PET Activities in INAHTA

This section is dedicated to various PET (Positron Emission Tomography) activities in INAHTA related to assessment and/or implementation.

You can find information about INAHTA's PET update, PET survey from KCE (Belgium), PET project at NCCHTA (UK), PET project at MAS (Canada); and PET updates from ICTAHC (Israel), CADTH (Canada) and England.

PET scanners in Australia


Click here to view a full report

Contact person: Mary Warner (mary.warner@health.gov.au)


 Update on a PET project from UETS

English summary of the review "Effectiveness and safety of Positron Emission Tomography in Breast Cancer" conducted by UETS is now available. The objective of the review is to assess effectiveness and safety of 10-FDG-PET in evaluating breast cancer in the main indications comparing the outcomes with other imaging techniques. Please click here to read the English summary.

Link: The full report in Spanish will be available here soon.

Contact person: Beatriz Valentin (UETS), beatriz.valentin@salud.madrid.org

Update on PET from CADTH, Canada, which is an extensive literature review of all indications for which PET is potential.

CADTH has recently published an issue of the Health Technology update Newsletter (issue 8, January 2008) that contains a feature on PET in Canada (location of PET & PET/CT units and cyclotrons, provincial funding for PET scans and information on licensing of radiopharmaceuticals in Canada).

Link: You can read the Newsletter here.

Contact person: Gabrielle Zimmermann (gabriellez@cadth.ca)


First INAHTA Joint Project on PET (1999): Experience with PET and Synthesis of the Evidence.

At the fifth Annual Meeting of INAHTA in 1997, members initiated a joint project on PET scanning in clinical medicine in response to a growing interest in the technology worldwide. INAHTA members have experianced different motivations or hindrances to the diffusion on PET, and their assessments reflect different lokal health care system environments. The goal of this collaboration is to Synthesize the range of approaches and assessment questions into a broadly applicable document that will expand the scope of individual agencies' assessments, and, ultimately, strengthen the support for policy and regulation of PET. Please find the first published report here.


Update on INAHTA's joint project on PET – Now Published

Part 1 of this Joint Project report presents survey results on diffusion, assessment activities, and policy for clinical use related to PET among INAHTA members since 1999. Part 2 of this updated Joint Project report summarizes HTA-based strategies for directing the clinical use of PET and a discussion on the value of HTA in managing the diffusion of high cost diagnostic technologies, which were presented at an INAHTA-sponsored workshop at the HTAi Annual Meeting in 2004 on strategies for managing high cost diagnostic technologies.

The Board of INAHTA has discussed whether or not an updated evidence synthesis is worth doing and if so, who should undertake it? INAHTA could ask members for volunteers or consider contracting it out. Because of the potential impact that an INAHTA synthesis could have on policy, as well as increased visibility and scrutiny among key stakeholders, INAHTA would require a formal, rigorous synthesis. The Board decided that it does not have the resources to undertake such as endeavor at this time.
 
Link: PET Workshop
Link: Joint project of the INAHTA: Part 1 and 2 (Survey results on diffusion, assessment, and clinical use of PET and Managing the diffusion of PET with HTA)

Contact person: Liz Adams (VATAP, USA), Email: elizabeth.adams@med.va.gov


KCE survey on PET

In the context of an HTA on PET scanners in Belgium, KCE is updating the results of the INAHTA survey presented in 2004. This survey showed that Belgium is the leading country in terms of number of PET scanners per million population. However, in most other countries things are moving fast in the PET-field. Therefore, KCE surveyed countries, which participated in last year's survey, on actual situation, their future plans, how decisions on planning are taken, decision process, major stakeholders in the demand for PET-scanners, and on the provision of PET-tracers. 

The report was published in 2005 on KCE'sy useful, described the current Belgian situation of PET and formulated recommendations for planning and financing.

Link: Survey questions 

Contact person: Irina Cleemput (KCE, Belgium), Email: Irina.Cleemput@kenniscentrum.fgov.be


NCCHTA and PET (ongoing project)

Project title: Overview of the clinical effectiveness of positron emission tomography (FDG-PET) imaging in selected cancers

The aim of this study is to provide a robust systematic review of the clinical effectiveness of Positron Emission Tomography imaging using 2-18F-fluoro-2-deoxy-D-glucose (FDG-PET) in the management eight specific cancers (breast, colorectal, head and neck, lung, lymphoma, melanoma, oesophageal and thyroid). Cancer management decisions of diagnosis, staging and progression (including recurrence) will be evaluated in detail. The newer use of therapy response will be considered in the discussion. This systematic review will build on systematic reviews published since 2000 and augment them with English and European primary studies published up to August 2005. All studies on the newer combined technology of PET/CT will be summarised separately, as will any economic evaluations.

Link: More about the project 

Contact person: Karen Facey, Consultant (NCCHTA, UK), Email: karen.facey@btinternet.com


PET updates in Israel

In Israel, special medical devices represent a large economic cost and therefore are a burden on the budget of the MOH. These devices are authorized by the Technology Division at the MOH. Recently, evaluations have been conducted to estimate the national needs for PET in Israel. This work has not yet been completed.

We will inform you of details following completion of the report (translating a brief summary from Hebrew to English). It appears that in Israel we shall continue to limit the number of devices according the basic principles of CON (Certificate of Need) enacted here in Israel for large expensive medical devices. This report also relates to the mapping of indications and it seems that PET will be replacing other forms of imaging devices for certain indications.

Contact person: Nina Hakak (ICTAHC, Israel), Email: NinaH@gertner.health.gov.il


MAS and PET (trials currently in progress)

  • A Prospective Cohort Study to Determine the Sensitivity of PET in Detecting Metastatic Cancer in Neck Lymph Nodes in Patients with Squamous Cell Head and Neck Cancer Managed with Primary Radiation Therapy (PET PREVENT Study)
  • The Impact of PET Imaging in Stage Three Non-Small Cell Lung Cancer: A Prospective Randomized Clinical Trial. (PET START Trial)
  • The Impact of PET Imaging in Staging Potentially Surgically Resectable Non-Small Cell Lung Cancers: A Prospective, Multicenter Randomized Clinical Trial (ELPET Trial)
  • A Prospective Study to Determine the Role of 2[18F] Fluoror-2-deoxy-D-glucose PET in the Assessment of Regional Nodal Spread of Disease in Breast Cancer Patients (PET PREDICT Study).

Link to trials: Ontario Cancer Research Network


Studies to be launched shortly:

  • The Impact of PET Imaging Prior to Liver Resection for Colorectal Adenocarcinoma Metastaes: A Prospective, Multicenter Randomized Clinical Trial (PET CAM Trial)
  • PET For the Investigation of Solitary Pulmonary Nodules (SPN) and Biomarker Positive-Anatomical Imaging Negative (BMPAIN) Thyroid, Germ Cell, and Colorectal Cancers: A Registry Study.

There are other PET research studies being conducted in the province that are not being directly funded by the Ministry of Health and Long-Term Care (e.g. cardiac PET research at the University of Ottawa Heart Institute and PET research at the Centre for Addiction and Mental Health).

MAS contact person: Ms. Micheline Cournoyer, Email: masinfo@moh.gov.on.ca


PET in England

A framework for the development of PET scanning services in England has been developed by the Department of Health at the request of Strategic Health Authorities and specialised commissioning groups. It is intended to guide commissioners and potential providers of services by providing advice on the current evidence of benefit from PET scanning; the current state of the technology; the number of scanners likely to be required; workforce and training issues; capital and revenue costs and further research and evaluation.

Links: Report in PDF and Department of Health