title: The role of PET/CT in the management of patients with cervical cancer: practice patterns of the members of the Society of Gynecologic Oncologists.
abstract: OBJECTIVE
  Recent data has highlighted the role of PET/CT in the pretreatment evaluation and follow-up of patients with cervical cancer. The objective of our study was to assess the acceptance of PET/CT into the management of patients with cervical cancer. We also explored potential barriers to the use of these imaging modalities in patients with cervical cancer.
  
  
  METHODS
  A 14-item electronic questionnaire was initially sent to all working addresses of members of the SGO (n=1048). An opt-out option was offered. For members who did not respond within 3 weeks, a second electronic invitation was sent. A third request was finally sent to further improve response rates. Data were collected and analyzed using a commercially available on-line survey database.
  
  
  RESULTS
  A total of 305 responses were collected for an overall 30% response rate. PET/CT appears to be widely available (99%) and accessible (75%) in most practices. Although 83% of members order routine CT imaging for all newly diagnosed cervical cancer cases, only 28% routinely order a PET/CT. Conversely, 64% would order a PET/CT for newly diagnosed patients with advanced disease or those at high risk for distant metastatic disease. Most members (82%) do not routinely use PET/CT to assess response to treatment. Twenty percent of members believe that no useful prognostic information can be obtained from routine use of molecular imaging in patients with cervical cancer. The most common barriers for use of PET/CT cited by members were perceived lack of third-party payer coverage and lack of scientific evidence.
  
  
  CONCLUSIONS
  Despite clear scientific data supporting the use of PET/CT in patients with cervical cancer and apparent widespread availability, this imaging modality remains highly underutilized in clinical practice. Clarifying insurance coverage early in the evaluation process and replicating studies that have shown effectiveness of PET/CT in multiple roles may improve adoption of this potentially useful imaging modality.
authors.affiliation: Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Washington University School of Medicine, The Siteman Comprehensive Cancer Center, Saint Louis, MO 63110, USA. kizern@wudosis.wustl.edu
authors.forename: Nora T
authors.initials: NT
authors.lastname: Kizer
authors.forename: Israel
authors.initials: I
authors.lastname: Zighelboim
authors.forename: Ashley S
authors.initials: AS
authors.lastname: Case
authors.forename: Summer B
authors.initials: SB
authors.lastname: Dewdney
authors.forename: Premal H
authors.initials: PH
authors.lastname: Thaker
authors.forename: L Stewart
authors.initials: LS
authors.lastname: Massad
mesh_terms: D005260:Female; D006176:Gynecology / Q000706:statistics & numerical data; D006801:Humans; D008495:Medical Oncology / Q000706:statistics & numerical data; D049268:Positron-Emission Tomography / Q000379:methods / Q000706:statistics & numerical data*; D010818:Practice Patterns, Physicians'; D011795:Surveys and Questionnaires; D014056:Tomography, X-Ray / Q000379:methods / Q000706:statistics & numerical data*; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology