title: Trends in PET Scan Usage for Imaging of Patients Diagnosed With Nonmetastatic Urologic Cancer.
abstract: The precise utility of positron emission tomography (PET) scanning for urologic cancers is not well defined. We examined the trends of usage in a population-based data set. PET scans were performed in 3.60% of patients with bladder cancer, 1.09% of those with prostate cancer, and 5.32% of those with renal cell carcinoma. This selective usage might be driven by reimbursement constraints or identification of appropriate medical indications.
  
  
  BACKGROUND
  Positron emission tomography (PET) scanning is increasingly being used for imaging a variety of cancers, including urologic cancers. The precise utility of PET scanning for bladder cancer, prostate cancer, and renal cell carcinoma (RCC) is not yet well known. We examined the trends in PET scan usage for 3 cancers using a large population-based data set.
  
  
  METHODS
  We analyzed all individuals identified with a diagnosis of nonmetastatic bladder cancer, prostate cancer, and RCC from the Surveillance, Epidemiology, and End Results-Medicare data set for 2004 to 2009 with follow-up data available to 2010. Logistic regression analysis and χ(2) and trend tests were performed to determine the predictors of performing PET scanning. Separate models were run for each of the cancer diagnoses. All analyses were performed using SAS, version 9.3, and P < .05 was considered significant.
  
  
  RESULTS
  We identified 20,865, 70,414, and 7007 patients with a diagnosis of bladder cancer, prostate cancer, and RCC, respectively, from 2004 to 2009. PET scans had been performed for 3.60% of patients with bladder cancer, 1.09% of those with prostate cancer, and 5.32% of those with RCC. On regression analysis, a more recent year of diagnosis, younger age, and high stage or grade were predictors of PET scan usage for patients with bladder cancer and RCC. A higher Gleason score and higher D'Amico risk group predicted imaging with prostate cancer.
  
  
  CONCLUSIONS
  The usage of PET scanning for bladder cancer, prostate cancer, and RCC is increasing but still very selective. The selective use might be driven by a combination of reimbursement constraints and careful identification of the appropriate medical indication.
authors.affiliation: Department of Urology, University of Minnesota, Minneapolis, MN.
authors.forename: Oluwakayode
authors.initials: O
authors.lastname: Adejoro
authors.affiliation: Department of Urology, University of Minnesota, Minneapolis, MN.
authors.forename: Amin
authors.initials: A
authors.lastname: Alishahi
authors.affiliation: Department of Urology, University of Minnesota, Minneapolis, MN.
authors.forename: Ayman
authors.initials: A
authors.lastname: Soubra
authors.affiliation: Department of Urology, University of Minnesota, Minneapolis, MN. Electronic address: brkonety@umn.edu.
authors.forename: Badrinath
authors.initials: B
authors.lastname: Konety
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000000981:diagnostic imaging*; D008297:Male; D015999:Multivariate Analysis; D049268:Positron-Emission Tomography / Q000706:statistics & numerical data / Q000639:trends*; D011471:Prostatic Neoplasms / Q000000981:diagnostic imaging*; D018426:SEER Program; D001749:Urinary Bladder Neoplasms / Q000000981:diagnostic imaging*
keywords: Bladder cancer; Kidney cancer; Positron emission tomography; Prostate cancer; Use