Authors' objectives:

The aims of this report were:

- To determine the role of fluorine-18 deoxyglucose (FDG)-positron emission tomography (PET) imaging in cancer management by evaluating the clinical and cost effectiveness in terms of impact on patient morbidity and mortality.

- To consider the best configuration of PET facilities and cyclotrons to serve Scotland, if PET was found to be clinically and cost effective.

Authors' results and conclusions: This assessment focused primarily on non-small cell lung cancer (NSCLC) and lymphoma. An economic model indicates that FDG-PET imaging is cost effective compared with computed tomography (CT) in re-staging of Hodgkin’s disease at the completion of induction chemotherapy, saving up to 30% of patients from receiving unnecessary radiotherapy. FDG-PET is also potentially cost effective in NSCLC if it is used before mediastinoscopy in CT-negative patients. In addition to this, information from other INAHTA published HTAs indicates that there is evidence of clinical effectiveness in solitary pulmonary nodule, malignant melanoma, recurrent head and neck cancer and lymphoma. From a patient's perspective it was identified that communication of the process and possible outcomes could be improved, but that some patients valued the reassurance that can be provided by the PET image compared with other diagnostic techniques.

Authors' recommendations: A PET imaging facility including a cyclotron, dedicated to clinical use and specific health services research, should be set up in Scotland and linked to an existing specialist cancer centre. All patients who require re-staging of Hodgkin's disease should receive FDG-PET imaging in order to select those for surveillance or radical radiotherapy. PET research should be undertaken in other cancers, such as lung cancer (NSCLC and single pulmonary nodule), malignant melanoma and recurrent head and neck cancer, to inform economic modelling and patient outcome.

Authors' methods: Systematic review

Project Status: Completed

URL for project: http://www.nhshealthquality.org/

Year Published: 2002

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Scotland, United Kingdom

Organisation Name: Health Technology Board for Scotland

Contact Address: Delta House, 50 West Nile Street Glasgow G1 2NP Scotland United Kingdom Tel: +44 141 225 6988; Fax: +44 141 221 3262

Contact Name: shtg.hcis@nhs.net

Contact Email: shtg.hcis@nhs.net

Copyright: Health Technology Board for Scotland (HTBS) (merged into NHS Quality Improvement Scotland (NHS QIS))