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Johannes Czernin - One of the best experts on this subject based on the ideXlab platform.
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update of the prospective impact on management study using 68ga dotatate pet ct in neuroendocrine tumor patients the Referring Physician s perspective
The Journal of Nuclear Medicine, 2016Co-Authors: Claudio Spick, Christiaan Schiepers, Johannes Czernin, Ken Herrmann, Pawan Gupta, Martin Barrio, Antonio Gutierrez, Wolin Edward, Roger Slavik, Martin AllenauerbachAbstract:22 Objectives Somatostatin receptor PET/CT imaging is increasingly used for managing patients with neuroendocrine tumors. The objective of this study was to determine Referring Physicians9 perspectives on the impact of 68Ga-DOTATATE PET/CT imaging (DOTATATE) on the management of neuroendocrine tumors. Methods A set of 2 questionnaires (pre-PET/CT and post-PET/CT) was sent to the Referring Physicians of 173 consecutive patients with known or suspected neuroendocrine tumors, who underwent DOTATATE. Questionnaires on 137 patients were returned (response rate, 79%). Referring Physicians categorized the DOTATATE findings on the basis of the written PET/CT reports as negative, positive, or equivocal for disease. The likelihood for metastatic disease was scored as low, moderate, or high. The intended management before and changes as a consequence of the PET study were indicated. Results The primary reasons for DOTATATE referral were staging and restaging of neuroendocrine tumors in 16% and 84% of patients, respectively. Physicians reported that DOTATATE caused a change in suspicion for metastatic disease in 32 patients (23%; increased and decreased suspicion in 14 [10%] and 18 [13%] patients, respectively). Intended management changes were reported in 74 of 137 (54%) patients. Twenty-one patients (15%) scheduled to undergo chemotherapy were switched to treatments without chemotherapy, and 10 (7%) were switched from watch-and-wait to other treatment strategies. Conversely, 12 patients (9%) were switched from their initial treatment strategy to watch-and-wait. Conclusions These updated data from an ongoing survey of Referring Physicians suggests that 68Ga-DOTATATE PET/CT has a major impact on the management of neuroendocrine neoplasms.
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impact of 68ga dotatate pet ct on the management of neuroendocrine tumors the Referring Physician s perspective
The Journal of Nuclear Medicine, 2015Co-Authors: Ken Herrmann, Christiaan Schiepers, Michael E Phelps, Johannes Czernin, Edward M Wolin, Pawan Gupta, Martin Barrio, Antonio Gutierrez, Sherly Mosessian, Martin AllenauerbachAbstract:Somatostatin receptor imaging with 68Ga-DOTATATE PET/CT (DOTATATE) is increasingly used for managing patients with neuroendocrine tumors. The objective of this study was to determine Referring Physicians9 perspectives on the impact of DOTATATE on the management of neuroendocrine tumors. Methods: A set of 2 questionnaires (pre-PET and post-PET) was sent to the Referring Physicians of 100 consecutive patients with known or suspected neuroendocrine tumors, who were evaluated with DOTATATE. Questionnaires on 88 patients were returned (response rate, 88%). Referring Physicians categorized the DOTATATE findings on the basis of the written PET reports as negative, positive, or equivocal for disease. The likelihood for metastatic disease was scored as low, moderate, or high. The intended management before and changes as a consequence of the PET study were indicated. Results: The indications for PET/CT were initial and subsequent treatment strategy assessments in 14% and 86% of patients, respectively. Referring Physicians reported that DOTATATE led to a change in suspicion for metastatic disease in 21 patients (24%; increased and decreased suspicion in 9 [10%] and 12 [14%] patients, respectively). Intended management changes were reported in 53 of 88 (60%) patients. Twenty patients (23%) scheduled to undergo chemotherapy were switched to treatments without chemotherapy, and 6 (7%) were switched from watch-and-wait to other treatment strategies. Conversely, 5 patients (6%) were switched from their initial treatment strategy to watch-and-wait. Conclusion: This survey of Referring Physicians demonstrates a substantial impact of DOTATATE on the intended management of patients with neuroendocrine tumors.
