Prostate-specific membrane antigen (PSMA) positron emission tomography/computed tomography (PET/CT) has lower costs than conventional imaging for men with high-risk prostate cancer, according to a study published in the March issue of European Urology.
Rafael E. de Feria Cardet, from the University of Technology Sydney, and colleagues developed a cost-effectiveness analysis using data from the proPSMA study, a randomized controlled trial that the authors note demonstrated superior diagnostic accuracy for PSMA PET/CT versus conventional imaging (CT and bone scan) for detection of metastatic disease. The study involved patients with high-risk prostate cancer assigned to conventional imaging or ⁶⁸Ga-PSMA-11 PET/CT.
The researchers found that PSMA PET/CT had an estimated cost per scan of Australian dollar (AUD)$1,203, which was less than the AUD$1,412 for conventional imaging. With better accuracy and lower cost, PSMA PET/CT was dominant. Per accurate detection of nodal disease, the resultant cost savings were AUD$959, while AUD$1,412 was saved for each additional accurate detection of distant metastases. In a sensitivity analysis, the weighted cost per metastasis detection was sensitive to the number of patients per elution for ⁶⁸Ga-PSMA PET/CT.
“Combined with the other findings from proPSMA for patient management change, lower radiation exposure, and fewer equivocal findings, a compelling case can be made for adopting PSMA PET/CT,” the authors write.
Two authors disclosed financial ties to the pharmaceutical industry.