AN INTERNATIONAL SURVEY ON CLINICAL REPORTING OF DUAL-MODALITY PET/CT IMAGING EXAMINATIONS: A STARTING POINT FOR CROSS-SPECIALTY ENGAGEMENT

Abstract

Introduction: Combined PET/CT imaging has become an integral part of patient management, particularly in oncology. Following the imaging examination, a report of the findings is created by the expert readers and sent to the referrers as a basis for subsequent management decision-making for their patients. In view of the known wide variation in operational models of PET/CT imaging, we initiated a survey of PET/CT users regarding their approaches towards PET/CT reporting. Materials and Methods: An electronic survey was composed with a set of 28 questions regarding the demographics and professional background of the survey responders, as well as questions regarding the structure and quality of PET/CT reports, including the type of reported information, the use of reporting standards and the mix of reporting and presenting experts. The survey was active during six weeks in early 2018. A total of 242 responses were collected worldwide. Results: The responders were mainly from Europe (78%), Of all responders, 21% were nuclear medicine specialists, 41% were radiologists, 22% were dual-board certified, 9% were residents in either nuclear medicine or radiology, and 5% were medical physicists, radiographers or oncologists. A slim majority (55%) of responses indicated reports being done according to the EANM/SNMMI 2015 guidelines for ¹⁸F-FDG-PET/CT imaging but 30% responders were unaware of these guidelines. Report structures varied across sites with most sites (38%) reporting the PET with supplementary localization information from CT, while 27% sites report along the lines of a CT report with supplementary PET information. One third of the reports include information on the TNM stage of the oncology patient in all reports, while 34% and 12% reports include this information occasionally or only for selected tumors, respectively. In case of therapy response assessment, various well-established criteria are employed ranging from 15% (EORTC) to 57% (Deauville) of cases. Conclusion: Broad variation in the PET/CT reporting strategies adopted for oncology studies and widespread lack of awareness of existing guidelines for PET/CT reporting are evident from responses to this survey, raising concerns as to whether reporting clinicians are optimally utilizing the complementary information from each modality. Greater efforts are needed to ensure harmonization of reporting practices.