Australian Government - Department of Health and Ageing

Medical Services Advisory Committee (MSAC)

Ref35d - Positron Emission Tomography (PET) review: Glioma and Sarcoma

Reference No.

35di & ii

Reference NamePositron EmissionTomography (PET) review: Glioma and Sarcoma
Advisory PanelAssociate Professor Fred Khafagi
(Chair)
(MSAC member)
Professor Brendon Kearney
(Deputy Chair)
(MSAC member until 31/12/2008)
(Health Administration and Planning)
Dr Salvatore Berlangieri
(Australian and New Zealand Association of Physicians in Nuclear Medicine nominee)
Dr Bryan Burmeister
(Royal Australian and New Zealand College of Radiologists nominee)
Mr Denis Strangman
(Consumers’ Health Forum of Australia nominee)
Dr Brian Stein
(Medical Oncology Group of Australia nominee)
Dr David Walker
(Neurosurgeon)
Dr Peter Choong
(Sarcoma surgeon)
Date Received by MSAC SecretariatN/A
Stage 1 - EligibilityEligible
Stage 2 - AssessmentCompleted
Stage 3 - Formulation of Advice to the MinisterGlioma

After considering the strength of the available evidence in relation to the safety, effectiveness and cost-effectiveness of PET in glioma:

MSAC supports public funding for a single FDG PET/CT study of the brain performed for the evaluation of a patient with suspected residual or recurrent malignant brain tumour on anatomical imaging after definitive therapy (or during ongoing chemotherapy) who is considered to be a candidate for further active treatment.

MSAC does not support the public funding of PET studies for the initial diagnosis of patients with suspected primary malignant brain tumour.

MSAC does not support the public funding of PET studies for tumour grading in patients with malignant brain tumour.


Sarcoma

After considering the strength of the available evidence in relation to the safety, effectiveness and cost-effectiveness of PET for sarcoma:

MSAC does not support public funding for PET studies for the initial grading and guiding biopsy of suspected sarcoma.
(Indication 1)

MSAC supports public funding for a single whole body FDG PET/CT study performed for the initial staging of a patient with biopsy-proven bone or soft tissue sarcoma (excluding gastrointestinal stromal tumour) who is considered to be potentially curable by conventional staging methods. (Indications 2 and 3)

MSAC supports public funding for a single whole body FDG PET/CT study performed for the evaluation of a patient with suspected residual or recurrent sarcoma (excluding gastrointestinal stromal tumour) after the initial course of definitive treatment to determine suitability for subsequent treatment with curative intent. (Indication 4)

To minimise the use of repeated PET scans as surveillance in patients without clinical evidence suggestive of active disease, a use which MSAC does not support, the relevant MBS Item Descriptor should not allow more than one scan. However, MSAC advises that there is no need to prescribe a particular period of time after cessation of initial therapy before the scan is conducted.

MSAC does not support public funding at this time for PET studies for the initial staging of patients with newly diagnosed gastrointestinal stromal tumours (GIST) or with recurrent GIST after locoregional therapy; or investigation of suspected progression or treatment resistance in patients with GIST. MSAC advises that further research is required regarding the use of PET for these indications (Indications 5 and 6).

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 29 March 2010
The Minister noted MSAC's advice 3 June 2010
Stage 5 - ImplementationIn Progress