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impact of 3 4 dihydroxy 6 18f fluoro l phenylalanine pet ct on managing patients with brain tumors the Referring Physician s perspective
The Journal of Nuclear Medicine, 2012Co-Authors: Franziska Walter, Michael E Phelps, Timothy F Cloughesy, Martin A Walter, Albert Lai, Phioanh L Nghiemphu, Naveed Wagle, Barbara J Fueger, Nagichettiar Satyamurthy, Johannes CzerninAbstract:We investigated the impact of 18F-DOPA brain PET/CT on the clinical management of patients with known or suspected brain tumors. Methods: A prospective survey of Referring Physicians was conducted. A pre-PET questionnaire inquired about indication, tumor histology or grade, level of suspicion for tumor recurrence, and planned management. Early post-PET questionnaires asked Referring Physicians to categorize PET findings as negative, equivocal, or positive; assessed the level of suspicion for primary or recurrent brain tumor; and recorded intended management changes prompted by PET findings. A late follow-up questionnaire 6 mo after the scan aimed at determining patient outcome (recurrence, survival). In addition, all Referring Physicians were contacted to determine whether management changes intended after 18F-DOPA PET/CT were implemented. Results: Fifty-eight consecutive patients were included. The clinical suspicion for recurrence increased in 33%, remained unchanged in 50%, and decreased in 17% of patients after adding the PET/CT result to the available diagnostic data. The late post-PET questionnaire confirmed recurrence in 26 patients whereas 32 had stable disease or remained disease-free. 18F-DOPA PET/CT resulted in intended management changes in 41% of patients. Changes in intended management from wait and watch to chemotherapy (6 patients [25%]) and from chemotherapy to wait and watch (4 patients [17%]) occurred most frequently. Clinical follow-up revealed that 75% of intended treatment changes were implemented. Conclusion:18F-DOPA PET/CT changed the intended management of 41% of patients with brain tumors, and intended management changes were implemented in 75% of these. These changes suggest a potentially important clinical role of imaging amino acid transport in the management of brain tumor patients.
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the impact of pet on the management of lung cancer the Referring Physician s perspective
The Journal of Nuclear Medicine, 2002Co-Authors: Marc Seltzer, Cecelia S Yap, Daniel H S Silverman, Joubin Meta, Christiaan Schiepers, Michael E Phelps, Sanjiv S Gambhir, Jyotsna U Rao, Peter E Valk, Johannes CzerninAbstract:18F-FDG PET is a molecular whole-body imaging modality that is increasingly being used for diagnosing, staging, and restaging cancer. The objective of this study was to determine Referring Physicians’ perspectives on the impact of 18F-FDG PET on staging and management of lung cancer. Methods: A questionnaire was sent to the 292 Referring Physicians of 744 consecutive patients with known or suspected lung cancer who were evaluated with PET. Questionnaires on 274 patients were returned (response rate, 37%). Management changes were categorized as intermodality (e.g., surgery to medical, surgery to radiation, and medical to no treatment) or intramodality (e.g., altered medical, surgical, or radiotherapy approach). Results: The primary reasons for PET referral were staging of lung cancer in 61% of patients, diagnosis in 20%, and monitoring of therapy or the course of disease in 6%. Physicians reported that PET caused them to change their decision on clinical stage in 44% of all patients: The disease was upstaged in 29% and downstaged in 15%. PET resulted in intermodality management changes in 39% of patients, whereas 15% had an intramodality change. Conclusion: This survey-based study of Referring Physicians suggests that PET has a major impact on staging and management of lung cancer.
