Decision-tree analysis for cost-effective management of solitary pulmonary nodules in China

Table 1 Performance parameters used in the decision-tree analyses

	Sensitivity	Specificity	Ref.
Chest CT	0.99	0.63	[5]
PET-CT	0.97	0.85	[5]
ACNB	0.769	0.936	[5]
CT-Follow	0.56	0.95	[3]
DWI	0.7	0.97	[3]

PET: Positron emission tomography; CT: Computed tomography; DWI: Diffusion-weighted magnetic resonance imaging; ACNB: Automated cutting needle biopsy.

Table 2 Medical costs in China used in the decision-tree analyses

	Cost (RMB)
Chest CT without contrast enhancement	￥360
PET-CT	￥6500
ACNB1	￥3000
CT-Follow: continuous three Chest CT	￥1080
DWI	￥585
Surgical resection of SPN	￥20000

¹Including the costs of possible treatment of pneumothorax. PET: Positron emission tomography; CT: Computed tomography; DWI: Diffusion-weighted magnetic resonance imaging; SPN: Solitary pulmonary nodule; ACNB: Automated cutting needle biopsy.

Table 3 Overall preoperative diagnostic accuracy, costs per patient and incremental cost-accuracy ratio in each strategy, when the prevalence of cancer is 50%

Strategy	Accuracy	Cost per patient	ICAR (RMB/%)
CT alone	0.81	14676	Baseline
CT + PET-CT	0.952	16164	8196
CT + ACNB	0.867	12731	-17583
CT + DWI + PET-CT	0.949	14086	-4247

PET: Positron emission tomography; CT: Computed tomography; DWI: Diffusion-weighted magnetic resonance imaging; ICAR: Incremental cost-accuracy ratio; ACNB: Automated cutting needle biopsy.