Impact on patientmanagement of [¹⁸F]-fluorodeoxyglucose-positron emission tomography (PET)used for cancer diagnosis: Analysis ofdata from the national oncologic PET registry

Introduction. We assessed the impact of [¹⁸F]-fluoro de oxyglucose (FDG)-positron emission tomography (PET) on intended management of patients in the National On cologic PET Registry (NOPR)for three different diagnostic indications: (a) determining whether a suspicious lesionis cancer (Dx), (b)detecting an unknown primary tumor site when there is confirmed or strongly suspected metastatic disease (cancer of unknown primary origin [CUP]), and(c) detectinga primary tumor sitewhen there is a presumed paraneo plastic syndrome (PNS). Methods.We reviewed a sample of randomly selected reports of NOPR subjects who underwent PET for Dx and CUPand all reports for PNS to find subjects foranalysis. For these studies, we evaluated the impact of PET on referring physicians’ intended management, based on their management plans reported before and after PET. Results. Intended management was changed more frequently in the CUP group (43.1%) than in the Dx (23.9%) and PNS (25.4%) groups (CUP vs. Dx, p < .0001; PNS vs. Dx, p < .0001; CUP vs. PNS, p < .0002). Referring physicians reported that, in light of PET results, they were able to avoid further testing in approximately three-fourths of patients (71.8%–74.6%). At the time when the post-PET forms were completed, biopsies of suspicious sites had been performed in 21.2%, 32.4%, and 23.2%, respectively, of Dx, CUP, and PNS cases. Conclusion. Our analysis of NOPR data shows that PET appears to have a substantial impact on intended management when used for three common diagnostic indications.