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the impact of 2 deoxy 2 18f fluoro d glucose whole body positron emission tomography for managing patients with melanoma the Referring Physician s perspective
Molecular Imaging and Biology, 2002Co-Authors: Catharina Wong, Marc Seltzer, Daniel H S Silverman, Christiaan Schiepers, Michael E Phelps, Sanjiv S Gambhir, Jyotsna U Rao, Peter E Valk, Maryam Ariannejad, Johannes CzerninAbstract:Abstract Purpose: Whole body positron emission tomography (PET) imaging with 2-deoxy-2[ 18 F]fluoro-D-glucose (FDG) has been used successfully to diagnose and stage melanoma. The impact of FDG-PET, however, on patient stage and management from the Referring Physicians' perspective is unknown. Procedures: A questionnaire was sent to Referring Physicians to investigate whether and how PET altered clinical decision in treatment of melanoma patients. Surveys were sent to Referring Physicians of every melanoma patient who had a PET scan performed at UCLA or the Northern California PET Imaging Center (NCPIC). Data were used to evaluate the impact of FDG-PET on clinical management of melanoma patients based on pre-PET and post-PET staging. Management changes were classified as inter-modality if therapy changed from one modality to another or intra-modality if changes were made within a treatment modality. Results: Fifty-one questionnaires (response rate of 35%) have been received to date. Referring Physicians indicated that whole body FDG-PET changed the clinical stage in 15 out of 51 (29%) patients: 10 (20%) were up-staged and five (10%) were down-staged. The PET findings resulted in inter-modality management changes in 15 out of 51 patients (29%). Intra-modality management change occurred in nine patients (18%). Conclusion: From the Referring Physicians' perspective, FDG-PET has a major impact and results in management changes in 53% of patients with melanoma. (Mol Imag Biol 2002;4:185–190)
Christiaan Schiepers - One of the best experts on this subject based on the ideXlab platform.
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update of the prospective impact on management study using 68ga dotatate pet ct in neuroendocrine tumor patients the Referring Physician s perspective
The Journal of Nuclear Medicine, 2016Co-Authors: Claudio Spick, Christiaan Schiepers, Johannes Czernin, Ken Herrmann, Pawan Gupta, Martin Barrio, Antonio Gutierrez, Wolin Edward, Roger Slavik, Martin AllenauerbachAbstract:22 Objectives Somatostatin receptor PET/CT imaging is increasingly used for managing patients with neuroendocrine tumors. The objective of this study was to determine Referring Physicians9 perspectives on the impact of 68Ga-DOTATATE PET/CT imaging (DOTATATE) on the management of neuroendocrine tumors. Methods A set of 2 questionnaires (pre-PET/CT and post-PET/CT) was sent to the Referring Physicians of 173 consecutive patients with known or suspected neuroendocrine tumors, who underwent DOTATATE. Questionnaires on 137 patients were returned (response rate, 79%). Referring Physicians categorized the DOTATATE findings on the basis of the written PET/CT reports as negative, positive, or equivocal for disease. The likelihood for metastatic disease was scored as low, moderate, or high. The intended management before and changes as a consequence of the PET study were indicated. Results The primary reasons for DOTATATE referral were staging and restaging of neuroendocrine tumors in 16% and 84% of patients, respectively. Physicians reported that DOTATATE caused a change in suspicion for metastatic disease in 32 patients (23%; increased and decreased suspicion in 14 [10%] and 18 [13%] patients, respectively). Intended management changes were reported in 74 of 137 (54%) patients. Twenty-one patients (15%) scheduled to undergo chemotherapy were switched to treatments without chemotherapy, and 10 (7%) were switched from watch-and-wait to other treatment strategies. Conversely, 12 patients (9%) were switched from their initial treatment strategy to watch-and-wait. Conclusions These updated data from an ongoing survey of Referring Physicians suggests that 68Ga-DOTATATE PET/CT has a major impact on the management of neuroendocrine neoplasms.
