Thyroid nodules with indeterminate cytology: molecular imaging with Tc-99m-methoxyisobutylisonitrile (MIBI) is more cost-effective than the AfirmaA (R) gene expression classifier

A. Heinzel*, D. Muller, F.F. Behrendt, L. Giovanella, F.M. Mottaghy, F.A. Verburg

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


PURPOSE: To compare the cost-effectiveness of (99m)Tc-methoxyisobutylisonitrile (MIBI) thyroid scintigraphy and the Afirma gene expression classifier for the assessment of cytologically indeterminate thyroid nodules. METHODS: A decision tree model was used. Costs were calculated from the perspective of the German health insurance system. The robustness of the results was assessed with probabilistic sensitivity analyses using a Monte Carlo simulation. RESULTS: Life expectancy was 34.3 years (estimated costs per patient euro1,459 - euro2,224) for the MIBI scan and 34.1 years (estimated costs euro3,560 - euro4,071) for the molecular test. These results were confirmed by the Monte Carlo simulation. CONCLUSION: MIBI thyroid scintigraphy is more cost-effective than the gene expression classifier.
Original languageEnglish
Pages (from-to)1497-1500
Number of pages4
JournalEuropean Journal of Nuclear Medicine and Molecular Imaging
Issue number8
Publication statusPublished - Aug 2014


  • Tc-99m-Methoxyisobutylisonitrile (MIBI)
  • Thyroid nodule
  • Afirma (R) gene expression classifier
  • Cost-effectiveness
  • TC-99M-MIBI

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