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18F-Fluorodeoxyglucose PET Procedures: Health Economic Aspects in Neurology

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Abstract

Whole-body 18F-FDG PET procedures in oncology have demonstrated utility in patient management in the clinic, especially with the emergence of new hybrid systems such as PET-CT or, more recently, PET-MR. Consequently, the use of 18F-FDG PET brain procedures, which currently represent on average <5 % of all PET procedures, is expected to increase significantly in the coming years. Indeed, driven mostly by the epidemiological burden of neurodegenerative diseases, principally Alzheimer’s disease, functional neuroimaging using PET is expected to become an equally important clinical tool as oncological PET procedures. However, before being implemented as a first-line procedure in neurology, 18F-FDG PET brain imaging must face several health economic challenges: for example, the emergence of direct competitors such as PET amyloid imaging, the availability of resources for tracer and image production, the impact of Health Technology Assessment reports and approval and reimbursement issues. Based on a SWOT analysis (Strengths, Weaknesses, Opportunities, and Threats) highlighting uncertainty parameters that may affect neuroimaging policies, the purpose of this chapter is to provide to decision makers some key health economic components which may remove barriers to the development of 18F-FDG PET in neurology.

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Abbreviations

ABC:

Activity-based costing

AD:

Alzheimer’s disease

CEA:

Cost-effectiveness analysis

CER:

Comparative effectiveness research

CMS:

Centers for medicare and medicaid services

CNS:

Central nervous system

CT:

Computed tomography

DT:

Diagnostic test

EANM:

European association of nuclear medicine

EBM:

Evidence-based medicine

FDG:

Fluoro-deoxy-glucose

FTD:

Frontotemporal dementia

GDP:

Gross domestic product

HEOR:

Health economic and outcome research

HTA:

Health technology assessment

LBD:

Lewy body dementia

MCI:

Mild cognitive impairment

MET:

Methionine

MRI:

Magnetic resonance imaging

OECD:

Organisation for economic co-operation and development

PD:

Parkinson’s disease

PET:

Positron emission tomography

QA:

Quality assurance

QALY:

Quality-adjusted life years

SNM:

Society of nuclear medicine

SNR:

Signal-to-noise ratio

SPECT:

Single-photon emission computed tomography

TI:

Therapeutic intervention

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Authors and Affiliations

  1. Nuclear Medicine Department, Centre Antoine Lacassagne, 33 avenue Valombrose, 06187, Nice Cedex 2, France

    Renaud Guignard, Matthieu J. Ouvrier & Jacques Darcourt

  2. Nuclear Medicine Department, Université Catholique de Louvain, University Hospital Mont-Godinne, 1 Dr Therasse, Yvoir, B-5530, Belgium

    Bruno Krug

  3. Division of Biomedical Engineering, Faculty of Electrical Engineering and Information Technology, University of Applied Sciences Offenburg, Badstrasse 24, Offenburg, 77652, Germany

    Andreas Otte

  4. Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Hanzeplein 1, Groningen, 9713GZ, The Netherlands

    Rudi A. J. O. Dierckx

  5. Department of Radiology and Nuclear Medicine, Ghent University, De Pintelaan 185 K12, Ghent, 9000, Belgium

    Rudi A. J. O. Dierckx

Authors
  1. Renaud Guignard
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  2. Matthieu J. Ouvrier
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  3. Bruno Krug
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  4. Andreas Otte
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  5. Jacques Darcourt
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  6. Rudi A. J. O. Dierckx
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Corresponding author

Correspondence to Renaud Guignard .

Editor information

Editors and Affiliations

  1. Dept. of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands

    Rudi A.J.O. Dierckx

  2. Faculty of Electrical Engineering and Information Technology, University of Applied Sciences Offenburg, Offenburg, Germany

    Andreas Otte

  3. Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, Groningen, The Netherlands

    Erik F.J. de Vries

  4. Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, Groningen, The Netherlands

    Aren van Waarde

  5. Neurology, University Medical Center Groningen, Groningen, The Netherlands

    Klaus L. Leenders

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Guignard, R., Ouvrier, M.J., Krug, B., Otte, A., Darcourt, J., Dierckx, R.A.J.O. (2014). 18F-Fluorodeoxyglucose PET Procedures: Health Economic Aspects in Neurology. In: Dierckx, R., Otte, A., de Vries, E., van Waarde, A., Leenders, K. (eds) PET and SPECT in Neurology. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-54307-4_2

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