Cost-effectiveness analysis of short biparametric magnetic resonance imaging protocol in men at risk of prostate cancer

Submitted: March 14, 2022
Accepted: April 25, 2022
Published: June 29, 2022
Abstract Views: 936
pdf: 421
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

Authors

Objectives: To compare the cost-effectiveness of a short biparametric MRI (BP-MRI) with that of contrast-enhanced multiparametric MRI (MP-MRI) for the detection of prostate cancer in men with elevated prostatespecific antigen (PSA) levels. Materials and methods: We compared two diagnostic procedures for detection of prostate cancer (Pca), BP-MRI and MP-MRI, in terms of quality-adjusted life years (QALY), incremental costeffectiveness ratio (ICER) and net monetary benefit (NMB) for a hypothetical cohort of 10,000 patients. We compared two scenarios in which different protocols would be used for the early diagnosis of prostate cancer in relation to PSA values. Scenario 1. BP-MRI/MP-MRI yearly if > 3.0 ng/ml, every 2 years otherwise; Scenario 2. BP-MRI/MP-MRI yearly with age-dependent threshold 3.5 ng/ml (50-59 years), 4.5 ng/ml (60-69 years), 6.5 ng/ml (70-79 years). Results: BP-MRI was more effective than the comparator in terms of cost (160.10 € vs 249.99€) QALYs (a mean of 9.12 vs 8.46), ICER (a mean of 232.45) and NMB (a mean of 273.439 vs 251.863). BP-MRI was dominant, being more effective and less expensive, with a lower social cost. Scenario 2 was more cost-effective compared to scenario 1. Conclusions: Our results confirmed the hypothesis that a short bi-parametric MRI protocol represents a cost-efficient procedure, optimizing resources in a policy perspective.

Dimensions

Altmetric

PlumX Metrics

Downloads

Download data is not yet available.

