title: Comparative effectiveness of follow-up imaging approaches in pancreatic cancer.
abstract: OBJECTIVE
  Although PET imaging is sometimes used in follow-up of pancreatic cancer, evidence regarding comparative effectiveness of PET and older imaging modalities is limited.
  
  
  METHODS
  Linked cancer registry and Medicare claims data were analyzed to examine patterns of imaging and effects on treatment patterns and survival among newly diagnosed pancreatic cancer patients from 2003 to 2007.
  
  
  RESULTS
  12% of patients received PET during follow-up. In a time-varying exposure model, computed tomography/MRI was associated with lower mortality risk relative to PET in surgical patients (HR: 0.66; 95% CI: 0.52-0.83). In a subset analysis, type of follow-up imaging before 180 days was not associated with mortality after 180 days (computed tomography/MRI vs PET; hazard ratio: 0.98; 95% CI: 0.84-1.16).
  
  
  CONCLUSIONS
  Follow-up PET is uncommon among Medicare beneficiaries with pancreatic cancer, and is generally used late in the disease course. This pattern of PET use was not associated with decreased mortality risk compared with conventional imaging.
authors.affiliation: Division of Hematology/Oncology, University of North Carolina-Chapel Hill, 170 Manning Drive, Campus Box #7305, Chapel Hill, NC 27599, USA.
authors.forename: Katherine E
authors.initials: KE
authors.lastname: Reeder-Hayes
authors.forename: Janet
authors.initials: J
authors.lastname: Freburger
authors.forename: John
authors.initials: J
authors.lastname: Feaganes
authors.forename: Sharon
authors.initials: S
authors.lastname: Peacock Hinton
authors.forename: Louise M
authors.initials: LM
authors.lastname: Henderson
authors.forename: Mark
authors.initials: M
authors.lastname: Massing
authors.forename: Anna P
authors.initials: AP
authors.lastname: Schenck
authors.forename: Sally C
authors.initials: SC
authors.lastname: Stearns
authors.forename: William R
authors.initials: WR
authors.lastname: Carpenter
authors.forename: Ronald C
authors.initials: RC
authors.lastname: Chen
authors.forename: Amir H
authors.initials: AH
authors.lastname: Khandani
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002140:California / Q000453:epidemiology; D015331:Cohort Studies; D057186:Comparative Effectiveness Research / Q000379:methods* / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D006278:Medicare; D064847:Multimodal Imaging / Q000379:methods; D009657:North Carolina / Q000453:epidemiology; D010179:Pancreas / Q000000981:diagnostic imaging / Q000473:pathology; D010190:Pancreatic Neoplasms / Q000175:diagnosis* / Q000453:epidemiology*; D049268:Positron-Emission Tomography / Q000379:methods*; D012042:Registries / Q000706:statistics & numerical data; D012189:Retrospective Studies; D016019:Survival Analysis; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014481:United States; D014589:Utah / Q000453:epidemiology
keywords: PET; comparative effectiveness; imaging; pancreatic cancer