CPP) were eligible for inclusion
Summary
Based on prior studies spectral CT has shown a higher sensitivity for malignant lesions than conventional CT at the cost of lower specificity. For the radiologists, it offers a higher degree of certainty in the diagnosis of benign lesions. The goal was an accelerated investigational course of no longer than 9 days to ensure relevant triage into either an organ-specific CPP or referral to relevant specialties to take care of treatment based on the diagnostic findings made during the workup [4,5,6,7]. Patients presenting with non-specific symptoms (e.g., fatigue, pain, fever, unintended weight loss, abnormal blood chemistry) were initially screened for occult malignancy with a physical examination and laboratory evaluation performed by the general practitioner. In case of continued suspicion, initial screening was supplemented with diagnostic contrast-enhanced computed tomography (CE-CT) of the thorax, abdomen, and pelvis [4, 5, 8]
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