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Relationship Between Cancer Type and Impact of PET and PET/CT on Intended Management: Findings of the National Oncologic PET Registry

¹ Department of Internal Medicine, Virginia Commonwealth University, Richmond, Virginia; ² Massey Cancer Center, Virginia Commonwealth University, Richmond, Virginia; ³ Division of Nuclear Medicine, Mallinckrodt Institute of Radiology, School of Medicine, Washington University, St. Louis, Missouri; ⁴ Siteman Cancer Center, School of Medicine, Washington University, St. Louis, Missouri; ⁵ Karmanos Cancer Institute, Wayne State University, Detroit, Michigan; ⁶ Center for Statistical Sciences, Brown University, Providence, Rhode Island; and ⁷ Department of Radiology, School of Medicine, Duke University, Durham, North Carolina

Correspondence: For correspondence or reprints contact: Bruce E. Hillner, Virginia Commonwealth University, 1101 E. Marshall St., Room 7013, Richmond, VA 23298-0170. E-mail: Hillner{at}vcu.edu

We previously reported aggregate data showing that PET was associated with a change in intended management for over one third of patients participating in the National Oncologic PET Registry (NOPR). Here, we present results for specific cancer types and indications for testing. Methods: The NOPR collected questionnaire data from referring physicians on intended management before and after PET. Data were available from 40,863 PET studies done at 1,368 centers. The impact of PET was assessed for 18 cancer types in patients with pathologically confirmed cancer by type and indication for testing (initial staging, restaging, or detection of suspected recurrence), other than treatment monitoring. Results: When intended management was classified as treatment or nontreatment, physicians changed their intended management for 38.0% of cases (95% confidence interval = 37.6%–38.5%). The frequencies of changes in management ranged from 48.7% for myeloma to 31.4% for nonmelanoma skin cancer. Comparisons across testing indications revealed that only in multiple myeloma did PET have a consistently greater impact on intended management. When the intended management plan before PET was treatment, a change in the intent of treatment (curative vs. palliative) or a major change in the modality of treatment occurred at similar frequencies across different cancer types. Conclusion: The impact of PET on physicians' intended management for patients with known cancer was consistent across cancer types.

Key Words: PET • cancer • registry • prospective studies

COPYRIGHT © 2008 by the Society of Nuclear Medicine, Inc.

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