Does the addition of positron emission tomography/computed tomography (PET/CT) to the routine investigation and assessment of patients with melanoma yield clinical and economic benefits?
Kelly J
Record ID 32013000471
English
Authors' recommendations:
Staging and recurrence
The results of one systematic review suggest that when diagnostic imaging is indicated for staging or surveillance of melanoma, ultrasonography is better than CT, PET or PET/CT for the detection of lymph node metastases. However, PET/CT appears to be more suitable for the detection of distant metastases in patients at intermediate or high risk or when distant metastases are clinically indicated.
Another systematic review reported that:
- two prospective studies suggest that PET or PET/CT is useful for the staging of high-risk patients with potentially resectable disease
- the evidence does not support the use of PET or PET/CT for the diagnosis of sentinel lymph node micrometastatic disease or for staging of I, IIa, or IIb melanoma.
- the identified evidence does not support the routine use of PET or PET/CT for the diagnosis of brain metastases or for the detection of primary uveal malignant melanoma.
A third systematic review concluded that the use of either PET or PET/CT in addition to conventional staging in the assessment of patients with recurrent melanoma may:
- be more accurate than CT alone for the detection of regional nodal metastases and distant metastases.
- lead to changes in patient management, most commonly the avoidance of surgery.
Treatment response
One systematic review noted that there were no prospective studies on the use of PET or PET/CT in the assessment of treatment response.
Cost effectiveness
A cost-effectiveness analysis from Belgium found that PET/CT dominated whole body CT (ie PET/CT cost less and was more effective) in the diagnostic imaging work-up of patients with suspected pulmonary metastasised melanoma, the main benefit coming from avoidance of unnecessary surgery.
Details
Project Status:
Completed
Year Published:
2013
URL for published report:
http://www.healthcareimprovementscotland.org/our_work/technologies_and_medicines/shtg_-_evidence_notes/evidence_note_48.aspx
English language abstract:
An English language summary is available
Publication Type:
Not Assigned
Country:
Scotland, United Kingdom
MeSH Terms
- Melanoma
- Neoplasm Staging
Contact
Organisation Name:
Scottish Health Technologies Group
Contact Address:
Scottish Health Technologies Group, Delta House, 50 West Nile Street, Glasgow, G1 2NP Tel: 0141 225 6998
Contact Name:
his.shtg@nhs.scot
Contact Email:
his.shtg@nhs.scot
Copyright:
Healthcare Improvement Scotland
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