Evidence map›Paper›PMID 28204572›Full record

ArticleNeuro-oncology2017

O-(2-18F-fluoroethyl)-L-tyrosine PET for evaluation of brain metastasis recurrence after radiotherapy: an effectiveness and cost-effectiveness analysis.

Alexander Heinzel, Dirk Müller, Sareh Said Yekta-Michael, Garry Ceccon, Karl-Josef Langen, Felix M Mottaghy, Martin Wiesmann, Martin Kocher, Elke Hattingen, Norbert Galldiks

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PubMed Full text at PMC Publisher
In one paragraph

Article in Neuro-oncology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
18citing papers in PubMed, 4 pooled it
2.7field-weighted citation impact, top 10% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

18 citing papers in PubMed, 4 syntheses or guidelines pooled it, 35 citations in OpenAlex.

  1. Guideline
  2. Pooled it
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  5. Real-world application ofEuropean journal of nuclear medicine and molecular imaging · 2026
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  16. Cost-Effectiveness of [Frontiers in oncology · 2019
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 4 institutions in 1 country.

Alexander HeinzelDepartment of Nuclear Medicine, University of Aachen, Aachen, Germany; Institute for Health Economics and Clinical Epidemiology, University of Cologne, Cologne, Germany; Department of Conservative Dentistry, Periodontology and Preventive Dentistry, University of Aachen, Aachen, Germany; Department of Neurology, University of Cologne, Cologne, Germany; Institute for Neuroscience and Medicine, Research Center Juelich, Juelich, Germany; Department of Neuroradiology University of Aachen, Aachen, Germany; Department of Radiation Oncology, University of Cologne, Cologne, Germany; Department of Radiology, University of Bonn, Bonn, Germany; Center of Integrated Oncology (CIO), Universities of Cologne and Bonn, Germany.
Dirk MüllerDepartment of Nuclear Medicine, University of Aachen, Aachen, Germany; Institute for Health Economics and Clinical Epidemiology, University of Cologne, Cologne, Germany; Department of Conservative Dentistry, Periodontology and Preventive Dentistry, University of Aachen, Aachen, Germany; Department of Neurology, University of Cologne, Cologne, Germany; Institute for Neuroscience and Medicine, Research Center Juelich, Juelich, Germany; Department of Neuroradiology University of Aachen, Aachen, Germany; Department of Radiation Oncology, University of Cologne, Cologne, Germany; Department of Radiology, University of Bonn, Bonn, Germany; Center of Integrated Oncology (CIO), Universities of Cologne and Bonn, Germany.
Sareh Said Yekta-MichaelDepartment of Nuclear Medicine, University of Aachen, Aachen, Germany; Institute for Health Economics and Clinical Epidemiology, University of Cologne, Cologne, Germany; Department of Conservative Dentistry, Periodontology and Preventive Dentistry, University of Aachen, Aachen, Germany; Department of Neurology, University of Cologne, Cologne, Germany; Institute for Neuroscience and Medicine, Research Center Juelich, Juelich, Germany; Department of Neuroradiology University of Aachen, Aachen, Germany; Department of Radiation Oncology, University of Cologne, Cologne, Germany; Department of Radiology, University of Bonn, Bonn, Germany; Center of Integrated Oncology (CIO), Universities of Cologne and Bonn, Germany.
Garry CecconDepartment of Nuclear Medicine, University of Aachen, Aachen, Germany; Institute for Health Economics and Clinical Epidemiology, University of Cologne, Cologne, Germany; Department of Conservative Dentistry, Periodontology and Preventive Dentistry, University of Aachen, Aachen, Germany; Department of Neurology, University of Cologne, Cologne, Germany; Institute for Neuroscience and Medicine, Research Center Juelich, Juelich, Germany; Department of Neuroradiology University of Aachen, Aachen, Germany; Department of Radiation Oncology, University of Cologne, Cologne, Germany; Department of Radiology, University of Bonn, Bonn, Germany; Center of Integrated Oncology (CIO), Universities of Cologne and Bonn, Germany.
Karl-Josef LangenDepartment of Nuclear Medicine, University of Aachen, Aachen, Germany; Institute for Health Economics and Clinical Epidemiology, University of Cologne, Cologne, Germany; Department of Conservative Dentistry, Periodontology and Preventive Dentistry, University of Aachen, Aachen, Germany; Department of Neurology, University of Cologne, Cologne, Germany; Institute for Neuroscience and Medicine, Research Center Juelich, Juelich, Germany; Department of Neuroradiology University of Aachen, Aachen, Germany; Department of Radiation Oncology, University of Cologne, Cologne, Germany; Department of Radiology, University of Bonn, Bonn, Germany; Center of Integrated Oncology (CIO), Universities of Cologne and Bonn, Germany.
Felix M MottaghyDepartment of Nuclear Medicine, University of Aachen, Aachen, Germany; Institute for Health Economics and Clinical Epidemiology, University of Cologne, Cologne, Germany; Department of Conservative Dentistry, Periodontology and Preventive Dentistry, University of Aachen, Aachen, Germany; Department of Neurology, University of Cologne, Cologne, Germany; Institute for Neuroscience and Medicine, Research Center Juelich, Juelich, Germany; Department of Neuroradiology University of Aachen, Aachen, Germany; Department of Radiation Oncology, University of Cologne, Cologne, Germany; Department of Radiology, University of Bonn, Bonn, Germany; Center of Integrated Oncology (CIO), Universities of Cologne and Bonn, Germany.
Martin WiesmannDepartment of Nuclear Medicine, University of Aachen, Aachen, Germany; Institute for Health Economics and Clinical Epidemiology, University of Cologne, Cologne, Germany; Department of Conservative Dentistry, Periodontology and Preventive Dentistry, University of Aachen, Aachen, Germany; Department of Neurology, University of Cologne, Cologne, Germany; Institute for Neuroscience and Medicine, Research Center Juelich, Juelich, Germany; Department of Neuroradiology University of Aachen, Aachen, Germany; Department of Radiation Oncology, University of Cologne, Cologne, Germany; Department of Radiology, University of Bonn, Bonn, Germany; Center of Integrated Oncology (CIO), Universities of Cologne and Bonn, Germany.
Martin KocherDepartment of Nuclear Medicine, University of Aachen, Aachen, Germany; Institute for Health Economics and Clinical Epidemiology, University of Cologne, Cologne, Germany; Department of Conservative Dentistry, Periodontology and Preventive Dentistry, University of Aachen, Aachen, Germany; Department of Neurology, University of Cologne, Cologne, Germany; Institute for Neuroscience and Medicine, Research Center Juelich, Juelich, Germany; Department of Neuroradiology University of Aachen, Aachen, Germany; Department of Radiation Oncology, University of Cologne, Cologne, Germany; Department of Radiology, University of Bonn, Bonn, Germany; Center of Integrated Oncology (CIO), Universities of Cologne and Bonn, Germany.
Elke HattingenDepartment of Nuclear Medicine, University of Aachen, Aachen, Germany; Institute for Health Economics and Clinical Epidemiology, University of Cologne, Cologne, Germany; Department of Conservative Dentistry, Periodontology and Preventive Dentistry, University of Aachen, Aachen, Germany; Department of Neurology, University of Cologne, Cologne, Germany; Institute for Neuroscience and Medicine, Research Center Juelich, Juelich, Germany; Department of Neuroradiology University of Aachen, Aachen, Germany; Department of Radiation Oncology, University of Cologne, Cologne, Germany; Department of Radiology, University of Bonn, Bonn, Germany; Center of Integrated Oncology (CIO), Universities of Cologne and Bonn, Germany.
Norbert GalldiksDepartment of Nuclear Medicine, University of Aachen, Aachen, Germany; Institute for Health Economics and Clinical Epidemiology, University of Cologne, Cologne, Germany; Department of Conservative Dentistry, Periodontology and Preventive Dentistry, University of Aachen, Aachen, Germany; Department of Neurology, University of Cologne, Cologne, Germany; Institute for Neuroscience and Medicine, Research Center Juelich, Juelich, Germany; Department of Neuroradiology University of Aachen, Aachen, Germany; Department of Radiation Oncology, University of Cologne, Cologne, Germany; Department of Radiology, University of Bonn, Bonn, Germany; Center of Integrated Oncology (CIO), Universities of Cologne and Bonn, Germany.
RWTH Aachen University · DEForschungszentrum Jülich · DEUniversity Hospital Cologne · DEUniversity of Bonn · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundConventional MRI is the standard method to diagnose recurrence of brain metastases after radiation. However, following radiation therapy, reactive transient blood-brain barrier alterations with consecutive contrast enhancement can mimic brain metastasis recurrence. Recent studies have suggested that O-(2-18F-fluoroethyl)-L-tyrosine (FET) PET improves the correct differentiation of brain metastasis recurrence from radiation injury. Based on published evidence and clinical expert opinion, we analyzed effectiveness and cost-effectiveness of the use of FET PET in addition to MRI compared with MRI alone for the diagnosis of recurrent brain metastases.

