Pancreatic cancer: cost-effectiveness of imaging technologies for assessing resectability

Radiology. 2001 Oct;221(1):93-106. doi: 10.1148/radiol.2211001656.


Purpose: To evaluate the cost-effectiveness of imaging strategies for the assessment of resectability in patients with pancreatic cancer.

Materials and methods: A decision model was developed to calculate costs and benefits (survival) accruing to hypothetical cohorts of patients with known or suspected pancreatic cancer. Results are presented as cost per life-year gained under various scenarios and assumptions of diagnostic test characteristics, surgical mortality, disease characteristics, and costs.

Results: With best estimates for all data inputs, the strategy of computed tomography (CT) followed by laparoscopy and laparoscopic ultrasonography (US) had an incremental cost-effectiveness ratio of $87,502 per life-year gained, compared with best supportive care. This strategy was significantly more cost-effective than CT followed by magnetic resonance (MR) imaging and was significantly less expensive than other imaging strategies while providing a statistically and clinically insignificant difference in life-year gains. A strategy involving no imaging (immediate surgery) was more expensive but less effective than all imaging strategies. A hypothetical perfect test with cost equal to that of CT followed by MR had an incremental cost-effectiveness ratio of $64,401 per life-year gained, compared to best supportive care.

Conclusion: Most available imaging tests for assessing resectability of pancreatic cancer do not differ in effectiveness, but a strategy of CT, laparoscopy, and laparoscopic US would consistently result in significantly lower costs than other imaging tests under a wide range of scenarios.

MeSH terms

  • Cost-Benefit Analysis
  • Decision Support Techniques*
  • Humans
  • Pancreatic Neoplasms / diagnosis*
  • Pancreatic Neoplasms / diagnostic imaging
  • Pancreatic Neoplasms / economics*
  • Pancreatic Neoplasms / mortality
  • Pancreatic Neoplasms / surgery
  • Sensitivity and Specificity
  • Survival Rate
  • Tomography, X-Ray Computed / economics
  • Ultrasonography