Recommendation for NHSScotland

• There is insufficient evidence on the clinical and cost-effectiveness of FDG PETCT and none of the identified studies reported any long-term oncological or quality of life outcomes resulting from changes in patient management.
• It is not currently possible to draw any conclusions on the effectiveness for staging and/or restaging of patients with penile or testicular cancers in the NHS in Scotland.
• Current evidence on FDG PET-CT for penile or testicular cancer patients appears to be at stage 2 or 3 of the IDEAL-D framework. Future studies should therefore be prospective, blind, controlled, diagnostic studies, or economic evaluations.

NHSScotland is required to consider the Scottish Health Technologies Group (SHTG) advice.

What were we asked to look at?

Is FDG PET-CT clinically and costeffective in the staging and/or restaging of disease in patients with penile or testicular cancers?

Why is this important?

Penile cancer is rare in developed countries and there are typically fewer than 100 people diagnosed with this disease every year in Scotland. Testicular cancer is relatively more common, and will lead to approximately 200 people being newly diagnosed in Scotland each year. In both penile and testicular cancers, conventional CT imaging has been recommended at specified points during the staging and/or restaging process. ¹⁸F-2-fluoro-2-deoxy-D-glucose (FDG) is a radioisotope given to patients prior to PET-CT hybrid imaging. The resulting images could potentially enhance the information yielded by current imaging techniques and other diagnostic information used to inform staging and/or restaging.

Referred by

The Scottish PET-CT Working Group