Pattern of use of positron emission tomography/computed tomography (PET/CT) scan in non-colorectal gastrointestinal cancers at KFSHRC, Riyadh, Saudi Arabia

被引:2
|
作者
Aljubran, Ali Husain [1 ]
Badran, Ahmed [1 ,2 ]
Alshaer, Omar [3 ]
Alhashem, Hashem [1 ]
Omar, Aymen [1 ,4 ]
Eldali, Abdelmoniem [5 ]
机构
[1] King Faisal Specialist Hosp & Res Ctr, Oncol Ctr, Med Oncol, MBC 64,POB 3354, Riyadh 11211, Saudi Arabia
[2] Ain Shams Univ, Fac Med, Dept Clin Oncol, Cairo, Egypt
[3] Secur Forces Hosp, Sect Oncol, Riyadh, Saudi Arabia
[4] Suez Cannel Univ, Fac Med, Dept Clin Oncol, Ismailia, Egypt
[5] King Faisal Specialist Hosp & Res Ctr, Dept Biostat Epidemiol & Sci Comp, Res Ctr, Riyadh, Saudi Arabia
来源
EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE | 2019年 / 50卷 / 01期
关键词
PET-CT; Gastrointestinal malignancy; Guidelines; HEPATOCELLULAR-CARCINOMA; COMPUTED-TOMOGRAPHY; F-18-FDG PET; FDG-PET; DIFFERENTIAL-DIAGNOSIS; MANAGEMENT; METASTASIS; CT;
D O I
10.1186/s43055-019-0067-y
中图分类号
R8 [特种医学]; R445 [影像诊断学];
学科分类号
1002 ; 100207 ; 1009 ;
摘要
Background Positron emission tomography/computed tomography (PET/CT) scan is useful if clinically indicated. It is not for conventional routine use due to its high cost. Moreover, it can be confusing if ordered in non-indicated conditions. We evaluate if the pattern of PET/CT ordered in gastrointestinal cancers (non-colorectal origin) has followed evidence-based guidelines and whether it helped in the improvement of patient's outcome. This study included non-colorectal gastrointestinal cancer patients from 2007 to 2008 who had one or more PET/CT scans done during their management. In each case, data collected revealed whether PET/CT affected the management or the stage or not. Patients were identified through the hospital tumor registry software CNExT (C/NET Solutions, Berkeley, CA). Tabulation and statistical data analysis were done using JMP-SAS statistical software application (version 9.4: SAS Institute, Cary, NC, USA). The scan report quality and use indications were outlined. Results Seventy-seven patients were identified, with 107 PET/CT scans done. Their median age is 59 (21-86) years. Males were 45 (58.5%). Tumor origin was 46.8% esophageal and gastroesophageal junction cancer, 15.6% gastric cancer, 11.7% pancreatic cancer, 11.7% hepatobiliary tumors, 10.4% neuroendocrine tumors, 2.6 % gastrointestinal stromal tumors, and 1.3% small bowel cancer. Indications of the PET/CT were as follows: staging in 59.8%, follow-up after finishing treatment in 14.9%, restaging at relapse in 8.4%, assessing response after/during treatment in 3.7%, follow-up of previous PET/CT in 12.1%, and others in 0.9%. PET/CT changed the stage in 19.6% and affected the management plan in 11.2% only. Fifty-two scans needed pathological pursuit as decided by investigators; of them, PET/CT for the lesions that could have changed the stage reported indeterminate/equivocal results in 32 (29.9%) of all scans. The pathological pursuit for the equivocal lesions on PET/CT scans was done in only 12 of 52 (23.1%) scans. Conclusions Local guidelines for ordering PET/CT scan are suggested because overuse was documented, and an evidence-based approach should be respected before its use.
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页数:8
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