Effect of whole-body F-18-FDG PET imaging on clinical staging and management of patients with malignant lymphoma

Correct staging is important in selecting the appropriate treatment for lym phoma patients. PET imaging with F-18-FDG is useful for staging of lymphoma as well as for monitoring of therapy. However, to our knowledge, the clini cal impact of PET on staging and management of lymphoma patients has not be en reported. Methods: Standardized questionnaires were mailed to referring physicians asking them whether and how the results of PET imaging had influ enced clinical staging and management of the disease in their patients. Man agement changes, when present, were classified as intermodality (e.g., medi cal to surgical, surgical to radiation, medical to no treatment) or intramo dality (e.g., altered medical, surgical, or radiotherapy approach). Results : The referring physicians returned 52 of 108 questionnaires (48.1%). Physi cians indicated that PET led to a change in the clinical stage in 44% of pa tients: 21% were upstaged and 23% were downstaged. Findings of the PET exam ination resulted in intermodality changes in management in 42% of patients, in intramodality changes in 10%, and in a combination of the management ch anges in 10%. Other, not further specified, treatment changes were reported in 6% of patients. PET did not result in any management changes in only 32 % of patients. Conclusion: This survey-based study of referring physicians indicates that FDG PET has a major impact on the management of lymphoma pat ients, contributing to changes in clinical stage in 44% and changes in trea tment in >60% of cases.