使用mpMRI和PSMA-PET/CT进行前列腺癌无活检诊断策略的成本效益分析
Joshua Yi Min Tung1,2, Rachel Shu-En Lau3, Edmund Pek Siang Teo4
1Department of Urology Singapore General Hospital Singapore.
BJUI compass
|February 6, 2026
概括
结合前列腺特异性膜抗原正子发射断层扫描计算机断层扫描 (PSMA PET/CT) 和多参数前列腺磁共振成像 (mpMRI) 的新诊断方法在诊断前列腺癌方面更有效和更具成本效益. 与传统方法相比,这种策略可以减少错误诊断.
科学领域:
- 在瘤学瘤学.
- 放射学 放射学是一门学科.
- 卫生经济学 卫生经济学
背景情况:
- 前列腺特异性膜抗原正子发射断层扫描计算机断层扫描 (PSMA PET/CT) 为前列腺癌提供了比传统成像更高的诊断准确性.
- 将PSMA PET/CT与多参数前列腺磁共振成像 (mpMRI) 结合起来,进一步提高了检测临床显著前列腺癌 (csPCa) 的灵敏度和特异性.
研究的目的:
- 为了评估一个没有活检的诊断策略的成本效益,使用组合PSMA PET/CT和mpMRI用于csPCa.
- 为了将这种新的方法与传统的mpMRI策略进行比较,然后进行跨关节前列腺活检.
主要方法:
- 开发了一个决策树模型,以比较前列腺特异抗原 (PSA) 升高的男性中cspca的两个诊断策略.
- 该研究评估了成本,质量调整后寿命年 (QALYs),并根据支付意愿值 (1x和3xGDP) 进行了敏感性分析.
主要成果:
- 联合PSMA PET/CT和mpMRI策略更有效 (0.04 QALY),成本更高 (4088.03 SGD),增量成本效益比 (ICER) 每QALY为92782.87 SGD.
- 与传统方法 (13.9%) 相比,这种新的策略导致错误诊断较少 (3.5%).
- 概率分析表明,在SGD$121160和SGD$363480.0的支付意愿门上,成本效益是显著的.
结论:
- 组合的mpMRI和PSMA PET/CT代表了诊断高血抗原水平的男性中csPCa的成本有效策略.
- 这种方法提高了健康效用,并可能减少了像活检这样的侵入性诊断程序的需要.
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