SPECT/CT has been found to improve predicted postoperative forced expiratory volume in one second (ppoFEV) assessments in patients with non-small-cell lung cancer (NSCLC). An economic simulation was developed comparing the cost-effectiveness of SPECT/CT versus planar scintigraphy for a US payer. Clinical outcomes and cost data were obtained through review of the published literature. SPECT/CT increased the accuracy ppoFEV assessment, changing the therapeutic decision for 1.3% of nonsurgical patients to a surgical option, while 3.3% of surgical patients shifted to more aggressive procedures. SPECT/CT led to an expected cost of $4694 per life year gained, well below typical thresholds. SPECT/CT resulted in substantially improved health outcomes and was found to be highly cost-effective.
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