Hardly any other medical technology has been evaluated as often in western countries as positron emission tomography (PET/PET-CT): this is an expression of uncertainty about the value of PET diagnostics in the care of patients. The present HTA report updates the evidence on oncological indications and adds neurological indications and inflammatory diseases to the LBI-HTA report of 2015. It was conducted in cooperation between the TU Berlin and the LBI-HTA to provide an updated decision support for evidence-based PET/PET-CT planning in Germany and Austria.

For the present HTA report a systematic literature search and a targeted hand search were carried out. Thus, a total of 10 HTAs, 234 positive as well as negative recommendations and 23 additional systematic reviews/meta-analyses (SR/MA) could be identified.

In the area of oncology 5 HTAs, 188 positive and negative recommendations as well as additional information from 12 SR/MA was available. Comparing the results regarding oncological indications, a consensus was found in 8 indication areas where there was sufficient evidence for the respective sub-indication in favour of PET or PET-CT examinations. In contrast, regarding 8 indications (too) little evidence in favour of PET (individual decisions possible) was present. In a further 8 indications there was controversial and inconclusive evidence. Therefore, recommendations can only be made with reservations.

With regard to neurological indications (2 HTAs, 28 recommendations & non-recommendations, 3 SR / MA), evidence was identified and presented for two sub-indication (Alzheimer's dementia or dementia as well as epilepsy). However, there was no agreement that there was sufficient evidence in favour of a PET / PET-CT scan for either of these two sub-indications.

For inflammatory diseases statements from 3 HTAs, 18 recommendations and non-recommendations as well as additional information from 8 SR / MA could be identified. There was a consensus of sufficient evidence in favour of PET or PET-CT for infections of the vertebral column/spondylodiscitis. In a further 4 sub-indications there was controversial and inconclusive evidence present.

Overall, the update 2018 resulted in more details and specifications compared to the LBI-HTA report of 2015. The overall recommendations for indications (and also detailed recommendations for sub-indications) as well as the explicit non-recommendations from the LBI-HTA report 2015 and this update of 2018 can serve as a needs-based and evidence-based decision support for PET/ PET-CT service provision in German and Austrian hospitals.