J Nucl Med 2001 Apr;42(4):586-90
Impact of (18)f-fdg pet on managing patients with colorectal cancer: the
referring physician's perspective.
Meta J, Seltzer M, Schiepers C, Silverman DH, Ariannejad M, Gambhir SS, Phelps
ME, Valk P, Czernin J.
Whole-body PET imaging with (18)F-FDG has been used successfully to stage
colorectal cancer. However, the impact of FDG PET on patient management from the
referring physician's point of view has not been determined. METHODS: A
questionnaire was sent to referring physicians to determine whether and how PET
altered the management of colorectal cancer patients. Management changes, when
present, were classified as intermodality (e.g., medical to surgical, surgical
to radiation, medical to no treatment) or intramodality (e.g., altered medical,
surgical, or radiotherapy approach). RESULTS: Of 60 responses from referring
physicians, changes in clinical stage were reported for 25 patients (42%). Among
these, the disease was upstaged in 20 patients (80%) and downstaged in 5
patients (20%). The PET findings contributed to intermodality management changes
in 22 of the 60 patients (37%), intramodality changes in 11 patients (18%), a
combination of management changes in 4 patients (7%), and no change in 19
patients (32%). Two of the 60 patients (3%) had other changes, and no response
to this question was received for the remaining 2 patients (3%). As a result of
PET findings, physicians avoided major surgery in 41% of patients for whom
surgery was the intended treatment. CONCLUSION: This survey-based study of
referring physicians shows that FDG PET had a major impact on the management of
colorectal cancer patients and contributed to changes in clinical stage and
major management decisions in >40% of patients.
