title: Impact of FDG-PET findings on decisions regarding patient management strategies: a multicenter trial in patients with lung cancer and other types of cancer.
abstract: OBJECTIVE
  To date, numerous studies have been conducted on the diagnostic capabilities of positron emission tomography using [(18)F]-fluorodeoxyglucose (FDG-PET). However, no studies designed to evaluate the influence of FDG-PET on the selection of patient management strategies within the Japanese healthcare system have been reported to date. The aim of the present study was to investigate prospectively the proportion of patients whose management strategies were modified based on FDG-PET findings (strategy modification rate).
  
  
  METHODS
  The strategy modification rate was calculated by comparing the patient management strategy (test and treatment plans) after FDG-PET with the strategy before FDG-PET for 560 cancer patients with nine types of cancer (lung cancer, breast cancer, colorectal cancer, head/neck cancer, brain tumor, pancreas cancer, malignant lymphoma, cancer of unknown origin, and melanoma). In addition, the details of the modifications to the patient management strategies were analyzed.
  
  
  RESULTS
  The strategy modification rate for patients with lung cancer was 71.6% (149 of 208 patients, 95% confidence interval 65.0-77.7%), which was higher than previously reported strategy modification rates for lung cancer before and after FDG-PET (25.6%). The strategy modification rates for patients with cancers other than lung cancer were as follows: breast, 44.4% (56/126); colorectal, 75.6% (62/82); head and neck, 65.2% (15/23); malignant lymphoma, 70.0% (35/50); pancreas, 85.0% (17/20); and cancer of unknown origin, 78.0% (32/41). The mean modification rate (major and minor modifications) of the treatment plans after FDG-PET, relative to the plans before FDG-PET, was 55.4% (range 44.0-69.2%), with major modifications pertaining to the treatment plan made in 43.3-68.2% of the patients based on the objectives of the FDG-PET examination.
  
  
  CONCLUSIONS
  The results from this study indicate that FDG-PET can contribute to the modification of management strategies (particularly treatment plans), especially for lung cancer patients but also for patients with other types of cancer.
authors: Division of Nuclear Medicine, Department of Radiology, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan, kkubota@cpost.plala.or.jp.
authors: Kazuo
authors: K
authors: Kubota
authors: Shinsuke
authors: S
authors: Matsuno
authors: Nobuo
authors: N
authors: Morioka
authors: Shuji
authors: S
authors: Adachi
authors: Mitsuru
authors: M
authors: Koizumi
authors: Hikaru
authors: H
authors: Seto
authors: Motohisa
authors: M
authors: Kojo
authors: Satoshi
authors: S
authors: Nishioka
authors: Michihiko
authors: M
authors: Nishimura
authors: Hiroshi
authors: H
authors: Yamamoto
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001932:Brain Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy; D001943:Breast Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy; D015179:Colorectal Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000009:adverse effects; D006258:Head and Neck Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D008175:Lung Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000473:pathology / Q000628:therapy*; D008223:Lymphoma / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy; D008297:Male; D008545:Melanoma / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy; D049268:Positron-Emission Tomography / Q000009:adverse effects / Q000379:methods; D019275:Radiopharmaceuticals / Q000009:adverse effects; D055815:Young Adult
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18