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.
The Scottish PET-CT Working Group