Should positron emission tomography/computed tomography be the first rather than the last test performed in the assessment of cancer?
Author
Hicks, RJDate
2012-09-28Source Title
CANCER IMAGINGPublisher
BMCUniversity of Melbourne Author/s
Hicks, RodneyAffiliation
The Sir Peter Maccallum Department Of OncologyMetadata
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Journal ArticleCitations
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 locationOpen Access at PMC
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3460557Description
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 DisordersExport Reference in RIS Format
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