The cost-effectiveness of ¹⁸FDG-PET in selecting patients with suspicion of recurrent laryngeal carcinoma after radiotherapy for direct laryngoscopy

The aim of this study was to estimate the cost-effectiveness of ¹⁸FDG-PET in the selection for direct laryngoscopy in patients with suspicion of recurrent laryngeal carcinoma after radiotherapy. The direct medical costs of 30 patients with suspicion of a recurrence were calculated from the first visit where suspicion was raised until one year after. A conventional strategy, in which all these patients underwent direct laryngoscopy, was compared to an ¹⁸FDG-PET strategy in which only patients with a positive or equivocal ¹⁸FDG-PET underwent direct laryngoscopy. A sensitivity analysis was performed to examine the influence of the type of camera and 'setting'. The mean costs of an ¹⁸FDG-PET strategy were €399 less than a direct laryngoscopy strategy. The type of camera and setting had no influence. In patients with suspicion for recurrent laryngeal carcinoma after radiotherapy, ¹⁸FDG-PET seems to be effective and less costly in selecting patients for direct laryngoscopy.