Cost-effectiveness of photon counting detector CT for coronary artery disease diagnostics: A Finnish healthcare perspective

IF 3.2 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Journal of Radiology Pub Date : 2025-06-16 DOI:10.1016/j.ejrad.2025.112245

Mikael A.K. Brix , Marjo Okkonen , Timo Mäkelä , Marko Nikki , Marko Korhonen , Miika T. Nieminen

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引用次数: 0

Abstract

Purpose

The purpose of this study was to evaluate the cost-effectiveness of photon-counting detector computed tomography (PCD-CT) compared to energy-integrating detector CT (EID-CT) for coronary artery disease (CAD) diagnostics in the Finnish healthcare context.

Methods

Two decision trees, incorporating local cost data and diagnostic pathways, were developed based on previously published Coronary Artery Disease – Reporting and Data System reclassification data for PCD-CT and EID-CT. A bootstrapping Monte Carlo simulation was used to model 10,000 virtual patients across a 10-year scanner lifespan. Two diagnostic scenarios were considered: one based on the diagnostic pathway of a previously published study (scenario 1) and another reflecting local clinical practice (scenario 2). Downstream testing costs and total diagnostic costs of both PCD-CT and EID-CT branches were assessed. The break-even point for PCD-CT investment was determined by including an assumed €1,500,000 price premium over EID-CT.

Results

PCD-CT significantly reduced downstream diagnostic testing compared to EID-CT. In scenario 1, mean downstream costs per patient were €377.1 ± 11.5 for PCD-CT and €569.7 ± 11.7 for EID-CT, (33.8 % reduction, p < 0.001). In scenario 2, downstream costs were €831.7 ± 19.7 for PCD-CT and €1138.2 ± 18.3 for EID-CT (26.9 % reduction, p < 0.001). Total diagnostic costs, including CCTA, were also lower with PCD-CT. The cost-benefit threshold was reached after 7,880 and 4,950 patients for scenarios 1 and 2 respectively.

Conclusions

PCD-CT would be a cost-effective alternative to EID-CT in high-volume centers, reducing unnecessary downstream tests through improved diagnostic accuracy. These findings support its adoption in Finnish healthcare systems.

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光子计数检测器CT在冠状动脉疾病诊断中的成本效益：芬兰医疗保健观点

目的本研究的目的是评估光子计数检测器计算机断层扫描（PCD-CT）与能量积分检测器CT （EID-CT）在芬兰医疗保健背景下用于冠状动脉疾病（CAD）诊断的成本效益。方法基于先前发表的冠状动脉疾病报告和数据系统对PCD-CT和EID-CT的重新分类数据，开发了两个决策树，结合了当地的成本数据和诊断途径。一个自举蒙特卡罗模拟被用来模拟10000个虚拟病人在一个10年的扫描仪寿命。考虑了两种诊断情景：一种基于先前发表的研究的诊断途径（情景1），另一种反映当地临床实践（情景2）。对PCD-CT和EID-CT分支的下游检测成本和总诊断成本进行了评估。与EID-CT相比，pc - ct投资的盈亏平衡点包括了150万欧元的溢价。结果与EID-CT相比，spd - ct显著减少了下游诊断检测。在方案1中，每位患者的平均下游成本为PCD-CT为377.1±11.5欧元，EID-CT为569.7±11.7欧元，降低了33.8%,p <；0.001)。在方案2中，pc - ct的下游成本为831.7±19.7欧元，ed - ct的下游成本为1138.2±18.3欧元（降低26.9%），p <；0.001)。包括CCTA在内的总诊断费用与PCD-CT相比也更低。分别在情形1和情形2的7880例和4950例患者后达到成本效益阈值。结论spd - ct可作为高容量中心EID-CT的替代方案，通过提高诊断准确性，减少不必要的下游检查。这些发现支持芬兰医疗保健系统采用该方法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Journal of Radiology 医学-核医学

CiteScore

6.70

自引率

3.00%

发文量

398

审稿时长

42 days

期刊介绍： European Journal of Radiology is an international journal which aims to communicate to its readers, state-of-the-art information on imaging developments in the form of high quality original research articles and timely reviews on current developments in the field. Its audience includes clinicians at all levels of training including radiology trainees, newly qualified imaging specialists and the experienced radiologist. Its aim is to inform efficient, appropriate and evidence-based imaging practice to the benefit of patients worldwide.