Australian Government - Department of Health and Ageing

Medical Services Advisory Committee (MSAC)

Reference 35 b (Iii) Positron emission tomography (PET) for head and neck

Positron emission tomography (PET) for head and neck

Reference No.

35bii

Reference NamePositron emission tomography (PET) for head and neck
Advisory PanelsAssociate Professor Frederick Khafagi
(Chair)
(MSAC Member)
Professor Brendon Kearney
(Deputy Chair)
(MSAC member until 31/12/08)
Mr Brian Stafford
(Consumer's Health Forum nominee)
Dr Bryan Burmeister
(Royal Australian and New Zealand College of Radiologists nominee)
Mr Bernard Lyons
(Royal Australian College of Surgeons nominee)
Dr George Larcos
(Australian and New Zealand Association of Physicians in Nuclear Medicine nominee)
Dr Brian Stein
(Medical Oncology Group of Australia Nominee)
Professor Bruce Mann
(Specialist Breast Surgeon and Surgical Oncologist)
Professor Glyn Jamieson
(Gastrointestinal Surgeon )
Date Received by MSAC Secretariat30 June 2007
Stage 1 - EligibilityEligible
Stage 2 - AssessmentCompleted
Stage 3 - Formulation of Advice to the MinisterMSAC has considered the safety, effectiveness and cost-effectiveness of PET/CT for squamous cell cancer of the head and neck:

1. in addition to conventional staging of newly diagnosed or recurrent cancer;
2. in addition to conventional assessment for suspected residual cancer after
definitive treatment; and
3. in addition to conventional staging of cancer metastatic to cervical lymph
nodes from an unknown primary site.

MSAC finds that PET/CT is safe.

MSAC finds that PET/CT improves the accuracy of staging of newly diagnosed or recurrent cancer, and leads to a change in management in the majority of patients in whom additional disease is detected; while this is expected to improve outcomes for patients, the magnitude of this effect could not be quantified.

MSAC finds that PET/CT has a high negative predictive value in patients with suspected residual cancer, and permits the avoidance of invasive procedures, including surgery, in the majority of patients in whom these were planned; while this is expected to reduce morbidity and improve quality of life, the magnitude of this effect could not be quantified.

MSAC finds that PET/CT improves the detection of otherwise occult primary sites of metastatic head and neck cancer, leading to changes in the management of these patients; the impact of such changes on patient outcomes could not be quantified.

MSAC advises that public funding should be supported for these indications.
Stage 4 - Decision
Noting of MSAC advice by the Minister does not constitute a final decision in relation to the provision of public funding.		MSAC considered this assessment on 28 November 2008.
The Minister noted MSAC's advice on 8 December 2008.
Stage 5 - Implementation1 September 2009