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impact of 68ga dotatate pet ct on the management of neuroendocrine tumors the Referring Physician s perspective
The Journal of Nuclear Medicine, 2015Co-Authors: Ken Herrmann, Christiaan Schiepers, Michael E Phelps, Johannes Czernin, Edward M Wolin, Pawan Gupta, Martin Barrio, Antonio Gutierrez, Sherly Mosessian, Martin AllenauerbachAbstract:Somatostatin receptor imaging with 68Ga-DOTATATE PET/CT (DOTATATE) is increasingly used for managing patients with neuroendocrine tumors. The objective of this study was to determine Referring Physicians9 perspectives on the impact of DOTATATE on the management of neuroendocrine tumors. Methods: A set of 2 questionnaires (pre-PET and post-PET) was sent to the Referring Physicians of 100 consecutive patients with known or suspected neuroendocrine tumors, who were evaluated with DOTATATE. Questionnaires on 88 patients were returned (response rate, 88%). Referring Physicians categorized the DOTATATE findings on the basis of the written PET reports as negative, positive, or equivocal for disease. The likelihood for metastatic disease was scored as low, moderate, or high. The intended management before and changes as a consequence of the PET study were indicated. Results: The indications for PET/CT were initial and subsequent treatment strategy assessments in 14% and 86% of patients, respectively. Referring Physicians reported that DOTATATE led to a change in suspicion for metastatic disease in 21 patients (24%; increased and decreased suspicion in 9 [10%] and 12 [14%] patients, respectively). Intended management changes were reported in 53 of 88 (60%) patients. Twenty patients (23%) scheduled to undergo chemotherapy were switched to treatments without chemotherapy, and 6 (7%) were switched from watch-and-wait to other treatment strategies. Conversely, 5 patients (6%) were switched from their initial treatment strategy to watch-and-wait. Conclusion: This survey of Referring Physicians demonstrates a substantial impact of DOTATATE on the intended management of patients with neuroendocrine tumors.
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the impact of pet on the management of lung cancer the Referring Physician s perspective
The Journal of Nuclear Medicine, 2002Co-Authors: Marc Seltzer, Cecelia S Yap, Daniel H S Silverman, Joubin Meta, Christiaan Schiepers, Michael E Phelps, Sanjiv S Gambhir, Jyotsna U Rao, Peter E Valk, Johannes CzerninAbstract:18F-FDG PET is a molecular whole-body imaging modality that is increasingly being used for diagnosing, staging, and restaging cancer. The objective of this study was to determine Referring Physicians’ perspectives on the impact of 18F-FDG PET on staging and management of lung cancer. Methods: A questionnaire was sent to the 292 Referring Physicians of 744 consecutive patients with known or suspected lung cancer who were evaluated with PET. Questionnaires on 274 patients were returned (response rate, 37%). Management changes were categorized as intermodality (e.g., surgery to medical, surgery to radiation, and medical to no treatment) or intramodality (e.g., altered medical, surgical, or radiotherapy approach). Results: The primary reasons for PET referral were staging of lung cancer in 61% of patients, diagnosis in 20%, and monitoring of therapy or the course of disease in 6%. Physicians reported that PET caused them to change their decision on clinical stage in 44% of all patients: The disease was upstaged in 29% and downstaged in 15%. PET resulted in intermodality management changes in 39% of patients, whereas 15% had an intramodality change. Conclusion: This survey-based study of Referring Physicians suggests that PET has a major impact on staging and management of lung cancer.
