Role of PET/CT in the management of cancer patients: Referring physicians' perspective

Objectives The aim of this work was to determine, based on the assessment of referring physicians,the role of PET /CT in the clinical management of various types of cancers.

Methods Between March 2005 and August 2006, PET/CT scans were performed on 1330 patients. Standardized questionnaires were then faxed to all referring physicians before and after the PET/CT. The questionnaire asked them to report on their management plan before and after the PET/CT and whether PET/CT provided any additional information. Surveys were completed in 447 cases. (Response rate, 34%).36 surveys were incomplete and were excluded. 411 Pre and Post PET/CT questionnaires were analyzed.

Results Additional information was provided by PET/CT in 342 (83%, 95% Confidence Interval (CI) =79.6-86.82%) patients. Overall, physicians changed their management in 153 patients after the PET/CT i.e. 37% (95% CI= 32.6-41.9%). In patients in which surgical intervention was intended before PET, surgery was avoided in 57%. In patients in whom no treatment was intended before the PET/CT , treatment was started in 23 % after PET/CT . In 19 patients, (12%) intramodality change of management (eg change in chemotherapeutic regimen) was seen. The management change seen in patients with lymphoma, melanoma , lung, breast, colon ,esophageal and head & neck cancer was 37%, 27%, 57%, 24%, 28% , 20% and 55% respectively.

Conclusions This survey-based study of referring physicians indicates that the results of PET/CT have a major impact on management (37%) of patients with various types of cancer.