title: Impact of dedicated brain PET on intended patient management in participants of the national oncologic PET Registry.
abstract: OBJECTIVE
  This study seeks to assess the impact of dedicated brain positron emission tomography (PET) with 2-deoxy-2-[(18)F]fluoro-D-glucose on intended management of patients with primary and metastatic brain tumors.
  
  
  METHODS
  We analyzed demographic characteristics and evaluated change in intended management after PET, using previously described metrics, for patients in the National Oncologic PET Registry (NOPR) undergoing dedicated brain PET. For cases of primary brain tumors, comparisons to the overall NOPR cohort were made. PATIENT PROFILE: Between December 2006 and April 2009, 509 dedicated brain PET scans were done on 479 patients--367 (72.1%) for suspected or proven primary brain tumors and 142 (27.9%) for brain metastases. Compared with the overall NOPR cohort, subjects in the dedicated brain cohort were younger (41.3% less than 65 years vs. 10.5% overall, p < 0.0001) and more frequently had functional limitations from their cancers (78.6% vs. 62.3% overall; odds ratio (OR) 2.2, 95% CI 1.8-2.8).
  
  
  RESULTS
  The pre-PET patient management plans in the primary brain tumor and metastasis subgroups were similar. A pre-PET plan of tissue biopsy was slightly more frequent than one of the treatments (31.3% vs. 28.6%) in the primary brain tumor subgroup and was more common than in the overall NOPR cohort (14.2%; OR 2.8, 95% CI 2.2-3.5). Changes from treatment to non-treatment also were more frequent than in the overall NOPR cohort (13.4% vs. 7.7%; OR 1.9, 95% CI 1.3-2.5).
  
  
  CONCLUSIONS
  Among NOPR patients, dedicated brain PET was associated with similar net changes in intended management as in the overall NOPR cohort. However, brain PET patients were younger, more likely to be symptomatic, and less likely to have a change in management from non-treatment to treatment as a post-PET plan.
authors.affiliation: Department of Internal Medicine, Virginia Commonwealth University, 1101 E Marshall St Room 7013, Richmond, VA 23298-0170, USA. Hillner@vcu.edu
authors.forename: Bruce E
authors.initials: BE
authors.lastname: Hillner
authors.forename: Barry A
authors.initials: BA
authors.lastname: Siegel
authors.forename: Anthony F
authors.initials: AF
authors.lastname: Shields
authors.forename: Fenghai
authors.initials: F
authors.lastname: Duan
authors.forename: Ilana F
authors.initials: IF
authors.lastname: Gareen
authors.forename: Lucy
authors.initials: L
authors.lastname: Hanna
authors.forename: R Edward
authors.initials: RE
authors.lastname: Coleman
mesh_terms: D001932:Brain Neoplasms / Q000000981:diagnostic imaging*; D006801:Humans; D049268:Positron-Emission Tomography; D012042:Registries