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the impact of 2 deoxy 2 18f fluoro d glucose whole body positron emission tomography for managing patients with melanoma the Referring Physician s perspective
Molecular Imaging and Biology, 2002Co-Authors: Catharina Wong, Marc Seltzer, Daniel H S Silverman, Christiaan Schiepers, Michael E Phelps, Sanjiv S Gambhir, Jyotsna U Rao, Peter E Valk, Maryam Ariannejad, Johannes CzerninAbstract:Abstract Purpose: Whole body positron emission tomography (PET) imaging with 2-deoxy-2[ 18 F]fluoro-D-glucose (FDG) has been used successfully to diagnose and stage melanoma. The impact of FDG-PET, however, on patient stage and management from the Referring Physicians' perspective is unknown. Procedures: A questionnaire was sent to Referring Physicians to investigate whether and how PET altered clinical decision in treatment of melanoma patients. Surveys were sent to Referring Physicians of every melanoma patient who had a PET scan performed at UCLA or the Northern California PET Imaging Center (NCPIC). Data were used to evaluate the impact of FDG-PET on clinical management of melanoma patients based on pre-PET and post-PET staging. Management changes were classified as inter-modality if therapy changed from one modality to another or intra-modality if changes were made within a treatment modality. Results: Fifty-one questionnaires (response rate of 35%) have been received to date. Referring Physicians indicated that whole body FDG-PET changed the clinical stage in 15 out of 51 (29%) patients: 10 (20%) were up-staged and five (10%) were down-staged. The PET findings resulted in inter-modality management changes in 15 out of 51 patients (29%). Intra-modality management change occurred in nine patients (18%). Conclusion: From the Referring Physicians' perspective, FDG-PET has a major impact and results in management changes in 53% of patients with melanoma. (Mol Imag Biol 2002;4:185–190)
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impact of whole body 18f fdg pet on staging and managing patients with breast cancer the Referring Physician s perspective
The Journal of Nuclear Medicine, 2001Co-Authors: Cecelia S Yap, Marc Seltzer, Christiaan Schiepers, Michael E Phelps, Sanjiv S Gambhir, Jyotsna U Rao, Peter E Valk, Johannes CzerninAbstract:FDG PET has emerged as an important clinical imaging modality for diagnosing and staging cancer. However, the impact of FDG PET on staging and managing patients with breast cancer from the Referring Physician’s point of view is unknown. Methods: The Referring Physicians of 160 breast cancer patients received standardized questionnaires inquiring if and how PET findings altered their patient’s stage and their clinical management decisions. Management changes were classified as intermodality if the change was from one modality to another (e.g., medical to surgical, surgical to radiation, medical to no treatment, and vice versa) or as intramodality if the change was within the same modality (e.g., altered medical or radiotherapy approach). Results: Fifty of the 160 surveys were completed (31% response rate). PET changed the clinical stage in 36% of patients (28% upstaged, 8% downstaged) and resulted in intermodality changes in 28% of patients and intramodality changes in 30% of patients. Conclusion: The results of this prospective survey show that FDG PET has a major impact on the management of breast cancer patients, influencing both clinical stage and management in more than 30% of patients.
Melvyn H. Schreiber - One of the best experts on this subject based on the ideXlab platform.
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Communicating with the Referring Physician: the standard of care.
American Journal of Roentgenology, 1997Co-Authors: Melvyn H. SchreiberAbstract:OBJECTIVE: This study sought to determine whether academic radiologists achieve the standard of care that the American College of Radiology recommends for communication of unexpected significant findings to Referring Physicians. CONCLUSION: Academic radiologists do achieve the recommended standard of care.
Ron Blankstein - One of the best experts on this subject based on the ideXlab platform.
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impact of Referring Physician specialty on downstream testing after exercise treadmill testing
Journal of the American College of Cardiology, 2013Co-Authors: Marcio Sommer Bittencourt, Mitalee Patil, Edward Hulten, Hicham Skali, Raymond Y Kwong, Jon Hainer, Daniel E Forman, Sharmila Dorbala, Marcelo F Di Carli, Ron BlanksteinAbstract:Apresentado no 62nd Annual Scientific Session of the American College of Cardiology, realizado em 09-11 de marco de 2013 em San Francisco, CA
Michael E Phelps - One of the best experts on this subject based on the ideXlab platform.
