Whole-body 18F-FDG PET significantly impacts patient management/radiation therapy

Reston, VA – Accurate tumor staging is essential in developing the appropriate treatment strategy for radiation therapy – including the determination of whether such therapy should be undertaken at all. A study conducted in Switzerland revealed that whole-body 18F-FDG PET changed the patient management for radiation therapy in 27% of the patients tested. Results included cancellation of planned therapy, changes in dosage and volume, and changes in the intent of radiation therapy (curative or palliative).

The research, published in the January 2003 issue of The Journal of Nuclear Medicine, tracked results in 202 patients with different malignant tumors. In each case, radiation oncologists developed an initial management plan for radiation therapy using all available information relevant to the tumor staging: clinical findings, imaging studies (CT or MRI) and surgical staging. Following whole-body 18F-FDG PET scanning, all clinical information was evaluated once again in conjunction with the PET scan. In 55 cases, incorporating the information from PET resulted in a change in the planned radiation therapy.

As noted by the study's authors, "Radiation treatment planning based only on CT or MR findings is likely to miss regions of macroscopic tumor in some patients and lead to the irradiation of unnecessarily large volumes in others." Whole-body PET provides more accurate staging of tumors. Also, PET scanning often detects previously undiagnosed distant metastases, which spares some patients from having futile radiation therapy, thus cutting unnecessary treatment costs.

Impact of Whole-Body 18F-FDG PET on Staging and Managing Patients for Radiation Therapy was written by Hans C. Steinert, MD, Elena V. Dizendorf, MD, Gustav K. von Schulthess, MD, PhD, Division of Nuclear Medicine; and Brigitta G. Baumert, MD, Urs M. Lütolf, MD, PhD, Clinic for Radiation Oncology, all from the Department of Medical Radiology, University Hospital, Zurich, Switzerland.

Copies of the article, accompanying commentary and images related to the study are available to media upon request to Kimberly A. Bennett (202-955-1253). Copies of the current and past issues of The Journal of Nuclear Medicine are available online at jnm.snmjournals.org. Print copies can be obtained at $15 per copy by contacting the SNM Service Center, Society of Nuclear Medicine, 1850 Samuel Morse Drive, Reston, VA 20190-5315; phone: 703-326-1186; fax: 703-708-9015; e-mail: servicecenter@snm.org. A yearly subscription to the journal is $170. A journal subscription is a member benefit of the Society of Nuclear Medicine.

The Society of Nuclear Medicine is an international scientific and professional organization of more than 14,000 members dedicated to promoting the science, technology, and practical applications of nuclear medicine. The SNM is based in Reston, VA.

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