Decision tree sensitivity analysis for cost-effectiveness of chest FDG- PET in patients with a pulmonary tumor (non-small cell carcinoma)

S. Kosuda, K. Ichihara, Masazumi Watanabe, H. Kobayashi, S. Kusano

Research output: Contribution to journalArticle

6 Citations (Scopus)


Decision tree analysis was used to assess cost-effectiveness of chest FDG-PET in patients with a pulmonary tumor (non-small cell carcinoma, ≤Stage IIIB), based on the data of the current decision tree. Decision tree models were constructed with two competing strategies (CT alone and CT plus chest FDG-PET) in 1,000 patient population with 71.4% prevalence. Baselines of FDG- PET sensitivity and specificity on detection of lung cancer and lymph node metastasis, and mortality and life expectancy were available from references. Chest CT plus chest FDG-PET strategy increased a total cost by 10.5% when a chest FDG-PET study costs 0.1 million yen, since it increased the number of mediastinoscopy and curative thoracotomy despite reducing the number of bronchofiberscopy to half. However, the strategy resulted in a remarkable increase by 115 patients with curable thoracotomy and decrease by 51 patients with non-curable thoracotomy. In addition, an average life expectancy increased by 0.607 year/patient, which means increase in medical cost is approximately 218,080 yen/year/patient when a chest FDG-PET study costs 0.1 million yen. In conclusion, chest CT plus chest FDG-PET strategy might not be cost-effective in Japan, but we are convinced that the strategy is useful in cost-benefit analysis.

Original languageEnglish
Pages (from-to)395-404
Number of pages10
Issue number6
Publication statusPublished - 1998
Externally publishedYes



  • Cost-effectiveness
  • Decision tree analysis
  • FDG- PET
  • Lung cancer
  • Sensitivity analysis

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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