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impact of 68ga dotatate pet ct on the management of neuroendocrine tumors the Referring Physician s perspective
The Journal of Nuclear Medicine, 2015Co-Authors: Ken Herrmann, Christiaan Schiepers, Michael E Phelps, Johannes Czernin, Edward M Wolin, Pawan Gupta, Martin Barrio, Antonio Gutierrez, Sherly Mosessian, Martin AllenauerbachAbstract:Somatostatin receptor imaging with 68Ga-DOTATATE PET/CT (DOTATATE) is increasingly used for managing patients with neuroendocrine tumors. The objective of this study was to determine Referring Physicians9 perspectives on the impact of DOTATATE on the management of neuroendocrine tumors. Methods: A set of 2 questionnaires (pre-PET and post-PET) was sent to the Referring Physicians of 100 consecutive patients with known or suspected neuroendocrine tumors, who were evaluated with DOTATATE. Questionnaires on 88 patients were returned (response rate, 88%). Referring Physicians categorized the DOTATATE findings on the basis of the written PET reports as negative, positive, or equivocal for disease. The likelihood for metastatic disease was scored as low, moderate, or high. The intended management before and changes as a consequence of the PET study were indicated. Results: The indications for PET/CT were initial and subsequent treatment strategy assessments in 14% and 86% of patients, respectively. Referring Physicians reported that DOTATATE led to a change in suspicion for metastatic disease in 21 patients (24%; increased and decreased suspicion in 9 [10%] and 12 [14%] patients, respectively). Intended management changes were reported in 53 of 88 (60%) patients. Twenty patients (23%) scheduled to undergo chemotherapy were switched to treatments without chemotherapy, and 6 (7%) were switched from watch-and-wait to other treatment strategies. Conversely, 5 patients (6%) were switched from their initial treatment strategy to watch-and-wait. Conclusion: This survey of Referring Physicians demonstrates a substantial impact of DOTATATE on the intended management of patients with neuroendocrine tumors.
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impact of 3 4 dihydroxy 6 18f fluoro l phenylalanine pet ct on managing patients with brain tumors the Referring Physician s perspective
The Journal of Nuclear Medicine, 2012Co-Authors: Franziska Walter, Michael E Phelps, Timothy F Cloughesy, Martin A Walter, Albert Lai, Phioanh L Nghiemphu, Naveed Wagle, Barbara J Fueger, Nagichettiar Satyamurthy, Johannes CzerninAbstract:We investigated the impact of 18F-DOPA brain PET/CT on the clinical management of patients with known or suspected brain tumors. Methods: A prospective survey of Referring Physicians was conducted. A pre-PET questionnaire inquired about indication, tumor histology or grade, level of suspicion for tumor recurrence, and planned management. Early post-PET questionnaires asked Referring Physicians to categorize PET findings as negative, equivocal, or positive; assessed the level of suspicion for primary or recurrent brain tumor; and recorded intended management changes prompted by PET findings. A late follow-up questionnaire 6 mo after the scan aimed at determining patient outcome (recurrence, survival). In addition, all Referring Physicians were contacted to determine whether management changes intended after 18F-DOPA PET/CT were implemented. Results: Fifty-eight consecutive patients were included. The clinical suspicion for recurrence increased in 33%, remained unchanged in 50%, and decreased in 17% of patients after adding the PET/CT result to the available diagnostic data. The late post-PET questionnaire confirmed recurrence in 26 patients whereas 32 had stable disease or remained disease-free. 18F-DOPA PET/CT resulted in intended management changes in 41% of patients. Changes in intended management from wait and watch to chemotherapy (6 patients [25%]) and from chemotherapy to wait and watch (4 patients [17%]) occurred most frequently. Clinical follow-up revealed that 75% of intended treatment changes were implemented. Conclusion:18F-DOPA PET/CT changed the intended management of 41% of patients with brain tumors, and intended management changes were implemented in 75% of these. These changes suggest a potentially important clinical role of imaging amino acid transport in the management of brain tumor patients.
