Oncologic <sup>18</sup>F-FDG PET/CT: Referring Physicians’ Point of View

Karantanis, Dimitrios; Kalkanis, Dimitrios; Allen-Auerbach, Martin; Bogsrud, Trond Velde; Subramaniam, Rathan M.; Danielson, Adam; Lowe, Val J.; Czernin, Johannes

doi:10.2967/jnumed.111.102228

Cited by 13 publications

(13 citation statements)

References 18 publications

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“…In this survey, referring physicians expressed considerable uncertainty about the appropriate use of oncologic 18 F-FDG PET/CT, and the experience and skill level of the interpreting physician was considered very important. 22 High accuracy of IC detection might increase referring physicians' reliance and raise the position of oncologic 18 F-FDG PET/CT.…”

Section: Full Paper: Detection Of Incidental Cancer By Fdg Pet/ct Bjrmentioning

confidence: 99%

Ability of 18-fludeoxyglucose positron emission tomography/CT to detect incidental cancer

Sone

Sobajima²,

Kawachi³

et al. 2014

BJR

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Objective: To determine the prevalence and clinical features of pathologically proven incidental cancer (IC) detected by whole-body fluorine-18 fludeoxyglucose ( 18 F-FDG) positron emission tomography (PET)/CT, as well as the incidence of false-positive and false-negative results. Methods: We retrospectively reviewed reports derived from 18 F-FDG PET/CT images of 3079 consecutive patients with known or suspected malignancies for 3 years. Discrete focal uptake indicating IC was identified from reports as well as pathological or clinical diagnoses, and the clinical courses were investigated. The false-positive result was defined as uptake indicating IC but not pathologically confirmed as malignant during follow-up. The false-negative result was defined as pathologically proven IC detected by another modality at initial clinical work-up or diagnosed during the follow-up period. Results: We found 18 F-FDG uptake indicating IC in 6.7% of all patients, and IC was pathologically proven in 2.2% of all patients. The most common sites were the colon, lung and stomach. The median survival duration of patients with IC was 42 months. The results were false positive in 4.5% of all patients, and the results were false negative in 2.3% of all patients. Conclusion:18 F-FDG PET/CT is a valuable tool for detecting IC. The rates of false-positive and false-negative results are within acceptable range. Advances in knowledge: This is the first report to describe the survival of patients with IC, and the detailed features of false-negative results at actual clinical settings.

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Section: Full Paper: Detection Of Incidental Cancer By Fdg Pet/ct Bjrmentioning

confidence: 99%

Ability of 18-fludeoxyglucose positron emission tomography/CT to detect incidental cancer

Sone

Sobajima²,

Kawachi³

et al. 2014

BJR

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“…This innovative procedure arrived in the 1970's and was applied first in the early 1980's, mainly for the evaluation of brain diseases. Accordingly, PET is actually worldwide diffuse, prominent in oncology amongst other clinical indications, such as those concerning patients with cerebral, inflammatory and cardiac diseases, which are also present [53][54][55][56].…”

Section: Pet Imagingmentioning

confidence: 99%

Basic Premises to Molecular Imaging and Radionuclide Therapy – Part 1

Mansi¹,

Kitson²,

Cuccurullo³

et al. 2014

J Diagn Imaging Ther

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This manuscript is a complementary article to an accompanying paper, published in a forthcoming issue, which will give an overview on the central role of chelation in labelling radiocompounds; either for imaging and/or for radionuclide therapy. In order to facilitate a better understanding of the importance of Chelator-Based Imaging & Therapy, we will briefly discuss in this publication -which is partially intended as an introduction to the second paper -which contains the major basic principles of molecular imaging and radionuclide therapy. Although these issues are of interest in the general field of Nuclear Medicine; since the chelation process involves the labelling with radiometals; we aim to highlight examples of this category in this paper which concern this class of nuclides in this particular issue.

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“…The idea for the present study was generated from the results of a recent survey of 961 referring physicians performed by our group (7). This survey revealed, among other issues, considerable concerns about the correct interpretation of oncologic 18 F-FDG PET/CT studies.…”

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confidence: 99%

Perceived Misinterpretation Rates in Oncologic ¹⁸F-FDG PET/CT Studies: A Survey of Referring Physicians

et al. 2014

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Because only pathologic examination can confirm the presence or absence of malignant disease in cancer patients, a certain rate of misinterpretation in any kind of imaging study is inevitable. For the accuracy of interpretation to be improved, determination of the nature, causes, and magnitude of this problem is needed. This study was designed to collect pertinent information from physicians referring patients for oncologic 18F-FDG PET/CT. Methods A total of 662 referring physicians completed an 11-question survey focused on their experience with the interpretation of oncologic 18F-FDG PET/CT studies. The participants were oncologists (36.1%; n = 239), hematologists (14.5%; n = 96), radiation oncologists (7.4%; n = 49), surgeons (33.8%; n = 224), and other physicians (8.2%; n = 54). Questions were aimed at determining the frequency, nature, and causes of scan misinterpretations as well as potential solutions to reduce the frequency of misinterpretations. Results Perceived misinterpretation rates ranged from 5% to 20%, according to most (59.3%) of the participants; 20.8% of respondents reported rates of less than 5%. Overinterpretation rather than underinterpretation was more frequently encountered (68.9% vs. 8.7%, respectively). Limited availability of a patient’s history and limited experience of interpreters were the major contributors to this phenomenon, according to 46.8% and 26.7% of the participants, respectively. The actions most commonly suggested to reduce misinterpretation rates (multiple suggestions were possible) were the institution of multidisciplinary meetings (59.8%), the provision of adequate history when ordering an examination (37.4%), and a discussion with imaging specialists when receiving the results of the examination (38.4%). Conclusion Overinterpretation rather than underinterpretation of oncologic 18F-FDG PET/CT studies prevails in clinical practice, according to referring physicians. Closer collaboration of imaging specialists with referring physicians through more multidisciplinary meetings, improved communication, and targeted training of interpreting physicians are actions suggested to reduce the rates of misinterpretation of oncologic 18F-FDG PET/CT studies.

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Oncologic ¹⁸F-FDG PET/CT: Referring Physicians’ Point of View

Cited by 13 publications

References 18 publications

Ability of 18-fludeoxyglucose positron emission tomography/CT to detect incidental cancer

Ability of 18-fludeoxyglucose positron emission tomography/CT to detect incidental cancer

Basic Premises to Molecular Imaging and Radionuclide Therapy – Part 1

Perceived Misinterpretation Rates in Oncologic ¹⁸F-FDG PET/CT Studies: A Survey of Referring Physicians

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Oncologic 18F-FDG PET/CT: Referring Physicians’ Point of View

Cited by 13 publications

References 18 publications

Ability of 18-fludeoxyglucose positron emission tomography/CT to detect incidental cancer

Ability of 18-fludeoxyglucose positron emission tomography/CT to detect incidental cancer

Basic Premises to Molecular Imaging and Radionuclide Therapy – Part 1

Perceived Misinterpretation Rates in Oncologic 18F-FDG PET/CT Studies: A Survey of Referring Physicians

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Product

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Oncologic ¹⁸F-FDG PET/CT: Referring Physicians’ Point of View

Perceived Misinterpretation Rates in Oncologic ¹⁸F-FDG PET/CT Studies: A Survey of Referring Physicians