[Impact of [18F]-FDG-PET on medical decision making in oncology: evaluation by the referring physicians during the opening year].
The first study evaluating directly by the referring physician the clinical impact of [18F]-FDG-PET on modification of patient's management was performed only recently in California by means of a questionnaire. We have used the same methodology to evaluate this clinical impact during the opening year of our PET centre in France. A questionnaire was sent to the referring physician of each of the 476 patients who had at least one routine FDG-PET examination during the year 2000. Of 348 responses (response rate = 73%), the disease was upstaged in 26% of the cases and down-staged in 9%. Intermodality management changes (change from a scheduled therapeutic modality for a different one) were reported in 37% of the cases and intramodality changes in 9%. Those modification rates were respectively 38% and 7% in recurrence of colorectal cancer (153 patients), 47% and 7% in lung cancer (118 patients), 16% and 23% in lymphoma (43 patients), 25% and 6% in the staging of head and neck cancers (32 patients). When comparing with the corresponding studies performed in California, there were no significant differences between the rates of intermodality management changes. In contrast, intramodality management changes were less frequent in our survey, except for lymphoma. Globally, the clinical impact of FDG PET was similar with a higher response rate in our study (73% versus 35%); it was above the mean rate derived from a recent meta-analysis in more than 5,000 patients.
Talbot
Jean-No l
JN
Comité de pilotage du centre TEP AP-HP, France. jean-noel.talbol@tnn.ap-hop-paris.fr
Rain
Jean-Didier
JD
Meignan
Michel
M
Askienazy
Serge
S
Grall
Yvon
Y
Bok
Bernard
B
Misset
Jean-Louis
JL
D015179:Colorectal Neoplasms / Q000000981:diagnostic imaging; D003657:Decision Making; D019788:Fluorodeoxyglucose F18; D005602:France; D019538:Health Care Surveys; D008175:Lung Neoplasms / Q000000981:diagnostic imaging; D008223:Lymphoma / Q000000981:diagnostic imaging; D008545:Melanoma / Q000000981:diagnostic imaging; D009369:Neoplasms / Q000000981:diagnostic imaging*; D010039:Otorhinolaryngologic Neoplasms / Q000000981:diagnostic imaging; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D011795:Surveys and Questionnaires
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
Impact de la TEP au [18F]-FDB sur la décision médicale en cancérologie: évaluation par les prescripteurs durant la première année de fonctionnement.