methodsA decision-tree model was designed to compare the 2 diagnostic strategies from the perspective of the German Statutory Health Insurance (SHI) system. Effectiveness was defined as correct diagnosis of recurrent brain metastasis and was compared between FET PET with MRI and MRI alone. Costs were calculated for a baseline scenario and for a more expensive scenario. Robustness of the results was tested using sensitivity analyses.

resultsCompared with MRI alone, FET PET in combination with MRI increases the rate of correct diagnoses by 42% (number needed to diagnose of 3) with an incremental cost-effectiveness ratio of €2821 (baseline scenario) and €4014 (more expensive scenario) per correct diagnosis. The sensitivity analyses confirmed the robustness of the results.

conclusionsThe model suggests that the additional use of FET PET with conventional MRI for the diagnosis of recurrent brain metastases may be cost-effective. Integration of FET PET has the potential to avoid overtreatment with corresponding costs as well as unnecessary side effects.

Indexed as

Brain NeoplasmsCost-Benefit AnalysisDecision TreesFluorine RadioisotopesHumansNeoplasm Recurrence, LocalNeuroimagingPositron-Emission TomographyRadiopharmaceuticalsFluorine RadioisotopesRadiopharmaceuticals18F-FET PETcost-effectiveness analysisdecision tree modelrecurrent brain metastases

Identifiers

PMID28204572
PMCPMC5570232
OpenAlexW2589088240

What OpenQuestion holds

Textmetadata
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.