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

IntroductionBetween 2009 and 2012, Ga-68-somatostatin analogue PET-CT progressively replaced In-111-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, Ga-68-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. MethodsThis analysis was based on retrospective clinical data from 95 In-111-octreotide scintigraphies performed in 2007 and 2008 at Sir Charles Gairdner (SCGH) and Royal Perth (RPH) hospitals and 219 Ga-68-somatostatin analogue PET-CT studies performed in 2013 at SCGH. Whole body effective radiation dose was derived from theradiopharmaceutical and low-doseCT scan. The cost analysisincluded radiopharmaceutical and imaging costs. ResultsThemedian imaging time for an In-111-octreotide scintigraphy was 152minat SCGH, 100minat RPH and 20min for a Ga-68-somatostatin analogue PET-CT scan. The mean effective radiationdose for In-111-octreotide scintigraphy was 18.1 mSv at SCGH and 13.8mSv at RPH. The effective dose for Ga-68-somatostatin analogue PET-CT was 8.7-10.8 mSv. The average cost of(68)Ga-somatostatin analogue PET-CT was four times less than In-111-octreotide scintigraphy. Conclusion(68)Ga-somatostatin analogue PET-CT is not only more accurate than In-111-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. Ga-68-somatostatin PET-CT provides an important combination of both reduced cost and improved clinical care for patients.