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European Journal of Nuclear Medicine and Molecular Imaging
Published in: European Journal of Nuclear Medicine and Molecular Imaging 4/2016

Open Access 01-04-2016 | Original Article

FDG PET/CT in cancer: comparison of actual use with literature-based recommendations

Authors: Henrik Petersen, Paw Christian Holdgaard, Poul Henning Madsen, Lene Meldgaard Knudsen, Dorte Gad, Anders Eggert Gravergaard, Max Rohde, Christian Godballe, Bodil Elisabeth Engelmann, Karsten Bech, Dorte Teilmann-Jørgensen, Ole Mogensen, Jens Karstoft, Jørgen Johansen, Janne Buck Christensen, Allan Johansen, Poul Flemming Høilund-Carlsen, on behalf of the PET/CT Task Force of the Region of Southern Denmark

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 4/2016

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Abstract

Purpose

The Region of Southern Denmark (RSD), covering 1.2 of Denmark’s 5.6 million inhabitants, established a task force to (1) retrieve literature evidence for the clinical use of positron emission tomography (PET)/CT and provide consequent recommendations and further to (2) compare the actual use of PET/CT in the RSD with these recommendations. This article summarizes the results.

Methods

A Work Group appointed a professional Subgroup which made Clinician Groups conduct literature reviews on six selected cancers responsible for 5,768 (62.6 %) of 9,213 PET/CT scans in the RSD in 2012. Rapid Evidence Assessment was applied, using the methodology of systematic reviews with predefined limitations to search PubMed, Embase and the Cochrane Library for articles published in English/Danish/Swedish/Norwegian since 2002. PICO questions were defined, data recorded and quality appraised and rated with regard to strength and evidence level. Consequent recommendations for applications of PET/CT were established. The actual use of PET/CT was compared with these, where grades A and B indicated “established” and “useful” and grades C and D “potentially useful” and “non-recommendable” indications, respectively.

Results

Of 11,729 citations, 1,729 were considered for review, and 204 were included. The evidence suggested usefulness of PET/CT in lung, lymphoma, melanoma, head and neck, and colorectal cancers, whereas evidence was sparse in gynaecological cancers. The agreement between actual use of PET/CT and literature-based recommendations was high in the first five mentioned cancers in that 96.2 % of scans were made for grade A or B indications versus only 22.2 % in gynaecological cancers.

Conclusion

Evidence-based usefulness was reported in five of six selected cancers; evidence was sparse in the sixth, gynaecological cancers. Actual use of PET/CT agreed well with recommendations.
Appendix
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Metadata
Title
FDG PET/CT in cancer: comparison of actual use with literature-based recommendations
Authors
Henrik Petersen
Paw Christian Holdgaard
Poul Henning Madsen
Lene Meldgaard Knudsen
Dorte Gad
Anders Eggert Gravergaard
Max Rohde
Christian Godballe
Bodil Elisabeth Engelmann
Karsten Bech
Dorte Teilmann-Jørgensen
Ole Mogensen
Jens Karstoft
Jørgen Johansen
Janne Buck Christensen
Allan Johansen
Poul Flemming Høilund-Carlsen
on behalf of the PET/CT Task Force of the Region of Southern Denmark
Publication date
01-04-2016
Publisher
Springer Berlin Heidelberg
Published in
European Journal of Nuclear Medicine and Molecular Imaging / Issue 4/2016
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI
https://doi.org/10.1007/s00259-015-3217-0

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