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PET and PET/CT Reports: Observations from the National Oncologic PET Registry

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

Correspondence: For correspondence or reprints contact: R. Edward Coleman, Duke University Medical Center, Box 3949, Durham, NC 27710. E-mail: colem010{at}mc.duke.edu

Our objective was to identify core elements for inclusion in oncologic PET reports and to evaluate a sample of reports in the National Oncologic PET Registry database. Methods: A list of desirable elements in PET reports was compiled from American College of Radiology and Society of Nuclear Medicine guidelines. A training set of 20 randomly selected reports was evaluated by the 4-physician panel, and the results were used to formulate a consensus approach for assessing report content and quality. Each reviewer then scored 65 randomly selected reports—20 common to all reviewers. The scores were tabulated, and interrater variability was measured for the common cases. Results: Each report was assessed for 34 elements—21 primary and 11 additional questions related to 6 of these primary elements. Among the common cases, there was strong (0.70) interrater agreement for 30 of 34 elements. Among the unique cases, only 9 elements were included in more than 90% of the reports. Several important elements were not included in more than 40% of the reports: the reason for the study, a description of treatment history, a statement about comparison to other imaging, and time from radiopharmaceutical injection to imaging. Conclusion: Essential elements that should be included in oncologic PET reports were missing from many reports. These deficiencies may render the reports less helpful to referring physicians, may lead to misdiagnoses, and may cause coding and billing errors. Interpreting physicians should audit their reports to ascertain that they include appropriate elements necessary for billing compliance and for effective communications with referring physicians.

Key Words: positron emission tomography • reports • cancer • registry • attributes • coding • billing • management • compliance

COPYRIGHT © 2010 by the Society of Nuclear Medicine, Inc.

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