engleski

An initial experience with dedicated 18-FDG PET imaging in oncology settings: a 2-year assessment

A large body of evidence, now translated into the US and EU national reimbursement practices and coverage policies attests to the superior diagnostic accuracy and cost-effectiveness of 18FDG PET in oncology. We evaluated our initial 2-year use of 18FDG PET in oncologic settings after first 213 studies, and briefly summarize our institutional experience with mobile PET service for the major referral indications, encompassing diagnostic, restaging and therapy control issues covered in details by the 1a German Interdisciplinary Consensus Conference procedure guidelines. A mobile PET service, based on Siemens ECAT EXACT 47 and GE Advance Nxi full ring BGO/LSO PET scanners, was commissioned in April 2005 for clinical provision in collaborative attempt to institute and expand the clinical availability of dedicated PET imaging in Croatia. During the trial period, the most frequent referral indications reflected malignancies shown to be accurately evaluated by PET: hematopoietic (NHL and HL, 37%), gastrointestinal (22% ; colorectal carcinoma 16%), breast (9%), thyroid (7%), NSCLC (7%), genitourinary tract carcinomas (ovaries and uterus, 6%), CUP (6%) and melanoma (5%), with clear evidences of superior clinical efficiency in preliminary interdisciplinary reviews of the most common cancer sites ; superior sensitivity, provision of exact anatomic guidance for biopsy procedures and impact on management and prognostication were major advantages in carefully selected patients. However, given the particular technical issues related to the mobile PET units, limited anatomical information, high operating costs and rapid adoption of PET in medical community ; rigorous scrutiny in patient advocacy and reimbursement policies, as well as implementation of reference guideline standards is necessary to achieve timely and cost-effective diagnostic and prognostic accuracy in cancer management. Essential to this process are: a reliable supply of 18FDG, staff accreditation, appropriate allocation of fixed PET units, an ongoing transparent interdisciplinary evaluation process and complementary use with structural imaging (PET/CT) to optimize benefit.

Positron-Emission Tomography; Fluorodeoxyglucose F18; Oncology Service; Hospital; Croatia

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