Indications for the pet-ct scan

The PET-CT scan is fully funded by the NFZ if the patient fulfils specific criteria (in accordance with Regulation No 67/2011/DSOZ issued by the President of the National Health Fund on 18 October 2011)

Current indications for reimbursement of the costs of the PET-CT scan by the NFZ:

1. Neoplastic diseases:
1) a single tumour of the lung of the diameter > 1 cm, to differentiate between benign and malignant character, with no diagnosis by other available methods;
2) non-small cell lung cancer, in order to assess its progression before the planned resection or radical radiotherapy, if other available examinations do not give an unequivocal assessment of progression (excluding bronchioalveolar cancer and neuroendocrine cancers or previously identified remote metastases)
3) non-small cell lung cancer, in order to make a residual assessment of the disease after induction chemotherapy
4) Hodgkin lymphoma and non-Hodgkin lymphoma in order to make an initial assessment of progression or the effectiveness of chemotherapy or early detection of recurrence, if other imaging examinations do not give an unequivocal assessment of progression;
5) cancer of the colon in order to make a preoperative assessment of progression or early detection of recurrence after radical treatment (in the case of an increase in marker concentration or equivocal imaging test results);
6) cancer of the oesophagus in order to assess the progression before treatment and early detection of recurrence after radical treatment (in the case of equivocal imaging test results);
7) assessment of a pathological lesion in the pancreas or liver, indicating cancer, if identification by means of other available methods is impossible;
8) breast cancer, to exclude remote metastases, when the results of other tests are unequivocal or, in the cases of secondaries to the auxiliary lymph nodes from a focus of unknown location and suspicion of primary focus in the mammary gland;
9) melanomas with clinical metastases to regional lymph nodes to exclude metastases to remote organs with potentially operational secondaries to remote organs or with a secondary without identified primary  focus;
10) ovarian cancer, so as to detect recurrence after a radical treatment (in the case of Ca 125 concentrations or unequivocal results of imaging tests);
11) epithelial cancers of the head and neck, to find recurrence early and to assess local-regional progression, if results of other tests are unequivocal;
12) malignant cerebral tumours to identify recurrence early or to determine the biopsy site;
13) cancer of the thyroid to localise the focus of recurrence in the case of increased concentration of thyroglobulin, if other examinations do not enable the localisation of the recurrence focus (necessary previous scintigraphy 131I);
14) suspicion of secondaries to the bones, if other examinations do not enable the localisation of the focus of cancer recurrence (preferred marker 18F);
15) planning of radical radiotherapy with an intensity-modulated beam, to assess the breakdown of viable cancerous cells, hypoxia or tumour proliferation, if other tests do not enable such an assessment;
16) cancers of the testicle (excluding mature teratomas), to check their range and the effectiveness of treatment (including the presence of residual tumour and identification of recurrence), if other tests do not enable such an assessment;
17) cancers of the prostate and kidney to detect the recurrence (metastases) after the radical treatment (only by means of PET with marked choline or acetate), if other tests do not enable such an assessment;
18) sarcomas, to assess the effectiveness of chemotherapy (after 1-3 courses compared with an initial examination) and early detection of recurrence if other tests do not enable such an assessment;
19) cancers of the stroma of the gastric tract (GIST), to monitor the responses to molecularly directed treatment;
20) secondaries with an unknown initial point to localise the primary tumour if it is not possible by means of other available tests.

2. Heart diseases:
1) cardiac perfusion examinations:
a) suspicion of ischaemic disease in the group of patients with an indirect risk of becoming ill, if other diagnostic tests (including especially the perfusion SPECT examination) do not enable equivocal diagnosis – as a conclusive examination;
b) suspicion of the ischaemic disease in a group of patients with an indirect risk of developing the disease, if objective factors indicate the possibility of obtaining a false result in classical SPECT examinations (obesity, mastectomy, large breast, implants, other) – as a basic examination;
2) examination for assessment of myocardial viability.

3. Diseases of the nervous system:
Diagnosed drug-resistant epilepsy with planned surgical treatment.
(According to attachment no 4 to Regulation no 67/2011/DSOZ issued by the President of the National Health Fund on 18 October 2011)