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the impact of pet on the management of lung cancer the Referring Physician s perspective
The Journal of Nuclear Medicine, 2002Co-Authors: Marc Seltzer, Cecelia S Yap, Daniel H S Silverman, Joubin Meta, Christiaan Schiepers, Michael E Phelps, Sanjiv S Gambhir, Jyotsna U Rao, Peter E Valk, Johannes CzerninAbstract:18F-FDG PET is a molecular whole-body imaging modality that is increasingly being used for diagnosing, staging, and restaging cancer. The objective of this study was to determine Referring Physicians’ perspectives on the impact of 18F-FDG PET on staging and management of lung cancer. Methods: A questionnaire was sent to the 292 Referring Physicians of 744 consecutive patients with known or suspected lung cancer who were evaluated with PET. Questionnaires on 274 patients were returned (response rate, 37%). Management changes were categorized as intermodality (e.g., surgery to medical, surgery to radiation, and medical to no treatment) or intramodality (e.g., altered medical, surgical, or radiotherapy approach). Results: The primary reasons for PET referral were staging of lung cancer in 61% of patients, diagnosis in 20%, and monitoring of therapy or the course of disease in 6%. Physicians reported that PET caused them to change their decision on clinical stage in 44% of all patients: The disease was upstaged in 29% and downstaged in 15%. PET resulted in intermodality management changes in 39% of patients, whereas 15% had an intramodality change. Conclusion: This survey-based study of Referring Physicians suggests that PET has a major impact on staging and management of lung cancer.
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the impact of 2 deoxy 2 18f fluoro d glucose whole body positron emission tomography for managing patients with melanoma the Referring Physician s perspective
Molecular Imaging and Biology, 2002Co-Authors: Catharina Wong, Marc Seltzer, Daniel H S Silverman, Christiaan Schiepers, Michael E Phelps, Sanjiv S Gambhir, Jyotsna U Rao, Peter E Valk, Maryam Ariannejad, Johannes CzerninAbstract:Abstract Purpose: Whole body positron emission tomography (PET) imaging with 2-deoxy-2[ 18 F]fluoro-D-glucose (FDG) has been used successfully to diagnose and stage melanoma. The impact of FDG-PET, however, on patient stage and management from the Referring Physicians' perspective is unknown. Procedures: A questionnaire was sent to Referring Physicians to investigate whether and how PET altered clinical decision in treatment of melanoma patients. Surveys were sent to Referring Physicians of every melanoma patient who had a PET scan performed at UCLA or the Northern California PET Imaging Center (NCPIC). Data were used to evaluate the impact of FDG-PET on clinical management of melanoma patients based on pre-PET and post-PET staging. Management changes were classified as inter-modality if therapy changed from one modality to another or intra-modality if changes were made within a treatment modality. Results: Fifty-one questionnaires (response rate of 35%) have been received to date. Referring Physicians indicated that whole body FDG-PET changed the clinical stage in 15 out of 51 (29%) patients: 10 (20%) were up-staged and five (10%) were down-staged. The PET findings resulted in inter-modality management changes in 15 out of 51 patients (29%). Intra-modality management change occurred in nine patients (18%). Conclusion: From the Referring Physicians' perspective, FDG-PET has a major impact and results in management changes in 53% of patients with melanoma. (Mol Imag Biol 2002;4:185–190)
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impact of whole body 18f fdg pet on staging and managing patients with breast cancer the Referring Physician s perspective
The Journal of Nuclear Medicine, 2001Co-Authors: Cecelia S Yap, Marc Seltzer, Christiaan Schiepers, Michael E Phelps, Sanjiv S Gambhir, Jyotsna U Rao, Peter E Valk, Johannes CzerninAbstract:FDG PET has emerged as an important clinical imaging modality for diagnosing and staging cancer. However, the impact of FDG PET on staging and managing patients with breast cancer from the Referring Physician’s point of view is unknown. Methods: The Referring Physicians of 160 breast cancer patients received standardized questionnaires inquiring if and how PET findings altered their patient’s stage and their clinical management decisions. Management changes were classified as intermodality if the change was from one modality to another (e.g., medical to surgical, surgical to radiation, medical to no treatment, and vice versa) or as intramodality if the change was within the same modality (e.g., altered medical or radiotherapy approach). Results: Fifty of the 160 surveys were completed (31% response rate). PET changed the clinical stage in 36% of patients (28% upstaged, 8% downstaged) and resulted in intermodality changes in 28% of patients and intramodality changes in 30% of patients. Conclusion: The results of this prospective survey show that FDG PET has a major impact on the management of breast cancer patients, influencing both clinical stage and management in more than 30% of patients.
