Perceived misinterpretation rates in oncologic 18F-FDG PET/CT studies

A survey of referring physicians

Dimitrios Karantanis, Dimitrios Kalkanis, Johannes Czernin, Ken Herrmann, Kelsey L. Pomykala, Trond V. Bogsrud, Rathan M. Subramaniam, Val J. Lowe, Martin S. Allen-Auerbach

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Because only pathologic examination can confirm the presence or absence of malignant disease in cancer patients, a certain rate of misinterpretation in any kind of imaging study is inevitable. For the accuracy of interpretation to be improved, determination of the nature, causes, and magnitude of this problem is needed. This study was designed to collect pertinent information from physicians referring patients for oncologic 18F-FDG PET/CT. Methods: A total of 662 referring physicians completed an 11-question survey focused on their experience with the interpretation of oncologic 18F-FDG PET/CT studies. The participants were oncologists (36.1%; n = 239), hematologists (14.5%; n = 96), radiation oncologists (7.4%; n = 49), surgeons (33.8%; n = 224), and other physicians (8.2%; n = 54). Questions were aimed at determining the frequency, nature, and causes of scan misinterpretations as well as potential solutions to reduce the frequency of misinterpretations. Results: Perceived misinterpretation rates ranged from 5% to 20%, according to most (59.3%) of the participants; 20.8% of respondents reported rates of less than 5%. Overinterpretation rather than underinterpretation was more frequently encountered (68.9% vs. 8.7%, respectively). Limited availability of a patient's history and limited experience of interpreters were the major contributors to this phenomenon, according to 46.8% and 26.7% of the participants, respectively. The actions most commonly suggested to reduce misinterpretation rates (multiple suggestions were possible) were the institution of multidisciplinary meetings (59.8%), the provision of adequate history when ordering an examination (37.4%), and a discussion with imaging specialists when receiving the results of the examination (38.4%). Conclusion: Overinterpretation rather than underinterpretation of oncologic 18F-FDG PET/CT studies prevails in clinical practice, according to referring physicians. Closer collaboration of imaging specialists with referring physicians through more multidisciplinary meetings, improved communication, and targeted training of interpreting physicians are actions suggested to reduce the rates of misinterpretation of oncologic 18F-FDG PET/CT studies.

Original languageEnglish (US)
Pages (from-to)1925-1929
Number of pages5
JournalJournal of Nuclear Medicine
Volume55
Issue number12
DOIs
StatePublished - Jan 1 2014

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Neoplasms

Keywords

  • Accuracy
  • False-negative results
  • False-positive results
  • Overinterpretation
  • Pitfall

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Medicine(all)

Cite this

Karantanis, D., Kalkanis, D., Czernin, J., Herrmann, K., Pomykala, K. L., Bogsrud, T. V., ... Allen-Auerbach, M. S. (2014). Perceived misinterpretation rates in oncologic 18F-FDG PET/CT studies: A survey of referring physicians. Journal of Nuclear Medicine, 55(12), 1925-1929. https://doi.org/10.2967/jnumed.114.145607

Perceived misinterpretation rates in oncologic 18F-FDG PET/CT studies : A survey of referring physicians. / Karantanis, Dimitrios; Kalkanis, Dimitrios; Czernin, Johannes; Herrmann, Ken; Pomykala, Kelsey L.; Bogsrud, Trond V.; Subramaniam, Rathan M.; Lowe, Val J.; Allen-Auerbach, Martin S.

In: Journal of Nuclear Medicine, Vol. 55, No. 12, 01.01.2014, p. 1925-1929.

Research output: Contribution to journalArticle

Karantanis, D, Kalkanis, D, Czernin, J, Herrmann, K, Pomykala, KL, Bogsrud, TV, Subramaniam, RM, Lowe, VJ & Allen-Auerbach, MS 2014, 'Perceived misinterpretation rates in oncologic 18F-FDG PET/CT studies: A survey of referring physicians', Journal of Nuclear Medicine, vol. 55, no. 12, pp. 1925-1929. https://doi.org/10.2967/jnumed.114.145607
Karantanis, Dimitrios ; Kalkanis, Dimitrios ; Czernin, Johannes ; Herrmann, Ken ; Pomykala, Kelsey L. ; Bogsrud, Trond V. ; Subramaniam, Rathan M. ; Lowe, Val J. ; Allen-Auerbach, Martin S. / Perceived misinterpretation rates in oncologic 18F-FDG PET/CT studies : A survey of referring physicians. In: Journal of Nuclear Medicine. 2014 ; Vol. 55, No. 12. pp. 1925-1929.
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abstract = "Because only pathologic examination can confirm the presence or absence of malignant disease in cancer patients, a certain rate of misinterpretation in any kind of imaging study is inevitable. For the accuracy of interpretation to be improved, determination of the nature, causes, and magnitude of this problem is needed. This study was designed to collect pertinent information from physicians referring patients for oncologic 18F-FDG PET/CT. Methods: A total of 662 referring physicians completed an 11-question survey focused on their experience with the interpretation of oncologic 18F-FDG PET/CT studies. The participants were oncologists (36.1{\%}; n = 239), hematologists (14.5{\%}; n = 96), radiation oncologists (7.4{\%}; n = 49), surgeons (33.8{\%}; n = 224), and other physicians (8.2{\%}; n = 54). Questions were aimed at determining the frequency, nature, and causes of scan misinterpretations as well as potential solutions to reduce the frequency of misinterpretations. Results: Perceived misinterpretation rates ranged from 5{\%} to 20{\%}, according to most (59.3{\%}) of the participants; 20.8{\%} of respondents reported rates of less than 5{\%}. Overinterpretation rather than underinterpretation was more frequently encountered (68.9{\%} vs. 8.7{\%}, respectively). Limited availability of a patient's history and limited experience of interpreters were the major contributors to this phenomenon, according to 46.8{\%} and 26.7{\%} of the participants, respectively. The actions most commonly suggested to reduce misinterpretation rates (multiple suggestions were possible) were the institution of multidisciplinary meetings (59.8{\%}), the provision of adequate history when ordering an examination (37.4{\%}), and a discussion with imaging specialists when receiving the results of the examination (38.4{\%}). Conclusion: Overinterpretation rather than underinterpretation of oncologic 18F-FDG PET/CT studies prevails in clinical practice, according to referring physicians. Closer collaboration of imaging specialists with referring physicians through more multidisciplinary meetings, improved communication, and targeted training of interpreting physicians are actions suggested to reduce the rates of misinterpretation of oncologic 18F-FDG PET/CT studies.",
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N2 - Because only pathologic examination can confirm the presence or absence of malignant disease in cancer patients, a certain rate of misinterpretation in any kind of imaging study is inevitable. For the accuracy of interpretation to be improved, determination of the nature, causes, and magnitude of this problem is needed. This study was designed to collect pertinent information from physicians referring patients for oncologic 18F-FDG PET/CT. Methods: A total of 662 referring physicians completed an 11-question survey focused on their experience with the interpretation of oncologic 18F-FDG PET/CT studies. The participants were oncologists (36.1%; n = 239), hematologists (14.5%; n = 96), radiation oncologists (7.4%; n = 49), surgeons (33.8%; n = 224), and other physicians (8.2%; n = 54). Questions were aimed at determining the frequency, nature, and causes of scan misinterpretations as well as potential solutions to reduce the frequency of misinterpretations. Results: Perceived misinterpretation rates ranged from 5% to 20%, according to most (59.3%) of the participants; 20.8% of respondents reported rates of less than 5%. Overinterpretation rather than underinterpretation was more frequently encountered (68.9% vs. 8.7%, respectively). Limited availability of a patient's history and limited experience of interpreters were the major contributors to this phenomenon, according to 46.8% and 26.7% of the participants, respectively. The actions most commonly suggested to reduce misinterpretation rates (multiple suggestions were possible) were the institution of multidisciplinary meetings (59.8%), the provision of adequate history when ordering an examination (37.4%), and a discussion with imaging specialists when receiving the results of the examination (38.4%). Conclusion: Overinterpretation rather than underinterpretation of oncologic 18F-FDG PET/CT studies prevails in clinical practice, according to referring physicians. Closer collaboration of imaging specialists with referring physicians through more multidisciplinary meetings, improved communication, and targeted training of interpreting physicians are actions suggested to reduce the rates of misinterpretation of oncologic 18F-FDG PET/CT studies.

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