Information provided by PET was found to affect how clinicians manage cancer patients’ care regardless of the cancer type and reason for ordering the imaging scan, according to results from the National Oncologic PET Registry (NOPR), published online Nov. 7 in the Journal of Nuclear Medicine.
Earlier this year, aggregate data contributed to the NOPR during year one of operation, which was published in the Journal of Clinical Oncology, demonstrated clinicians changed the intended care of more than one in three cancer patients as the result of PET scan findings.
For the NOPR study update in JNM, researchers analyzed data for 40,863 PET studies performed at 1,368 facilities participating in the NOPR nationwide during the registry’s first two years of operation. The impact of PET was assessed for 18 cancer types in patients with pathologically confirmed cancer and for indication for testing that included initial cancer staging (14,365 scans), restaging (14,584 scans), or detection of suspected cancer recurrence (11,914 scans).
The results showed that when intended management was classified as treatment or nontreatment, physicians changed their intended management in 38 percent of cases. The frequencies of changes in management ranged from 48.7 percent for myeloma to 31.4 percent for nonmelanoma skin cancer, the authors said.
Comparisons across testing indications revealed that only in multiple myeloma did PET have a consistently greater impact on intended management. When the intended management plan before PET was treatment, a change in the intent of treatment (curative vs. palliative) or a major change in the modality of treatment occurred at similar frequencies across different cancer types.
The authors concluded that the impact of PET on physicians' intended management for patients with known cancer was consistent across cancer types.
“For the purposes of guiding clinical practice and shaping coverage policy, it is important to determine the relative effects of PET for different cancer types and indications for testing,” said Bruce Hillner, MD, lead author for the study and professor and eminent university scholar in the department of internal medicine at Virginia Commonwealth University. “These results strongly indicate the utility of PET for managing cancer patient care across a broad spectrum of cancer types and imaging indications.”