Recommendation for NHSScotland
The evidence for diagnostic accuracy of PET/CT consists of limited clinical effectiveness evidence and PET/CT was also found not to be cost-effective for the diagnosis of myeloma across a wide range of possible sensitivity and specificity values (60-100%).
For disease staging in newly diagnosed myeloma patients, PET/CT detects a greater number of lesions than plain film radiography (x-ray) but there is insufficient evidence to determine if it can detect more lesions than MRI.
The current evidence suggests that PET/CT should not be routinely considered in the diagnosis and staging of myeloma.
NHSScotland is required to consider the Scottish Health Technologies Group (SHTG) advice.
What were we asked to look at?
We were asked to provide advice on the use of positron emission tomography/computed tomography (PET/CT) in investigating and/or assessing patients for diagnosis and/or staging of myeloma.
Why is this important?
Guidelines on imaging technologies for myeloma have recently been reviewed. New information about the effectiveness of FDG PET/CT could see this being used more widely. By evaluating clinical situations where PET/CT could prove most effective, patients and the NHS can both benefit from investment in these machines.
Scottish Clinical Imaging Network PET/CT Group