Study confirms impact of PET scans on cancer care

A national review has revealed that positron emission tomography (PET) scans of cancer patients led clinicians to change treatment plans for more than a third of the patients, scientists report this week in the Journal of Clinical Oncology.

Researchers analyzed data on nearly 23,000 cancer patients nationwide to obtain the results. The data came from the National Oncologic PET Registry (NOPR), which compiled information from more than 1,200 imaging centers.

Study authors including Barry A. Siegel, M.D., professor of medicine and of radiology at Washington University School of Medicine in St. Louis, plan to cite the findings as proof that PET scans can make positive contributions to cancer care. Siegel and others will use the results to advocate for expanded Medicare coverage of PET scans for different types of cancers.

“Based on this data, Medicare should strongly consider opening up its coverage of these scans to include their use in diagnosis, staging and restaging for all cancers,” says Siegel, who is chief of the Division of Nuclear Medicine at the School’s Mallinckrodt Institute of Radiology and a member of the Siteman Cancer Center.

Sponsored by the Academy of Molecular Imaging and managed by the American College of Radiology (ACR) and the ACR Imaging Network, the NOPR gathers data from referring physicians on intended patient management before and after PET scans that use the radioactive imaging agent fluorodeoxyglucose (FDG). The imaging agent helps highlight differences between healthy and diseased tissue.

Analysis of the data showed that FDG-PET is associated with a 36.5 percent change in the decision of whether or how to treat a patient’s cancer. One particularly surprising result came from patients scheduled for a biopsy. After FDG-PET scans, physicians were able to determine that biopsies were unnecessary for nearly three in every four patients originally scheduled to receive such procedures.

Hillner BE, Siegel BA, Dawei L, Shields AF, Gareen IF, Hanna L, Stine SH, Coleman RE. Impact of positron emission tomography/computed tomography and positron emission tomography (PET) alone on expected management of patients with cancer: initial results from the National Oncologic Pet Registry. Journal of Clinical Oncology, online publication.

Funding for development of the NOPR was provided by the Academy for Molecular Imaging; the registry is otherwise self-supported by the fees paid by participating PET facilities.

Washington University School of Medicine’s 2,100 employed and volunteer faculty physicians also are the medical staff of Barnes-Jewish and St. Louis Children’s hospitals. The School of Medicine is one of the leading medical research, teaching and patient care institutions in the nation, currently ranked fourth in the nation by U.S. News & World Report. Through its affiliations with Barnes-Jewish and St. Louis Children’s hospitals, the School of Medicine is linked to BJC HealthCare.