Reporting Guidance for Oncologic ¹⁸F-FDG PET/CT Imaging

Abstract

Learning Objectives: On successful completion of this activity, participants should be able to discuss (1) the elements of a concise and complete oncologic 18 F-FDG PET/CT report; (2) the importance of obtaining and including in the report a focused history of the patient malignancy and treatments; and (3) the importance of interpreting both the 18 F-FDG PET and the CT findings of PET/CT and of integrating both the metabolic and the anatomic components in the report.Financial Disclosure: The authors of this article have indicated no relevant relationships that could be perceived as a real or apparent conflict of interest. CME Credit: SNMMI is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to sponsor continuing education for physicians. SNMMI designates each JNM continuing education article for a maximum of 2.0 AMA PRA Category 1 Credits. Physicians should claim only credit commensurate with the extent of their participation in the activity. For CE credit, participants can access this activity through the SNMMI Web site (http:// www.snmmi.org/ce_online) through May 31, 2016.The written report (or its electronic counterpart) is the primary mode of communication between the physician interpreting an imaging study and the referring physician. The content of this report not only influences patient management and clinical outcomes but also serves as legal documentation of services provided and can be used to justify medical necessity, billing accuracy, and regulatory compliance. Generating a high-quality PET/CT report is perhaps more challenging than generating a report for other imaging studies because of the complexity of this hybrid imaging modality. This article discusses the essential elements of a concise and complete oncologic 18 F-FDG PET/ CT report and illustrates these elements through examples taken from routine clinical practice. At most facilities, the written report (or its electronic counterpart) is the primary mode of communication between the physician interpreting an imaging study and the referring physician. This report often serves as the basis for medical treatment decisions (1) and is used by third-party payers to justify medical necessity for the study and validity of reimbursement (2). Several authors have previously addressed the topic of reporting quality in the medical literature. Studying the process and quality of reporting not only is a necessity but also provides a unique opportunity to examine and refine the role imaging physicians play in medical care (3).The number of combined PET/CT studies performed annually has markedly increased over the last decade. It is estimated that between 2001 and 2010, the number of active PET/CT systems in the United States increased by approximately 10-fold (from approximately 200 to more than 2,000), and the number of PET examinations performed in the United States increased nearly 7-fold (from about 250,000 to more than 1.7 million) (4). At some institutions, PET/CT is now the most frequently performed nuclear medicine...

An International Survey on Clinical Reporting of PET/CT Examinations: A Starting Point for Cross-Specialty Engagement

“…Several nonprofit organizations and professional associations have published guidelines on imaging procedures and recommendations for reporting (5,16,(18)(19)(20), including a list of essential elements in a clinical report (7,21,22). The reporting guidance by Niederkohr et al from 2013 states specifically that ''the accuracy of image interpretation and the quality of the diagnostic report are critical to the continued success of PET/CT in the medical community'' (5). This statement should be seen in light of a conclusion drawn from a recent study on malpractice in radiology: ''Communication failures are ubiquitous in medicine and lead to a variety of medical errors and patient harm.…”

“…follow-up (including imaging) (4). It is obvious that an imaging report (quality, timeliness, communication path) directly influences patient management (5).…”

Task Group 174 Report: Utilization of [18F]Fluorodeoxyglucose Positron Emission Tomography ([18F]FDG‐PET) in Radiation Therapy

“…23 The advantages of combined anatomic and functional imaging have led to widespread adoption of PET/CT in RT clinics. 24 The growth in the number of PET/CT scanners in the Unites States increased approximately tenfold in a decade, 25 from approximately 200 in 2001 to more than 2500 in 2013. 26 Approximately 4% of the PET procedures were for RT treatment planning.…”

SUVmax of FDG PET-CT Can Be Used As An Identifier of Lesion for AI To Interpret Radiology Reports

“…A signi cant number of these studies require radiologist(s) to interpret the images and write the reports. Describing intensity of FDG uptake either using SUVmax or qualitatively has been recommended [13]. Radiology reports not only contribute greatly to helping the attending physician interpret the image and diagnose the disease, but also prevent important ndings from being overlooked.…”