The German Joint Federal Committee (G-BA) approved two additional indications for application of positron emission tomography (PET) / computed tomography (CT) in head and neck area

In 2006, the Institute for Quality and Efficiency in Health Care (IQWIG) was commissioned to perform evaluation of application positron emission tomography (PET) / computed tomography (CT) in patients with different diseases.

In 2011, IQWIG published final report for evaluation of PET/CT in patients with head and neck tumors where it was concluded that the benefit assessment could not be performed due to lack of evidence. Additionally, it was stated that comparative studies especially randomized controlled trials (RCTs) are needed to assess diagnostic quality of PET or PET/CT.

In 2016, the situation with evidence for the use of PET/CT in head and neck tumors changed. The reevaluation of evidence for this indication was performed and 3 RCTs were identified. Then Joint Federal Committee (G-BA) concluded that the PET/CT is, in certain cases, suitable for avoiding the invasive procedures of neck dissection and laryngoscopic biopsy that required general anesthesia and can lead to several complications.

In March 2017, G-BA approved two additional indications for application of PET/CT for management of neck and head tumors in hospital settings after reevaluation. Thus, PET/CT was considered to use within:

• Deciding whether a neck dissection in patients with advanced head and neck tumors or with unknown primary thrombosis syndromes of the head and neck region should be performed
• Deciding whether a laryngoscopic biopsy should be performed in the laryngeal carcinoma if a reasoned suspicion of a persistent disease or recurrence exists after completion of a curatively intended therapy

These two indications were added within amendment of the Directive for methods and examinations that are used in hospital settings. This decision entered into force after publication in the Federal Law Gazette (Bundesgesetzblatt) on 1st of June. Then the same amendment was performed in the Directive for methods of the contract medical care and this decision entered into force on 7th of June.

See full text documents in German for hospital settings here.

See full text documents in German for contract care here.

See press release in German here.

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