Quality and consistency of clinical practice guideline recommendations for PET/CT and PET: a systematic appraisal

Li, Q.; Hou, Wenxiu; Wu, Mei; Li, Ling; Su, Minggang; Ma, Baochun; Cui, Futao; Ren, Yan; Xu, Jing; Zou, Kang; Tian, Rong; Sun, Xin

doi:10.1007/s00330-023-09786-8

Cited by 4 publications

(7 citation statements)

References 25 publications

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“…A wide variety of possible diseases and applications emerged as most common indication for PET/ceCT among responders, mainly lymphoma, lung cancer, abdomino-pelvic cancer, melanoma, and NET. This is in line with available guidelines suggesting possible added value of PET/ceCT in the diagnostic work-up of these diseases ( 7 ). In particular, the use of hybrid PET/ceCT in oncology seems to offer advantages in terms of higher diagnostic accuracy (e.g., oncological staging), time-saving (“one-shot” imaging) and multidisciplinary integration between different clinical professionals ( 7–10 ).…”

Section: Discussionsupporting

confidence: 89%

“…According to a recent editorial, several papers investigated the role of PET/ceCT in different clinical settings (1,670 papers in the timeframe 2010–2021), with a prevalence of articles published in Nuclear Medicine journals, demonstrating a large interest on this topic in scientific literature and clinical routine ( 6 ). Available guidelines make suggestions about the use of PET/ceCT in specific clinical scenarios ( 7 ), but the real-world dissemination of this tool seems to still rely on subjective factors.…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, other technical and administrative points could be considered about the use of PET/ceCT. Consistent guidelines do not exist for the acquisition of PET/ceCT, and CT protocols used in PET/CT are not supported by a robust scientific literature regarding acquisition parameters, IV contrast administration, and their contribution to dosimetry ( 6 , 7 ). Ideally, higher costs, integrative NM/radiology workflows and dose to patients due to ceCT seem to negatively affect the use of PET/ceCT in routine.…”

Section: Discussionmentioning

confidence: 99%

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Contrast enhanced CT on PET/CT imaging in clinical routine: an international survey

Annunziata,

Testart,

Auf der Springe

et al. 2023

Front. Med.

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AimTo perform an international survey about PET/CT imaging with contrast enhanced CT (PET/ceCT) in clinical routine worldwide.MethodsA questionnaire of ten questions was prepared for health professionals, addressing the following issues: (1) general demographic, hospital, and department information; (2) use and diffusion of PET/ceCT worldwide; (3) factors influencing the use of PET/ceCT. An invitation to the survey was sent to the corresponding authors of NM scientific articles indexed in SCOPUS in 2022 and dedicated to PET/CT imaging. Data were analysed per individual responder.Results191 individual responders worldwide participated in this survey. Most of the responders are using PET/ceCT in their center (74%). Interestingly, the relative use of PET/ceCT over the total PET/CT scans has an anti-Gaussian distribution (<20% ceCT and > 80% ceCT were most represented). Most of responders are using PET/ceCT in oncological settings (62%) and irrespectively from radiopharmaceuticals (62%). In most cases, PET/ceCT scans are reported by NM physicians alone or together by NM physicians and radiologists with an integrated report (31%).ConclusionPET/ceCT imaging is largely used worldwide. Local factors can affect the choice of PET/ceCT in respect to conventional PET/CT imaging. Further cost–benefit analysis could be useful to consider other possible influencing variables, such as technologies, dosimetry, department organization and economics.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Contrast enhanced CT on PET/CT imaging in clinical routine: an international survey

Annunziata,

Testart,

Auf der Springe

et al. 2023

Front. Med.

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“…The guidelines were defined as documents that self-identified as a guideline, or a guidance document with recommendations including consensus, appropriateness criteria, manual, etc. [ 21 , 22 ]. We restricted the publication time from 01 January 2018 onwards to present the recent developments on this topic, and only guidelines written in English and Chinese were available.…”

Section: Methodsmentioning

confidence: 99%

“…We restricted the publication time from 01 January 2018 onwards to present the recent developments on this topic, and only guidelines written in English and Chinese were available. The following articles were excluded: (1) guidelines developed from the perspective of a medical specialty, in which contrast media were discussed as one of those risk factors for kidney injury [ 21 ]; (2) guidelines on intra-arterial contrast media administration, because intra-arterial administration has unique considerations that do not apply to the intravenous route of administration [ 23 ]; (3) a previous version of an updated guidelines or a guideline under development; (4) study protocols, primary studies, comments on guidelines, conference abstracts, or other not guidance documents; (5) duplications. The titles and abstracts of unique records were screened, and then their eligibility was confirmed by reading the full texts and supplementary materials.…”