Citations

Associazione italiana dei registri tumori (AIRTUM) Working Group 2014 www.registri-tumori.it/cms/it/AIRTUMWG2014.
Turkbey B, Rosenkrantz AB, Haider MA, et al. Prostate Imaging Reporting and Data System Version 2.1: 2019 Update of Prostate Imaging Reporting and Data System Version 2. Eur Urol. 2019; 76:340-351. DOI: https://doi.org/10.1016/j.eururo.2019.02.033
Dickinson L, Ahmed HU, Allen C, et al. Magnetic resonance imaging for the detection, localisation, and characterisation of prostate cancer: recommendations from a European consensus meeting. Eur Urol. 2011; 59:477-494. DOI: https://doi.org/10.1016/j.eururo.2010.12.009
Van der Leest M, Israël B, Cornel EB, et al. High diagnostic performance of short magnetic resonance imaging protocols for prostate cancer detection in biopsy-naïve men: The next step in magnetic resonance imaging accessibility. Eur Urol. 2019; 76:574-581. DOI: https://doi.org/10.1016/j.eururo.2019.05.029
Choi MH, Kim CK, Lee YJ, Jung SE. Prebiopsy biparametric MRI for clinically significant prostate cancer detection with PI-RADS version 2: a multicenter study. AJR Am J Roentgenol. 2019; 212:839-846. DOI: https://doi.org/10.2214/AJR.18.20498
Woo S, Suh CH, Kim SY, et al. Head-to-head comparison between
biparametric and multiparametric MRI for the diagnosis of prostate : a systematic review and meta-analysis. AJR Am J Roentgenol. 2018; 211:W226-W241. DOI: https://doi.org/10.2214/AJR.18.19880
Bjurlin MA, Carroll PR, Eggener S, et al. Update of the standard operating procedure on the use of multiparametric magnetic resonance imaging for the diagnosis, staging and management of prostate cancer. J Urol 2020; 203:706-712. DOI: https://doi.org/10.1097/JU.0000000000000617
Olchowy C, Cebulski K, Łasecki M, et al. The presence of the gadolinium-based contrast agent depositions in the brain and symptoms of gadolinium neurotoxicity - A systematic review. PLoS One. 2017; 12:e0171704. DOI: https://doi.org/10.1371/journal.pone.0171704
Lee SS, Lee DH, Song WH, et al. Usefulness of bi-parametric magnetic resonance imaging with b=1,800 s/mm² diffusion-weighted imaging for diagnosing clinically significant prostate cancer. World J Mens Health. 2020; 38:370-376. DOI: https://doi.org/10.5534/wjmh.190079
Girometti R, Cereser L, Bonato F, Zuiani C. Evolution of prostate MRI: from multiparametric standard to less-is-better and different-is better strategies. Eur Radiol Exp. 2019; 3:5. DOI: https://doi.org/10.1186/s41747-019-0088-3
Kuhl CK, Bruhn R, Krämer N, et al. Abbreviated biparametric prostate MR Imaging in men with elevated prostate-specific antigen. Radiology. 2017; 285:493-505. DOI: https://doi.org/10.1148/radiol.2017170129
Teixeira Anacleto S, Neves Alberto J, Carvalho Dias E, et al. Do all patients with suspicious prostate cancer need Multiparametric Magnetic Resonance Imaging before prostate biopsy? Arch Ital Urol Androl 2022; 4:32-36. DOI: https://doi.org/10.4081/aiua.2022.1.32
Hao S, Karlsson A, Heintz E, et al. Cost-effectiveness of magnetic resonance imaging in prostate cancer screening: a microsimulation study. Value Health. 2021; 24:1763-1772. DOI: https://doi.org/10.1016/j.jval.2021.06.001
Roth JA, Gulati R, Gore JL, et al. Economic analysis of prostatespecific antigen screening and selective treatment strategies. JAMA Oncol. 2016; 2:890-898. DOI: https://doi.org/10.1001/jamaoncol.2015.6275
Booth N, Rissanen P, Tammela TLJ, et al. Cost-effectiveness analysis of PSA-based mass screening: Evidence from a randomised controlled trial combined with register data. PLoS One. 2019; 14:e0224479. DOI: https://doi.org/10.1371/journal.pone.0224479
Fenton JJ, Weyrich MS, Durbin S, et al. Prostate-specific antigenbased screening for prostate cancer: a systematic evidence review for the U.S. preventive services task force. Rockville (MD): Agency for Healthcare Research and Quality (US); 2018. DOI: https://doi.org/10.1001/jama.2018.3712
Sanders GD, Neumann PJ, Basu A, et al. Recommendations for conduct, methodological practices, and reporting of cost-effectiveness analyses: second panel on cost-effectiveness in health and medicine. JAMA. 2016; 316:1093-1103. DOI: https://doi.org/10.1001/jama.2016.12195
Eurostat, Statistical Office of the European Communities, Labour market statistics. Luxembourg, 2011. Issue number 48/2012.
Sanghera S, Mohiuddin S, Coast J, et al. Modelling the lifetime cost-effectiveness of radical prostatectomy, radiotherapy and active monitoring for men with clinically localised prostate cancer from median 10-year outcomes in the ProtecT randomised trial. BMC Cancer. 2020; 20:971. DOI: https://doi.org/10.1186/s12885-020-07276-4
Harat A, Harat M, Martinson M. A Cost-effectiveness and quality of life analysis of different approaches to the management and treatment of localized prostate cancer. Front Oncol. 2020; 10:103. DOI: https://doi.org/10.3389/fonc.2020.00103
