European Urology Oncology The Role of Multiparametric Magnetic Resonance Imaging in Active Surveillance for Men with Low-risk Prostate Cancer: A Cost-effectiveness Modeling Study  Sejal Patel, Jan J. Rongen, Jurgen J. Fütterer, Artem Boltyenkov, Maroeska M. Rovers  European Urology Oncology  DOI: 10.1016/j.euo.2018.05.007 Copyright © 2018 European Association of Urology Terms and Conditions

Fig. 1 Markov model. PCa=prostate cancer. European Urology Oncology DOI: (10.1016/j.euo.2018.05.007) Copyright © 2018 European Association of Urology Terms and Conditions

Fig. 2 Scatter plots of probabilistic sensitivity analyses. (A) Scatter plot of probabilistic sensitivity analysis for multiparametric magnetic resonance imaging (mpMRI) with biopsy versus transrectal ultrasound-guided biopsy (TRUSGB) including a summary point that represents the overall estimate of the incremental cost-effectiveness ratio (ICER) over the 10 000 iterations. At a willingness to pay (WTP) of €50 000 per quality-adjusted life year (QALY), mpMRI with biopsy was cost-effective in 90% of the iterations. (B) Scatter plot of probabilistic sensitivity analysis for mpMRI only versus TRUSGB including a summary point that represents the overall estimate of the ICER over the 10 000 iterations. At WTP of €50 000 per QALY, mpMRI only was cost-effective in 14% of the iterations. (C) Scatter plot of probabilistic sensitivity analysis with the results reported by Ahmed et al [28] for mpMRI with biopsy versus TRUSGB, including a summary point that represents the overall estimate of the ICER over the 10 000 iterations. At WTP of €50 000 per QALY, mpMRI with biopsy was cost-effective in 97% of the iterations. (D) Scatter plot of probabilistic sensitivity analysis for the results reported by Ahmed et al [28] for mpMRI only versus TRUSGB, including a summary points that represents the overall estimate of the ICER over the 10 000 iterations. At WTP of €50 000 per QALY, mpMRI only was cost-effective in 17% of the iterations. European Urology Oncology DOI: (10.1016/j.euo.2018.05.007) Copyright © 2018 European Association of Urology Terms and Conditions

Fig. 3 Deterministic sensitivity analyses. (A) Tornado plot (deterministic one-way sensitivity analysis). (B) Deterministic two-way sensitivity analysis at a willingness to pay of €50 000 per quality-adjusted life year. TRUSGB=transrectal ultrasound-guided biopsy; mpMRI=multiparametric magnetic resonance imaging; MR-TRUSGB=magnetic resonance TRUSGB; AS=active surveillance. European Urology Oncology DOI: (10.1016/j.euo.2018.05.007) Copyright © 2018 European Association of Urology Terms and Conditions