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Improving the investigation of suspected respiratory disease
P182 Utility of PET/CT reporting in lung cancer
  1. S M Kazmi,
  2. S Sureshkumar,
  3. A Nazir,
  4. D Nazareth,
  5. J Greenwood,
  6. M Ledson,
  7. M Walshaw
  1. Liverpool Heart and Chest Hospital, Liverpool, UK

Abstract

Introduction PET scans are useful in lung cancer by facilitating accurate staging to ensure that optimal treatment can be offered. Although the European Association of Nuclear Medicine (EANM) has produced reporting guidelines, the utility of the test depends upon the interpretation of the obtained images by the reporting radiologist. Since most UK PET services are provided by the independent sector (IS) remote from cancer units, we were interested to assess the value of PET/CT reporting in the MDT management of lung cancer.

Methods We looked at the quality of reports of all 97 PET/CT scans performed in our busy lung cancer unit between December 2010 and April 2011, measuring the reports (from 6 IS radiologists) against the EANM standards. In addition, we analysed the length of the report and documentation of PET staging.

Results FDG accumulation was documented in standard guideline format (mild, moderate or intense) in 39 cases (40%), all with SUVs noted, but in 37 cases (38%) FDG accumulation was described as significant, increased or highgrade (36 with SUVs). However, 21scans (22%) had no report of FDG accumulation but 20 (90%) still described SUVs. Corresponding CT findings were reported in 93 (96%), and a summary report was issued in 94 (97%), but 33 reports (34%) were >1 page in length. Seven scans showed benign disease and 8 had no excess FDG activity: of the remaining 82 with malignancy, only 39 (48%) were staged. Reasons for not staging included “inflammatory changes” (2), “uncertain findings” (18), “further investigation required” (15), and “clinical correlation required” (8). Although all radiologists failed to stage some scans, three were responsible for the majority (30 scans, 70%).

Conclusions Our results show that a significant proportion of scan reports fell below the recommended EANM standards either in the description of FDG accumulation or matching those patterns to SUV. Furthermore, many scans were unstaged, diminishing their value to the commissioning MDT. Closer liaison between IS radiologists and MDT members may assist the reporting process to ensure the maximum value is obtained from this expensive test for the benefit of this unfortunate patient group.

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