Roth A, Nelson CJ, Rosenfeld B, et al. Assessing anxiety in men with prostate cancer: further data on the reliability and validity of the Memorial Anxiety Scale for Prostate Cancer (MAX-PC). Psychosomatics. 2006; 47:340-347. DOI: https://doi.org/10.1176/appi.psy.47.4.340
Garvelink MM, Boland L, Klein K, et al. Decisional conflict scale
use over 20 years: the anniversary review. Med Decis Making. 2019; 39:301-314. DOI: https://doi.org/10.1177/0272989X19851345
Smith DP, King MT, Egger S, et al. Quality of life three years after diagnosis of localised prostate cancer: population based cohort study. BMJ. 2009; 339:b4817. DOI: https://doi.org/10.1136/bmj.b4817
Scialpi M, Prosperi E, D'Andrea A, et al. Biparametric versus multiparametric MRI with non-endorectal coil at 3T in the detection and localization of prostate cancer. Anticancer Res. 2017; 37:1263-1271. DOI: https://doi.org/10.21873/anticanres.11443
Sherrer RL, Glaser ZA, Gordetsky JB, et al. Comparison of biparametric MRI to full multiparametric MRI for detection of clinically significant prostate cancer. Prostate Cancer Prostatic Dis. 2019; 22:331-336. DOI: https://doi.org/10.1038/s41391-018-0107-0
Boesen L, Nørgaard N, Løgager V, et al. Assessment of the diagnostic accuracy of biparametric magnetic resonance imaging for prostate cancer in biopsy-naive men: the biparametric MRI for
detection of prostate cancer (BIDOC) study. JAMA Netw Open. 2018; 1:e180219. DOI: https://doi.org/10.1001/jamanetworkopen.2018.0219
Faria R, Soares MO, Spackman E, et al. Optimising the diagnosis of prostate cancer in the era of multiparametric magnetic resonance imaging: a cost-effectiveness analysis based on the Prostate MR Imaging Study (PROMIS). Eur Urol. 2018; 73:23-30. DOI: https://doi.org/10.1016/j.eururo.2017.08.018
Weiss J, Martirosian P, Notohamiprodjo M, et al. Implementation of a 5-minute magnetic resonance imaging screening protocol for prostate cancer in men with elevated prostate-specific antigen before biopsy. Invest Radiol. 2018; 53:186-190. DOI: https://doi.org/10.1097/RLI.0000000000000427
Hugosson J, Roobol MJ, Månsson M, et al. A 16-yr follow-up of the European Randomized study of Screening for Prostate Cancer. Eur Urol. 2019; 76:43-51. DOI: https://doi.org/10.1016/j.eururo.2019.02.009
Faccioli N, Dietrich CF, Foti G, et al. Activity-based cost analysis of including contrast-enhanced ultrasound (CEUS) in the diagnostic pathway of focal pancreatic lesions detected by abdominal ultrasound. Ultraschall Med. 2019; 40:618-624. DOI: https://doi.org/10.1055/a-0869-7861
Faccioli N, Santi E, Foti G, D'Onofrio M. Cost-effectiveness analysis of including contrast-enhanced ultrasound in management of pancreatic cystic neoplasms. Radiol Med. 2022; 127:349-359. DOI: https://doi.org/10.1007/s11547-022-01459-8
Chessa F, Schiavina R, Ercolino A, et al. Diagnostic accuracy of the Novel 29 MHz micro-ultrasound "ExactVuTM" for the detection of clinically significant prostate cancer: A prospective single institutional
study. A step forward in the diagnosis of prostate cancer. Arch Ital Urol Androl. 2021; 93:132-138. DOI: https://doi.org/10.4081/aiua.2021.2.132
Schröder FH, Hugosson J, Roobol MJ, et al. Screening and prostate cancer mortality: results of the European Randomised Study of Screening for Prostate Cancer (ERSPC) at 13 years of follow-up. Lancet. 2014; 384:2027-2035. DOI: https://doi.org/10.1016/S0140-6736(14)60525-0
Mezrich JL, Weinreb JC. Financial and medicolegal implications of focused/fast abdominopelvic MRI exams. Abdom Radiol 2022; 47:471-474. DOI: https://doi.org/10.1007/s00261-021-03328-w
Johansson K, Mustonen H, Nieminen H, et al. MRI follow-up for pancreatic intraductal papillary mucinous neoplasm: an ultrashort versus long protocol. Abdom Radiol 2022; 47:727-737. DOI: https://doi.org/10.1007/s00261-021-03382-4
Russo F, Mazzetti S, Regge D, et al. Diagnostic accuracy of single- plane biparametric and multiparametric magnetic resonance imaging in prostate cancer: a randomized noninferiority trial in biopsy-naive men. Eur Urol Oncol. 2021; 4:855-862. DOI: https://doi.org/10.1016/j.euo.2021.03.007
Galosi AB, Palagonia E, Scarcella S, et al. Detection limits of significant prostate cancer using multiparametric MR and digital rectal examination in men with low serum PSA: Up-date of the Italian Society of Integrated Diagnostic in Urology. Arch Ital Urol Androl. 2021; 93:92-100. DOI: https://doi.org/10.4081/aiua.2021.1.92
Pepe P, Candiano G, Pepe L, et al. mpMRI PI-RADS score 3 lesions diagnosed by reference vs affiliated radiological centers: Our experience in 950 cases. Arch Ital Urol Androl. 2021; 93:139-142. DOI: https://doi.org/10.4081/aiua.2021.2.139

How to Cite

Faccioli, N., Santi, E., Foti, G., Curti, P., & D’Onofrio, M. (2022). Cost-effectiveness analysis of short biparametric magnetic resonance imaging protocol in men at risk of prostate cancer. Archivio Italiano Di Urologia E Andrologia, 94(2), 160–165. https://doi.org/10.4081/aiua.2022.2.160