|Criteria for appropriate use of FDG-PET in colorectal cancer
|Ballini L, Vignatelli L, Negro A, Maltoni S, Longo G
This is a bibliographic record of a published health technology assessment from a member of INAHTA. No evaluation of the quality of this assessment has been made for the HTA database.
Ballini L, Vignatelli L, Negro A, Maltoni S, Longo G. Criteria for appropriate use of FDG-PET in colorectal cancer
. Bologna: Agenzia sanitaria e sociale regionale, Regione Emilia-Romagna (ASSR). ORIentamenti 5. 2011
The criteria reported in this document, are to be intended as guidance for programs of clinical governance aimed at: supporting clinicians on the use of FDG-PET; post hoc analyses of appropriate use of FDG-PET; contributing to the planning of the regional health service.
A panel of 26 experts, comprising methodologists, nuclear physicians, radiologists, radiotherapists, surgeons, oncologists, ENT specialists, hematologists and health directors working in Health Trusts and Teaching Hospitals of Emilia-Romagna was convened to discuss and agree on the methodology for a research program aimed at defining the criteria for appropriate use of FDG-PET in oncology. For each indication a systematic review was performed. The GRADE approach was applied to assess the quality of included studies, the level of confidence in the overall evidence for each outcome of interest. The GRADE approach for diagnostic recommendations was also used to elicit judgement from the panel members on benefit and harms trade-off for patient-important outcomes. The RAND method was used to vote and reach an agreement on the appropriateness criteria.
The panel examined and assessed the role of FDG-PET for the following 7 clinical indications: N staging of primary esophageal cancer; M staging of primary esophageal cancer; Target volume definition of curative radiation treatment; Evaluation of early response to neoadjuvant therapy; Evaluation of response to neoadjuvant therapy at the end of treatment; Follow up in patients with no suspicion of recurrence; Diagnosis and staging of suspect distant recurrence. Thirtyfour studies were finally included.
Criteria for appropriate use of FDG-PET in colorectal cancer: diagnosis of primary colorectal cancer - Inappropriate due to lack of diagnostic role of FDG-PET; N staging of primary colorectal cancer - Inappropriate due to lack of diagnostic role of FDG-PET; M staging of locally advanced colorectal cancer - Appropriate (level of evidence: moderate); target volume definition of curative radiation treatment in patients with rectal cancer - Inappropriate due to lack of diagnostic role of FDG-PET; during treatment evaluation of early response to therapy of liver metastases in colorectal cancer - Indeterminate due to lack of studies; end of treatment evaluation of response to neoadjuvant radiotherapy for rectal cancer - Inappropriate due to lack of diagnostic role of FDG-PET; evaluation of residual disease following ablative treatment of liver metastases - Uncertain (level of evidence: very low); follow up in patients with no suspicion of recurrence - Inappropriate (level of evidence: very low); staging of recurrence in patients treated for colorectal cancer - Appropriate (level of evidence: moderate)
Subject indexing assigned by CRD
Colorectal Neoplasmss; Fluorodeoxyglucose F18; Positron-Emission Tomography
Country of organisation
An English language summary is available.
Address for correspondence
Viale Aldo Moro 21, 40127 Bologna, Italia tel. +39 051 5277177 fax +39 051 5277049
Date abstract record published