Original Title: FDG-PET/TC y SPECT para la estadificación oncológica: estadificación del cáncer colorrectal, identificación del nódulo pulmonar solitario y re-estadificación del linfoma

Authors' objectives: This study aims to determine FDG-PET/CT and SPECT effectiveness, safety and efficiency for the following clinical situations: • Preoperatie staging for colorectal cancer patients Benign and malignant identification for solitary pulmonary nodule nodule patients • Restaging for Hodgkin and non-Hodgkin lymphoma patients o • Secondary objectives are to determine the impact of the diagnostic information provided by FDG-PET/CT and SPECT on decisions about patient management, and adverse effects of these procedures.

Authors' results and conclusions: In patients with CRC, FDG-PET/CT has a high sensitivity and specificity for tumor T staging, although the sensitivity of this test decreases with lymph node involvement (N stage) of these patients. These results could not be compared with those obtained by SPECT by the lack of studies involving these patients. For the identification of benign and malignant SPN with diameter less than 1cm, FDG-PET/CT sensitivity is higher than SPECT sensitivity, showing a lower specificity. The SPECT sensitivity for lymphoma patients restaging is clearly lower than FDG-PET/CT sensitivity and the differences for specificity of both techniques are minimal. The FDG-PET/CT imaging as additional test in preoperative staging of metastatic CRC patients is cost-effective, although no evidence has been found on the SPECT efficiency for these patients. No evidence has been identified about efficiency of these imaging in patients with SPN or requiring lymphoma restaging. FDG-PET/CT safety problems are related to accidental pathological findings, since the FDG has shown no toxicity when used as a single dose only prescription without other drugs. SPECT safety is limited by toxicity symptoms (fatigue, headache, dry oral mucosa, facial flushing and nausea) associated to radioisotope. However, some caution is needed interpreting these results, hence the scarce evidence identified, the small sample size and the risk of bias associated with each of them. Most of included studies did not report about index conducted test or test used a suitable reference, and often the method for selecting patients is not clearly described.

Project Status: Completed

Year Published: 2015

URL for published report: https://www.aetsa.org/publicacion/fdg-pettc-y-spect-para-la-estadificacion-oncologica-estadificacion-del-cancer-colorrectal-identificacion-del-nodulo-pulmonar-solitario-y-re-estadificacion-del-linfoma/

English language abstract: An English language summary is available

Publication Type: Full HTA

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 Health Technology Assessment Area (AETSA)