Quality statement 2: Staging using FDG-PET-CT

Quality statement

Young people and adults with specific subtypes of non-Hodgkin's lymphoma have staging using fluorodeoxyglucose-positron emission tomography-CT (FDG-PET-CT).

Rationale

Imaging before treatment is important to define the disease stage and enable appropriate therapy. Metabolic imaging with FDG-PET-CT is more accurate than CT imaging alone for detecting the disease site in several specific histological subtypes of non-Hodgkin's lymphoma.

Quality measures

Structure

Evidence of local arrangements to ensure that young people and adults with specific subtypes of non-Hodgkin's lymphoma have staging using FDG-PET-CT.

Data source: Local data collection.

Process

a) Proportion of young people and adults with stage I diffuse large B-cell lymphoma who have staging using FDG-PET-CT.

Numerator – the number in the denominator who have staging using FDG-PET-CT.

Denominator – the number of young people and adults with stage I diffuse large B-cell lymphoma.

Data source: Local data collection.

b) Proportion of young people and adults with stage I or localised stage II follicular lymphoma for whom radiotherapy would be technically possible who have staging using FDG-PET-CT.

Numerator – the number in the denominator who have staging using FDG-PET-CT.

Denominator – the number of young people and adults with stage I or localised stage II follicular lymphoma for whom radiotherapy would be technically possible.

Data source: Local data collection.

c) Proportion of young people and adults with stage I or II Burkitt lymphoma with other low-risk features who have staging using FDG-PET-CT.

Numerator – the number in the denominator who have staging using FDG-PET-CT.

Denominator – the number of young people and adults with stage I or II Burkitt lymphoma with other low-risk features.

Data source: Local data collection.

Outcome

a) Number of young people and adults with specific subtypes of non-Hodgkin's lymphoma who have accurate staging.

Data source: Local data collection.

b) Treatment appropriate to the subtype of non-Hodgkin's lymphoma.

Data source: Local data collection.

What the quality statement means for different audiences

Service providers (specialist regional centres) have processes in place to ensure that young people and adults with specific subtypes of non-Hodgkin's lymphoma have FDG-PET-CT for staging.

Healthcare professionals (such as clinical oncologists) use FDG-PET-CT for accurate staging of specific subtypes of non-Hodgkin's lymphoma in young people and adults.

Commissioners (clinical commissioning groups) ensure that they commission services in which young people and adults with specific subtypes of non-Hodgkin's lymphoma have FDG-PET-CT for staging.

Young people and adults with certain types of non-Hodgkin's lymphoma have a special scan called a FDG-PET-CT scan to show where the cancer cells are in the body and confirm the stage of the cancer. FDG-PET-CT scans are particularly useful for people who have been diagnosed with types of lymphoma called large B-cell lymphoma, follicular lymphoma and Burkitt lymphoma.

Source guidance

Non-Hodgkin's lymphoma: diagnosis and management (2016) NICE guideline NG52, recommendation 1.2.1

Definitions of terms used in this quality statement

Young people and adults

16 years and over.

Specific subtypes of non-Hodgkin's lymphoma

FDG-PET-CT imaging should be offered to young people and adults with:

  • stage I diffuse large B‑cell lymphoma

  • stage I or localised stage II follicular lymphoma for whom radiotherapy would be technically possible (if the disease is thought to be encompassable within a radiotherapy field)

  • stage I or II Burkitt lymphoma with other low‑risk features.

[Adapted from NICE's guideline on Non-Hodgkin's lymphoma: diagnosis and management recommendation 1.2.1]