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European Radiology: The added value of imaging examination in pancreatic cancer m stages

Pancreatic cancer is a very invasive malignant tumor that has the lowest 5 -year survival rate among all solid tumors. In addition to obvious heterogeneity, poor prognosis is mainly due to the delay of diagnosis. About 50%of pancreatic cancer has metastasized during the initial diagnosis. As the incidence continues to rise, it is predicted that by 2030, pancreatic cancer will become the second major cause of cancer -related death in the United States. Surgical resection usually refers to the pancreatic duodenal resection, and then auxiliary chemotherapy, which is the only healing treatment option. Although surgical technology and perioperative management have continued to improve, the resection of pancreatic cancer is still extremely risky, and the mortality rate after surgery is 3-5%. The potential adverse reactions of the treatment plan emphasize the importance of the correct TNM classification. The existence of metastasis is one of the main taboos of surgical resection. For M staging, the liver is especially important as the most common transfer site. The staging examination of pancreatic cancer mainly includes CT scanning of the chest, abdomen and pelvic cavity to evaluate the resection of the tumor and exclusion and metastasis. Enhanced MRI is often used as an alternative method for evaluating the range of lesions and lymph nodes and liver metastasis.



Although the diagnosis and treatment of pancreatic cancer have improved, compared with the economic perspective and standard imaging (enhanced CT), the combined enhancement of MRI and CT’s utilization and value in detecting non -removed lesions. Recently, a study published in the EUROPEAN RADIOLOGY magazine evaluated the cost benefits of the liver metastasis during the staging of pancreatic cancer compared to the standard imaging (SCI) using CE-CT. The formulation of the inspection process provides a reference basis.

This study establishes a decision -making model based on the Markov simulation to adjust the life of life (QALYS) and lifelong costs with a quality diagnostic method. The input parameters of the model are evaluated based on the recent document evidence. Payment willingness (WTP) is set to $ 100,000/QALY. In order to evaluate the uncertainty of the model, the sensitivity analysis of certainty and probability is performed.

In the benchmark case analysis, the total cost generated by the model is 185,597 US dollars, the CE-MR/CT has a curative effect of 2.347 QALYS, CE-CT is 187,601 US dollars, and 2.337 QALYS. CE-MR/CT’s net currency benefits (NMB) are $ 49, $ 133, and CE-MR/CT’s net currency benefits are 46,117 US dollars, showing the leading position of CE-CT. The survival analysis of certainty and probability shows the stability of the model to different input parameters.

This study shows that CE-MR/CT combined treatment is a very economic-effective pancreatic cancer staging strategy, which has higher cost benefits compared to SCIs that only use CE-CT.

Original source:

Felix G Gassert, Sebastian Ziegelmayer, Johanna Luitjens, et al.ADDITIONAL MRI for Initial M-Staging in PanCreatecer: A Cost-Effectiveness Analysis.doi: 10.1007/S00330-021-021-021-021-021-021-021-021-021130-021-0211130-021-0211130-021-021111111311

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