No robust conclusions possible on advantages or disadvantages of PET

Malignant gliomas are fast-growing brain tumours with poor prospects of recovery depending on disease stage. Experts hope that the examination of patients by means of positron emission tomography (PET) is more helpful in the choice of the right treatment than other procedures. In a final report the German Institute for Quality and Efficiency in Health Care (IQWiG) has now investigated the benefit of PET in the detection of recurrences. According to this report, no robust conclusions are possible on the advantages or disadvantages of PET.

PET is supposed to help solve this problem. For this purpose, patients are injected a contrast agent that emits weak and non-toxic radiation. As tumour tissue often has a more active metabolism than healthy or necrotic tissue, the radioactive contrast agent accumulates there. This "illuminating" tissue in the body can be measured by means of PET and blended into CT images, so that doctors can see the location and metabolic activity of any tissue abnormalities at the same time. In newer studies, PET and MRI are also combined.

Even if the PET examination provided more information, this would not necessarily mean that patients would benefit from it. The decisive question is whether PET or PET/CT improves the treatment of patients by, for example, helping doctors choose the best treatment for the individual patient.

Procedure of report production

IQWiG published the preliminary results in the form of the preliminary report in July 2010 and interested parties were invited to submit comments. When the comments stage ended, the preliminary report was revised and sent as a final report to the contracting agency, the Federal Joint Committee, in November 2010. The written comments are published in a separate document at the same time as the final report. The report was produced in collaboration with external experts.

Source: Institute for Quality and Efficiency in Health Care

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