J Nucl Med 2001 Aug;42(8):1139-43
Effect of whole-body (18)F-FDG PET imaging on clinical staging and management
of patients with malignant lymphoma.
Schoder H, Meta J, Yap C, Ariannejad M, Rao J, Phelps ME, Valk PE, Sayre J,
Czernin J.
Correct staging is important in selecting the appropriate treatment for lymphoma
patients. PET imaging with (18)F-FDG is useful for staging of lymphoma as well
as for monitoring of therapy. However, to our knowledge, the clinical impact of
PET on staging and management of lymphoma patients has not been reported.
METHODS: Standardized questionnaires were mailed to referring physicians asking
them whether and how the results of PET imaging had influenced clinical staging
and management of the disease in their 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: The referring physicians returned
52 of 108 questionnaires (48.1%). Physicians indicated that PET led to a change
in the clinical stage in 44% of patients: 21% were upstaged and 23% were
downstaged. Findings of the PET examination resulted in intermodality changes in
management in 42% of patients, in intramodality changes in 10%, and in a
combination of the management changes in 10%. Other, not further specified,
treatment changes were reported in 6% of patients. PET did not result in any
management changes in only 32% of patients. CONCLUSION: This survey-based study
of referring physicians indicates that FDG PET has a major impact on the
management of lymphoma patients, contributing to changes in clinical stage in
44% and changes in treatment in >60% of cases.
