The lack of evidence for PET or PET/CT surveillance of patients with treated lymphoma, colorectal cancer, and head and neck cancer: a systematic review

Source: jnm.snmjournals.org Authors: Kamal Patel et al PET and PET/CT are widely used for surveillance of patients after cancer treatments. We conducted a systematic review to assess the diagnostic accuracy and clinical impact of PET and PET/CT used for surveillance in several cancers. Methods: We searched MEDLINE and Cochrane Library databases from 1996 to March 2012 for English-language studies of PET or PET/CT used for surveillance of patients with lymphoma, colorectal cancer, or head and neck cancer. We included prospective or retrospective studies that reported test accuracy and comparative studies that assessed clinical impact. Results: Twelve studies met our inclusion criteria: 6 lymphoma (n = 767 patients), 2 colorectal cancer (n = 96), and 4 head and neck cancer (n = 194). All studies lacked a uniform definition of surveillance and scan protocols. Half the studies were retrospective, and a third were rated as low quality. The majority reported sensitivities and specificities in the range of 90%–100%, although several studies reported lower results. The only randomized controlled trial, a colorectal cancer study with 65 patients in the surveillance arm, reported earlier detection of recurrences with PET and suggested improved clinical outcomes. Conclusion: There is insufficient evidence to draw conclusions on the clinical impact of PET or PET/CT surveillance for these cancers. The lack of standard definitions for surveillance, heterogeneous scanning protocols, and inconsistencies in reporting test accuracy preclude making an informed judgment on the value of PET for this potential indication. Authors: Kamal Patel, Nira Hadar, Jounghee Lee, Barry A. [...]

2013-09-04T07:09:32-07:00September, 2013|Oral Cancer News|

Journal of Nuclear Medicine: Costs for PET, PET/CT decreasing with increase in oncologic exams

Source: www.healthimaging.com Author: staff An article published in the March issue of the Journal of Nuclear Medicine reports on the methodologies for conducting economic evaluations of PET and PET/CT in oncologic applications, suggesting that PET and PET/CT are cost effective for staging of non–small cell lung cancer, differential diagnosis of solitary pulmonary nodules, restaging of Hodgkin's disease and non-Hodgkin's lymphoma and the restaging of colorectal carcinoma. Healthcare systems globally have recently approved reimbursement for PET and PET/CT for staging of non-small cell lung cancer and differential diagnosis of solitary pulmonary nodules because PET and PET/CT have been found to be cost-effective for those uses, according to Andreas K. Buck, MD from Nuklearmedizinische Klinik und Poliklinik in München, Germany, and colleagues. Additional indications that are covered by healthcare systems in the U.S. and several European countries include staging of gastrointestinal tract cancers, breast cancer, malignant lymphoma, melanoma, and head and neck cancers, added Buck and colleagues. PET and PET/CT are highly sensitive diagnostic tests to screen for metastatic tumor deposits in the entire body that may be missed by standard imaging modalities. On a patient basis, costs for PET and PET/CT are decreasing with the increasing numbers of examinations performed, noted Buck and colleagues. In Germany, “costs per examination range between approximately € 600 ($885 U.S.) and €1,000 ($1,474 U.S.); the amount for production and delivery of radiopharmaceuticals is approximately €180–€ 260 ($265–$383 U.S.) per scan.” In Great Britain, costs range from £635–£1,300 ($1,030– $2,109 U.S.) for PET. In Europe, reimbursement [...]

Bevacizumab better than gold standard imaging at detecting tumors

Source: www.biocompare.com Author: staff Scientists have developed a new imaging agent that can be used in scanning for tumours, and which gives a much clearer and more precise image than existing methods. The discovery has the potential to revolutionise pre-clinical cancer research and clinical diagnostic practice, and it makes use of compounds that have already been approved for treating patients: the anti-cancer drug bevacizumab (Avastin) and Copper-64, a radioactive copper nuclide, which is approved by the US Food and Drug Administration (FDA) for some clinical trials. Dr Zheng Jim Wang told the 20th EORTC-NCI-AACR [1] Symposium on Molecular Targets and Cancer Therapeutics in Geneva today (Wednesday 22 October) that he and his colleagues had attached bevacizumab to a molecule called DOTA (a cyclic compound) and tagged it with a radioactive tracer, Copper-64 (64Cu). Bevacizumab is an antibody that targets vascular endothelial growth factor (VEGF), a signalling protein released by tumour cells and which plays an important role in angiogenesis (the process by which a growing tumour creates its own blood supply). Currently, bevacizumab is being used to treat patients with advanced colorectal cancer and is being tested in several other metastatic cancers. When the researchers injected the compound (64Cu-bevacizumab) into mice with breast, lung and pancreatic cancers and then used PET/CT imaging to scan the animals, they found that it successfully targeted the cancer cells, accumulating in high concentrations in the tumours, and that it enabled clear and well-defined images of the tumours to be detected during scanning. When compared [...]

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