SPECT/CT may save more than $1.7M over 3 years in total knee replacement surgeries

By 2030, some 3.5 million Americans are expected to be living with total knee replacements. The price of performing total-knee arthroplasty (TKA) revision surgery continues to rise, costing 60 percent more than the initial replacement. 

“Interventions that can improve diagnosis and assist surgeon decision-making will be important for patient management, long-term outcomes and budget control,” wrote corresponding author Tim Van den Wyngaert, with Antwerp University Hospital in Belgium and colleagues.

Recent research published online March 29 in the Journal of Nuclear Medicine found single-photon emission computed tomography (SPECT)/CT more accurate and cost-effective compared to standard approaches in patients with recurrent and persistent knee pain after TKA.

In the study, a team of international researchers modeled a hypothetical group of 1,000 TKA patients experiencing recurrent moderate to severe pain over three years.

From a payer perspective, results showed for every 1,000 knee-replacement patients, diagnostic bone SPECT/CT was estimated save up to $1.87 million over three years when compared to CT alone and $1.72 million compared to metal artifact reduction sequence (MARS)-MRI.

This equated to savings for payers of $622.60 per-patient, per-year against CT, and $574.50 against MARS-MRI.

Additionally, the SPECT/CT route resulted in 39.7 quality-adjusted life years (QALY) gained compared to CT and 41 QALY gained against MARS-MRI.

“Bone SPECT/CT is a potentially highly cost-saving and dominant imaging intervention versus CT or MARS-MRI scanning in patients with recurrent and persistent knee pain after TKA,” wrote Wyngaert et al.

“Integrated bone SPECT/CT is…considered superior to conventional bone SPECT imaging because of its improved resolution, attenuation and scatter correction, and accurate anatomical localization,” added Wyngaert et al. in the study.

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Matt joined Chicago’s TriMed team in 2018 covering all areas of health imaging after two years reporting on the hospital field. He holds a bachelor’s in English from UIC, and enjoys a good cup of coffee and an interesting documentary.

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