Original Title: Utilidad de la PET en indicaciones no oncológicas

Authors' objectives: Structure the information relative to the utility or diagnostic performance of the different radiopharmaceuticals that are used in the PET, for the different non-oncological indications established in its technical sheet.

Authors' results and conclusions: We found 909 documents, of which 25 were selected after reading the full text. There are currently 15non oncological indications for which there is an authorized radiotracer in our country that is 18F-FDG, in most cases. Systematic reviews have been located in several indications in the areas of infectious, inflammatory diseases (sarcoidosis, inflammatory bowel disease and large vessel vasculitis) and also the neurological area (partial temporal epilepsy refractory to medical treatment). No synthetic studies were found in the use of 18F-FDG in with severe left ventricular failure, requiring an evaluation of myocardial viability, although many primary studies have been identified. In several indications such as, suspected chronic bone infection or adjacent structures; diabetics with suspicious foot of Charcot neuroarthropathy, osteomyelitis and / or soft tissue infection; sarcoidosis; partial temporal epilepsy refractory to medical treatment and in severe left ventricular failure, published primary studies have been identified. In the rest of the indications studied; 18F-FDG in fever and AIDS, alveolar echinococcosis, patients with bacteremia and 18F-Dopa in parkinsonian syndrome or parkinsonism; no secondary or primary studies were located. A protocol was found for a systematic review of the Cochrane Collaboration in the 18F-FDG indication for detection of infections in vascular prostheses. The area of greatest scientific evidence has been the progression of mild cognitive impairment to Alzheimer's Disease (AD), which good quality systematic reviews, have been concluding that the routine use of PET with florbetapir, florbetapen or flutemetamol cannot be recommended to predict this progression. Published primary studies have been identified in indications of suspected chronic bone infection or adjacent structures; diabetics with suspicious foot of Charcot neuroarthropathy, osteomyelitis and / or soft tissue infection; sarcoidosis; partial temporal epilepsy refractory to medical treatment and in severe left ventricular failure. • Systematic reviews with or without meta-analysis have been located in 10 of the 15 indications analyzed. • The quality of systematic reviews has been generally low and, in some cases, moderate. Only in the indication of patients with cognitive impairment with suspected Alzheimer's disease, high quality reviews been found. This concludes that its routine use cannot be recommended. • A complete evaluation report is justified in the use of PET 18F-FDG in severe left ventricular failure, because primary studies have been located.

Authors' methods: Brief response report, based on a structured bibliographic search with subsequent qualitative synthesis of the results obtained in secondary studies and primary quantification. The studies were grouped according to their design. In order to establish the search strategy and the individual PICOd research questions of each indication, a manual search was made in the CIMA application of the AEMPS, to locate all authorized drugs and include in their technical specifications any non-oncological indication. Subsequently, a structured search was carried out for each of the indication identified in the Medline, Embase, The Cochrane Library and Web of Science databases. Additionally, in order to locate documents that would help to complete the information obtained previously, the web pages of the main organizations at a national and international level, were consulted.

Project Status: Completed

Year Published: 2019

URL for published report: https://www.aetsa.org/publicacion/utilidad-de-la-pet-en-indicaciones-no-oncologicas/

Requestor: Health ministry of spain

English language abstract: An English language summary is available

Publication Type: Rapid Review

Country: Spain

Organisation Name: Andalusian Health Technology Assessment Area

Contact Address: Area de Evaluacion de Tecnologias Sanitarias Sanitarias de Andalucia (AETSA) Avda. Innovación, s/n Edificio Arena 1. Sevilla (Spain) Tel. +34 955 006 309

Contact Name: aetsa.csalud@juntadeandalucia.es

Contact Email: aetsa.csalud@juntadeandalucia.es

Copyright: Andalusian Agency for Health Technology Assessment (AETSA)