Recommendation for NHSScotland

There was evidence from meta-analyses of small numbers of patients (n=535 and n=253, respectively) that FDG PET-CT is effective for detecting disease recurrence or metastases in patients with suspected renal or bladder cancer following indeterminate findings on conventional imaging. Evidence from a small number of observational studies suggests that FDG PET-CT findings influence treatment decisions in up to half of patients with suspected renal or bladder cancer following indeterminate conventional imaging results. No studies were identified that reported long-term oncological or quality of life outcomes resulting from changes in patient management.

Therefore it is uncertain what impact FDG PET-CT findings have on long-term patient outcomes. No evidence was identified which assessed the cost-effectiveness of FDG PET-CT in patients with urological cancers.

Therefore, no conclusions could be drawn about the cost-effectiveness of FDG PET-CT in this patient group.

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 for staging and/or restaging in patients with suspected renal or bladder cancer following an abnormal result on contrast-enhanced CT or MRI?

Why is this important?

Conventional radiological imaging for suspected urological cancers includes ultrasound, computed tomography (CT), magnetic resonance imaging (MRI), and bone scintigraphy. ¹⁸F-fluorodeoxyglucose positron emission tomography - computed tomography (FDG PET-CT) is an additional imaging modality that could potentially be used for staging or restaging in patients with suspected renal or bladder cancer following indeterminate findings on conventional imaging.

Referred by

The Scottish PET-CT Working Group