Australian Government - Department of Health and Ageing

Medical Services Advisory Committee (MSAC)

Reference 35c Positron emission tomography (PET) review: Lymphoma

Positron emission tomography (PET) review: Lymphoma

Positron emission tomography (PET) review: Lymphoma

Reference No.

35c

Reference NamePositron emission tomography (PET) review: Lymphoma
Advisory PanelAssociate Professor Fred Khafagi
(Chair)
(MSAC member)
Professor Brendon Kearney
(Deputy Chair)
(MSAC member until 30/12/08)
Dr Ian Prosser
(MSAC member until 30/06/2009)
Dr Bryan Burmeister
(Royal Australian and New Zealand College of Radiologists nominee)
Dr George Larcos
(Australian and New Zealand Association of Physicians in Nuclear Medicine nominee)
Dr Gabrielle Cehic
(Medical Oncology Group of Australia nominee)
Mr Brian Stafford
(Consumers' Health Forum of Australia nominee)
Associate Professor John Seymour
(Haemaltologist)
Dr Andrew Wirth
(Oncology)
Date Received by MSAC SecretariatN/A
Stage 1 - EligibilityEligible
Stage 2 - AssessmentCompleted
Stage 3 - Formulation of Advice to the MinisterMembers supported public funding for indolent NHL, HL and aggressive NHL in the specific circumstances outlined below.

Indolent NHL
Based on the evidence in terms of diagnostic accuracy, changes in patient management, and hence probable improvements in health outcomes, MSAC advised that public funding should continue for a single dual modality PET/CT per patient in the initial staging of indolent NHL where clinic-pathological and anatomical imaging indicated that the stage was I or IIA and where the proposed management plan was to administer definitive radiotherapy with curative intent.

HL and aggressive NHL
Based on similar considerations, MSAC advised that public funding should continue for patients who have HL and aggressive NHL as:
  • a single dual modality PET/CT whole body scan per patient at baseline for staging newly diagnosed or previously untreated disease;
  • a single dual modality PET/CT whole body scan per patient (as an alternative to CT) to assess response to first-line therapy either during treatment or within three months of completing definitive first-line treatment;
  • a single dual modality PET/CT whole body scan per patient (as an alternative to CT) to establish a new baseline following confirmed recurrence of disease; and
  • a single dual modality PET/CT whole body scan per patient (as an alternative to CT) to assess response to second-line chemotherapy prior to consideration of stem cell transplantation.
MSAC does not support the public funding of dual modality PET/CT for surveillance and also notes concern at the use of any diagnostic imaging modality for surveillance, and suggests that the cost-effectiveness of this practice should be investigated further.

MSAC advises that arrangements should be made to ensure that dual modality PET/CT scanning for HL and aggressive NHL is used in place of (rather than in addition to) conventional CT scanning as above.

MSAC advises that funding of PET for suspected (as opposed to confirmed) recurrent disease should no longer be supported (currently MBS item number 61628).
Stage 4 - DecisionMSAC considered this assessment on 11 September 2009.
The Minister noted MSAC's advice 5 January 2010
Stage 5 - ImplementationIn Progress