Additional Imaging Recs in Oncologic PET/CT Reports Often Unnecessary

About half of additional imaging requests in oncologic PET/CT reports are unnecessary, said researchers from Brigham and Women’s Hospital in Boston. The results of their study were presented at the American Roentgen Ray Society Annual Meeting in Vancouver, Canada.

Radiologists and nuclear medicine physicians recommend additional imaging to confirm findings about 30 percent of the time. To assess the necessity of the additional scans, researchers looked at the records of 250 patients, 84 of whom had been recommended for additional imaging. Researchers found that 43 of the recommendations were not necessary and would not have affected patient outcome if they had not been done.

“We feel that some of the most important factors leading to unnecessary recommendations include reluctance of physicians to accept uncertainty regarding diagnosis, partly driven by medicolegal concerns, combined with a failure to fully consider the patients’ clinical circumstances and the likely cost-effectiveness of additional imaging tests,” said Atul Shinagure, MD, one of the study’s authors.

Referring physicians also did not follow through on the recommendations 70 percent of the time, the authors said. This may be because radiologists and nuclear medicine physicians might not have complete medical histories of patients referred for PET/CT imaging.

“Ordering clinicians usually know the patient record and history,” said Shinagare. “[This] may put them in a better position to judge the necessity of some recommended additional imaging.”