Section: Methodsmentioning

confidence: 99%

Just give the contrast? Appraisal of guidelines on intravenous iodinated contrast media use in patients with kidney disease

Zhong,

Chen,

Xing

et al. 2024

Insights Imaging

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Objective To appraise the quality of guidelines on intravenous iodinated contrast media (ICM) use in patients with kidney disease, and to compare the recommendations among them. Methods We searched four literature databases, eight guideline libraries, and ten homepages of radiological societies to identify English and Chinese guidelines on intravenous ICM use in patients with kidney disease published between January 2018 and June 2023. The quality of the guidelines was assessed with the Scientific, Transparent, and Applicable Rankings (STAR) tool. Results Ten guidelines were included, with a median STAR score of 46.0 (range 28.5–61.5). The guidelines performed well in “Recommendations” domain (31/40, 78%), while poor in “Registry” (0/20, 0%) and “Protocol” domains (0/20, 0%). Nine guidelines recommended estimated glomerular filtration rate (eGFR) < 30 mL/min/1.73 m2 as the cutoff for referring patients to discuss the risk-benefit balance of ICM administration. Three guidelines further suggested that patients with an eGFR < 45 mL/min/1.73 m2 and high-risk factors also need referring. Variable recommendations were seen in the acceptable time interval between renal function test and ICM administration, and that between scan and repeated scan. Nine guidelines recommended to use iso-osmolar or low-osmolar ICM, while no consensus has been reached for the dosing of ICM. Nine guidelines supported hydration after ICM use, but their protocols varied. Drugs or blood purification therapy were not recommended as preventative means. Conclusion Guidelines on intravenous ICM use in patients with kidney disease have heterogeneous quality. The scientific societies may consider joint statements on controversial recommendations for variable timing and protocols. Critical relevance statement The heterogeneous quality of guidelines, and their controversial recommendations, leave gaps in workflow timing, dosing, and post-administration hydration protocols of contrast-enhanced CT scans for patients with kidney diseases, calling for more evidence to establish a safer and more practicable workflow. Key points • Guidelines concerning iodinated contrast media use in kidney disease patients vary. • Controversy remains in workflow timing, contrast dosing, and post-administration hydration protocols. • Investigations are encouraged to establish a safer iodinated contrast media use workflow. Graphical Abstract

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A systematic review for the evidence of recommendations and guidelines in hybrid nuclear cardiovascular imaging

Besson,

Treglia,

Bucerius

et al. 2024

Eur J Nucl Med Mol Imaging

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Objectives This study aimed to evaluate the level of evidence of expert recommendations and guidelines for clinical indications and procedurals in hybrid nuclear cardiovascular imaging. Methods From inception to August 2023, a PubMed literature analysis of the latest version of guidelines for clinical hybrid cardiovascular imaging techniques including SPECT(/CT), PET(/CT), and PET(/MRI) was performed in two categories: (1) for clinical indications for all-in primary diagnosis; subgroup in prognosis and therapy evaluation; and for (2) imaging procedurals. We surveyed to what degree these followed a standard methodology to collect the data and provide levels of evidence, and for which topic systematic review evidence was executed. Results A total of 76 guidelines, published between 2013 and 2023, were included. The evidence of guidelines was based on systematic reviews in 7.9% of cases, non-systematic reviews in 47.4% of cases, a mix of systematic and non-systematic reviews in 19.7%, and 25% of guidelines did not report any evidence. Search strategy was reported in 36.8% of cases. Strengths of recommendation were clearly reported in 25% of guidelines. The notion of external review was explicitly reported in 23.7% of cases. Finally, the support of a methodologist was reported in 11.8% of the included guidelines. Conclusion The use of evidence procedures for developing for evidence-based cardiovascular hybrid imaging recommendations and guidelines is currently suboptimal, highlighting the need for more standardized methodological procedures.

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Quality and consistency of clinical practice guideline recommendations for PET/CT and PET: a systematic appraisal

Cited by 4 publications

References 25 publications

Contrast enhanced CT on PET/CT imaging in clinical routine: an international survey

Contrast enhanced CT on PET/CT imaging in clinical routine: an international survey

Just give the contrast? Appraisal of guidelines on intravenous iodinated contrast media use in patients with kidney disease

A systematic review for the evidence of recommendations and guidelines in hybrid nuclear cardiovascular imaging

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