title: Perceived misinterpretation rates in oncologic 18F-FDG PET/CT studies: a survey of referring physicians.
abstract: Because only pathologic examination can confirm the presence or absence of malignant disease in cancer patients, a certain rate of misinterpretation in any kind of imaging study is inevitable. For the accuracy of interpretation to be improved, determination of the nature, causes, and magnitude of this problem is needed. This study was designed to collect pertinent information from physicians referring patients for oncologic (18)F-FDG PET/CT.
  
  
  METHODS
  A total of 662 referring physicians completed an 11-question survey focused on their experience with the interpretation of oncologic (18)F-FDG PET/CT studies. The participants were oncologists (36.1%; n = 239), hematologists (14.5%; n = 96), radiation oncologists (7.4%; n = 49), surgeons (33.8%; n = 224), and other physicians (8.2%; n = 54). Questions were aimed at determining the frequency, nature, and causes of scan misinterpretations as well as potential solutions to reduce the frequency of misinterpretations.
  
  
  RESULTS
  Perceived misinterpretation rates ranged from 5% to 20%, according to most (59.3%) of the participants; 20.8% of respondents reported rates of less than 5%. Overinterpretation rather than underinterpretation was more frequently encountered (68.9% vs. 8.7%, respectively). Limited availability of a patient's history and limited experience of interpreters were the major contributors to this phenomenon, according to 46.8% and 26.7% of the participants, respectively. The actions most commonly suggested to reduce misinterpretation rates (multiple suggestions were possible) were the institution of multidisciplinary meetings (59.8%), the provision of adequate history when ordering an examination (37.4%), and a discussion with imaging specialists when receiving the results of the examination (38.4%).
  
  
  CONCLUSIONS
  Overinterpretation rather than underinterpretation of oncologic (18)F-FDG PET/CT studies prevails in clinical practice, according to referring physicians. Closer collaboration of imaging specialists with referring physicians through more multidisciplinary meetings, improved communication, and targeted training of interpreting physicians are actions suggested to reduce the rates of misinterpretation of oncologic (18)F-FDG PET/CT studies.
authors.affiliation: Ahmanson Translational Imaging Division, Department of Molecular and Medical Pharmacology, David Geffen School of Medicine, UCLA, Los Angeles, California Department of Nuclear Medicine, Greek Air Force Hospital, Athens, Greece dkarantanis@nuclmed.net.
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Karantanis
authors.affiliation: Department of Nuclear Medicine, Greek Air Force Hospital, Athens, Greece.
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Kalkanis
authors.affiliation: Ahmanson Translational Imaging Division, Department of Molecular and Medical Pharmacology, David Geffen School of Medicine, UCLA, Los Angeles, California.
authors.forename: Johannes
authors.initials: J
authors.lastname: Czernin
authors.affiliation: Ahmanson Translational Imaging Division, Department of Molecular and Medical Pharmacology, David Geffen School of Medicine, UCLA, Los Angeles, California Department of Nuclear Medicine, University Hospital Würzburg, Würzburg, Germany.
authors.forename: Ken
authors.initials: K
authors.lastname: Herrmann
authors.affiliation: Ahmanson Translational Imaging Division, Department of Molecular and Medical Pharmacology, David Geffen School of Medicine, UCLA, Los Angeles, California.
authors.forename: Kelsey L
authors.initials: KL
authors.lastname: Pomykala
authors.affiliation: Department of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway Department of Nuclear Medicine and PET-Center, Aarhus University Hospital, Aarhus, Denmark.
authors.forename: Trond V
authors.initials: TV
authors.lastname: Bogsrud
authors.affiliation: Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University, Baltimore, Maryland; and.
authors.forename: Rathan M
authors.initials: RM
authors.lastname: Subramaniam
authors.affiliation: Division of Nuclear Medicine, Department of Radiology, Mayo Clinic, Rochester, Minnesota.
authors.forename: Val J
authors.initials: VJ
authors.lastname: Lowe
authors.affiliation: Ahmanson Translational Imaging Division, Department of Molecular and Medical Pharmacology, David Geffen School of Medicine, UCLA, Los Angeles, California.
authors.forename: Martin S
authors.initials: MS
authors.lastname: Allen-Auerbach
mesh_terms: D003951:Diagnostic Errors / Q000706:statistics & numerical data*; D019788:Fluorodeoxyglucose F18; D019538:Health Care Surveys; D006801:Humans; D020407:Internet; D008495:Medical Oncology / Q000706:statistics & numerical data*; D064847:Multimodal Imaging; D009369:Neoplasms / Q000000981:diagnostic imaging*; D049268:Positron-Emission Tomography / Q000706:statistics & numerical data*; D019275:Radiopharmaceuticals; D012017:Referral and Consultation; D011795:Surveys and Questionnaires
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
keywords: accuracy; false-negative results; false-positive results; overinterpretation; pitfall