The clinical impact of [18F]-FDG pet during the opening year of a pet centre

We have evaluated the clinical impact of FDG-PET on patient staging and management during the opening year of our PET centre in France. A questionnaire, translation in French of the questionnaire used recently in California, was sent to the referring physician of each of the 476 patients who had at least one routine FDG-PET examination during the year 2000. Of 348 responses (response rate = 73%), the disease was upstaged in 26% of the cases and downstaged in 9%. Inter-modality management changes (change from a scheduled therapeutic modality for a different one) were reported in 37% of the cases and intra-modality changes in 9%. Those modification rates were respectively 38% and 7% in recurrence of colorectal cancer (153 patients), 47% and 7% in lung cancer (118 patients), 16% and 23% in lymphoma (43 patients), 25% and 6% in the staging of head and neck cancers (32 patients). When comparing with the similar studies performed in California, there were no significant differences between the rates of inter-modality management changes. In contrast, intra-modality management changes were less frequent in our survey, except for lymphoma. Globally, the clinical impact of FDG PET was similar. with a higher response rate to our survey (73% versus 35016); it was above the mean 31% rate of therapeutic modification derived from a recent tabulated summary in over 3400 patients.