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  • Sir Peter MacCallum Department of Oncology
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    Should positron emission tomography/computed tomography be the first rather than the last test performed in the assessment of cancer?

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    11
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    Author
    Hicks, RJ
    Date
    2012-09-28
    Source Title
    CANCER IMAGING
    Publisher
    BMC
    University of Melbourne Author/s
    Hicks, Rodney
    Affiliation
    The Sir Peter Maccallum Department Of Oncology
    Metadata
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    Document Type
    Journal Article
    Citations
    Hicks, R. J. (2012). Should positron emission tomography/computed tomography be the first rather than the last test performed in the assessment of cancer?. CANCER IMAGING, 12 (2), pp.315-323. https://doi.org/10.1102/1470-7330.2012.9005.
    Access Status
    Access this item via the Open Access location
    URI
    http://hdl.handle.net/11343/33051
    DOI
    10.1102/1470-7330.2012.9005
    Open Access at PMC
    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3460557
    Description

    C1 - Journal Articles Refereed

    Abstract
    Cancer is a major cause of illness and death in Western society and is associated with a heavy concomitant economic burden. Although use of imaging comprises only a small proportion of the fiscal impact of cancer, its use has been increasing over recent decades, causing concern amongst funders of health care and efforts to constrain the use of new imaging tests with a relatively high unit cost. In clinical practice, positron emission tomography/computed tomography (PET/CT) is generally performed when less expensive tests have left some uncertainty regarding appropriate management. In this setting, its utility relates to provision of incremental diagnostic information. However, given that superior diagnostic information can positively affect patient management, wherein the majority of costs reside, it may be both more efficient and cost effective to go directly to the most accurate investigation in certain situations. For PET/CT, the ability to provide more accurate assessment of metastatic status than is available from conventional diagnostic paradigms provides a rationale for its independent rather than incremental use in patients presenting with either a high likelihood of malignancy or proven malignancy of a locally advanced nature and an accordingly high risk of metastatic disease. A randomized trial design is described that could be used to test this hypothesis.
    Keywords
    Cancer Diagnosis; Cancer and Related Disorders

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