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Objective  The objective was to quantify the potential economic value of single‐photon emission computed tomography ( SPECT ) with computed tomography ( CT ;  SPECT / CT ) versus  CT  pulmonary angiography ( CTPA ), ventilation–perfusion (V/Q) planar scintigraphy, and V/Q  SPECT  imaging modalities for diagnosing suspected pulmonary embolism ( PE ) patients in an emergency setting.    Methods  An Excel‐based simulation model was developed to compare  SPECT / CT  versus the alternate scanning technologies from a payer's perspective. Clinical endpoints (diagnosis, treatment, complications, and mortality) and their corresponding cost data (2016  USD ) were obtained by performing a best evidence review of the published literature. Studies were pooled and parameters were weighted by sample size. Outcomes measured included differences in 1) excess costs, 2) total costs, and 3) lives lost per annum between  SPECT / CT  and the other imaging modalities. One‐way (±25%) sensitivity and three scenario analyses were performed to gauge the robustness of the results.    Results  For every 1,000 suspected  PE  patients undergoing imaging, expected annual economic burden by modality was found to be 3.2 million ( SPECT / CT ), 3.8 million ( CTPA ), 5.8 million (planar), and 3.6 million ( SPECT )  USD , with a switch to  SPECT / CT  technology yielding per‐patient‐per‐month cost savings of $51.80 (vs.  CTPA ), $213.80 (vs. planar), and $36.30 (vs.  SPECT ), respectively. The model calculated that the incremental number of lives saved with  SPECT / CT  was six (vs.  CTPA ) and three (vs. planar). Utilizing  SPECT / CT  as the initial imaging modality for workup of acute  PE  was also expected to save $994,777 (vs.  CTPA ), $2,852,014 (vs. planar), and $435,038 (vs.  SPECT ) in “potentially avoidable”’ excess costs per annum for a payer or health plan.    Conclusion  Compared to the currently available scanning technologies for diagnosing suspected  PE ,  SPECT / CT  appears to confer superior economic value, primarily via improved sensitivity and specificity and low nondiagnostic rates. In turn, the improved diagnostic accuracy accords this modality the lowest ratio of expenses attributable to potentially avoidable complications, misdiagnosis, and underdiagnosis.

The Economic Value of Hybrid Single‐photon Emission Computed Tomography With Computed Tomography Imaging in Pulmonary Embolism Diagnosis