Oncologic PET/CT interpretation and reporting approaches

D. Karantanis; D. Kalkanis; M. S. Allen-Auerbach; K. Herrmann; K. L. Pomykala; T. V. Bogsrud; V. J. Lowe; J. Czernin

doi:10.3413/Nukmed-0613-13-07

Nuklearmedizin - NuclearMedicine, Table of Contents

Nuklearmedizin 2014; 53(02): 19-25
DOI: 10.3413/Nukmed-0613-13-07

Original article

Schattauer GmbH

Oncologic PET/CT interpretation and reporting approaches

Survey in clinical practiceOnkologische PET/CT-Interpretation und Erstellung der BefundberichteUmfrage im klinischen Bereich

D. Karantanis

¹Ahmanson Translational Imaging Division, Department of Molecular and Medical Pharmacology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA

²Department of Nuclear Medicine, Greek Air Force Hospital, Athens, Greece

,

D. Kalkanis

²Department of Nuclear Medicine, Greek Air Force Hospital, Athens, Greece

,

M. S. Allen-Auerbach

¹Ahmanson Translational Imaging Division, Department of Molecular and Medical Pharmacology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA

,

K. Herrmann

¹Ahmanson Translational Imaging Division, Department of Molecular and Medical Pharmacology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA

,

K. L. Pomykala

¹Ahmanson Translational Imaging Division, Department of Molecular and Medical Pharmacology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA

,

T. V. Bogsrud

³Division of Nuclear Medicine, Department of Diagnostic Imaging and Intervention, Oslo University Hospital, Norway

,

V. J. Lowe

⁴Division of Nuclear Medicine, Department of Radiology, Mayo Clinic, Rochester, MN, USA

,

J. Czernin

¹Ahmanson Translational Imaging Division, Department of Molecular and Medical Pharmacology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA

› Author Affiliations

Abstract

Summary

Aim: To elucidate techniques most commonly used for interpreting oncologic PET/CT studies. This survey forms a basis to work on standardization of reporting and highlight the most important issues to be addressed. Methods: A web-based survey of 329 PET/CT imaging specialists was designed with the intent to determine image interpretation patterns. The questionnaire consisted of 19 questions. Of the 329 participants, 230 were nuclear medicine specialists, 46 were radiologists, and 53 had dual-board certification. Results: Report of standardized uptake values (SUV) is not consistent; only 50.2% of respondents always report SUVs, while 45.2% report only if needed or requested. 80.9% of respondents indicated that reporting of SUV is only appropriate when its limitations are understood whereby a large majority prefer to report SUVmax. Maximum intensity projection (MIP) images are almost always reviewed by 91.1% of the respondents. An accurate and detailed clinical history is considered an essential element for reading PET/ CT studies by 84.0%, but only 20.7% report that this is always available. The most common self-reported average time for reviewing and reporting of whole body PET/CT (with no prior comparison scan) was 15-20 min (27.5%). Conclusion: PET readers have considerable reservations regarding the use and reporting of SUVs. SUVmax is more frequently used than SUVmean. Evaluation of MIP images is considered an important element of PET/CT interpretation. Although availability of sufficient patient’s history is considered essential, this is rarely available.

Zusammenfassung

Ziel: Darstellung der häufigsten Interpretationstechniken onkologischer PET/CT-Untersu- chungen. Diese Umfrage bildet die Grundlage für die Standardisierung von Befundberichten und beleuchtet die wichtigsten zu berücksichtigenden Aspekte. Methoden: Bei 329 Spezialisten für PET/CT-Aufnahmen wurde eine Webbasierte Umfrage durchgeführt, um Bildinterpretationsmuster identifizieren. Der Fragebogen enthielt 19 Fragen. Unter den 329 Teilneh mern waren 230 Fachärzte für Nuklearmedizin, 46 Radiologen und 53 für beide Fachgebiete. Ergebnisse: Angaben zu standardisierten Aufnahmewerten (SUV) sind uneinheitlich; nur 50,2% der Teilnehmer geben SUVs immer an, während dies bei 45,2% nur bei Bedarf oder auf Anfrage der Fall ist. 80,9% der Befragten meinen, dass SUVs nur angegeben werden sollten, wenn deren Grenzen bekannt sind; hingegen bevorzugt eine große Mehrheit die Nennung von SUVmax. Maximumintensitätsprojektion (MIP)-Aufnahmen werden von 91,1% der Teilnehmer fast immer besprochen. Eine genaue, detaillierte klinische Anamnese wird von 84,0% als wesentlich für die Interpretation von PET/CT-Un- tersuchungen erachtet, aber nur bei 20,7% liegt diese immer vor. Nach subjektiver Einschätzung werden für Beurteilung und Beschreibung eines Ganzkörper-PET/CT (ohne frühere Vergleichsaufnahme) durchschnittlich 15-20 Minuten (27,5%) benötigt. Schlussfolgerung: Bei der Befundung von PET/CT-Auf- nahmen bestehen erhebliche Vorbehalte gegenüber der Angabe von SUVs. SUVmax wird häufiger verwendet als SUVmean. Die Bewertung von MIP-Aufnahmen erscheint wichtig für die Interpretation der PET/CT. Zwar gilt eine ausreichende Anamnese des Patienten als wesentlich, diese ist aber nur selten verfügbar

Keywords

Survey - FDG - standard uptake value - SUV - maximum intensity projection - limitations

Schlüsselwörter

Umfrage - FDG - SUV - Maximumintensitäts-projektion - Limitationen

Full Text

References

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