68Ga‐somatostatin analogue PET‐CT: Analysis of costs and benefits in a public hospital setting

Introduction Between 2009 and 2012, 68Ga‐somatostatin analogue PET‐CT progressively replaced 111In‐octreotide scintigraphy for imaging neuroendocrine tumours in WA public hospitals due to published literature demonstrating improved diagnostic accuracy and increased availability. Despite significantly improved sensitivity and specificity, 68Ga‐somatostatin analogue PET is currently unfunded in Australia. This study sought to undertake cost analysis of the two modalities in a public hospital setting and to compare them with regard to patient factors such as imaging time and radiation dose. Methods This analysis was based on retrospective clinical data from 95 111In‐octreotide scintigraphies performed in 2007 and 2008 at Sir Charles Gairdner (SCGH) and Royal Perth (RPH) hospitals and 219 68Ga‐somatostatin analogue PET‐CT studies performed in 2013 at SCGH. Whole body effective radiation dose was derived from the radiopharmaceutical and low‐dose CT scan. The cost analysis included radiopharmaceutical and imaging costs. Results The median imaging time for an 111In‐octreotide scintigraphy was 152 min at SCGH, 100 min at RPH and 20 min for a 68Ga‐somatostatin analogue PET‐CT scan. The mean effective radiation dose for 111In‐octreotide scintigraphy was 18.1 mSv at SCGH and 13.8 mSv at RPH. The effective dose for 68Ga‐somatostatin analogue PET‐CT was 8.7–10.8 mSv. The average cost of 68Ga‐somatostatin analogue PET‐CT was four times less than 111In‐octreotide scintigraphy. Conclusion 68Ga‐somatostatin analogue PET‐CT is not only more accurate than 111In‐octreotide scintigraphy, this study has also shown that it is significantly less expensive, delivers a lower radiation dose to patients and requires less imaging time for patients and staff. 68Ga‐somatostatin PET‐CT provides an important combination of both reduced cost and improved clinical care for patients.