Increased Utilization of Positron Emission Tomography/Computed Tomography (PET/CT) Imaging and Its Economic Impact for Patients Diagnosed With Bladder Cancer

Jinhai Huo, Yiyi Chu, Karim Chamie, Marc C. Smaldone, Stephen A. Boorjian, Jacques Baillargeon, Yong Fang Kuo, Preston Kerr, Padraic O'Malley, Eduardo Orihuela, Douglas Tyler, Stephen J. Freedland, Sharon H. Giordano, Raghu Vikram, Ashish M. Kamat, Stephen Williams

Research output: Contribution to journalArticle

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.

Original languageEnglish (US)
JournalClinical Genitourinary Cancer
DOIs
StateAccepted/In press - 2017

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Urinary Bladder Neoplasms
Economics
Tomography
Magnetic Resonance Imaging
Odds Ratio
Confidence Intervals
Logistic Models
Regression Analysis
Positron Emission Tomography Computed Tomography
Costs and Cost Analysis
Research
Neoplasms

Keywords

  • Bladder cancer
  • Imaging
  • PET/CT
  • Positron emission tomography-computed tomography

ASJC Scopus subject areas

  • Oncology
  • Urology

Cite this

Increased Utilization of Positron Emission Tomography/Computed Tomography (PET/CT) Imaging and Its Economic Impact for Patients Diagnosed With Bladder Cancer. / Huo, Jinhai; Chu, Yiyi; Chamie, Karim; Smaldone, Marc C.; Boorjian, Stephen A.; Baillargeon, Jacques; Kuo, Yong Fang; Kerr, Preston; O'Malley, Padraic; Orihuela, Eduardo; Tyler, Douglas; Freedland, Stephen J.; Giordano, Sharon H.; Vikram, Raghu; Kamat, Ashish M.; Williams, Stephen.

In: Clinical Genitourinary Cancer, 2017.

Research output: Contribution to journalArticle

Huo, Jinhai ; Chu, Yiyi ; Chamie, Karim ; Smaldone, Marc C. ; Boorjian, Stephen A. ; Baillargeon, Jacques ; Kuo, Yong Fang ; Kerr, Preston ; O'Malley, Padraic ; Orihuela, Eduardo ; Tyler, Douglas ; Freedland, Stephen J. ; Giordano, Sharon H. ; Vikram, Raghu ; Kamat, Ashish M. ; Williams, Stephen. / Increased Utilization of Positron Emission Tomography/Computed Tomography (PET/CT) Imaging and Its Economic Impact for Patients Diagnosed With Bladder Cancer. In: Clinical Genitourinary Cancer. 2017.
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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.",
keywords = "Bladder cancer, Imaging, PET/CT, Positron emission tomography-computed tomography",
author = "Jinhai Huo and Yiyi Chu and Karim Chamie and Smaldone, {Marc C.} and Boorjian, {Stephen A.} and Jacques Baillargeon and Kuo, {Yong Fang} and Preston Kerr and Padraic O'Malley and Eduardo Orihuela and Douglas Tyler and Freedland, {Stephen J.} and Giordano, {Sharon H.} and Raghu Vikram and Kamat, {Ashish M.} and Stephen Williams",
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T1 - Increased Utilization of Positron Emission Tomography/Computed Tomography (PET/CT) Imaging and Its Economic Impact for Patients Diagnosed With Bladder Cancer

AU - Huo, Jinhai

AU - Chu, Yiyi

AU - Chamie, Karim

AU - Smaldone, Marc C.

AU - Boorjian, Stephen A.

AU - Baillargeon, Jacques

AU - Kuo, Yong Fang

AU - Kerr, Preston

AU - O'Malley, Padraic

AU - Orihuela, Eduardo

AU - Tyler, Douglas

AU - Freedland, Stephen J.

AU - Giordano, Sharon H.

AU - Vikram, Raghu

AU - Kamat, Ashish M.

AU - Williams, Stephen

PY - 2017

Y1 - 2017

N2 - 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.

AB - 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.

KW - Bladder cancer

KW - Imaging

KW - PET/CT

KW - Positron emission tomography-computed tomography

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