Adejoro Oluwakayode, Alishahi Amin, Soubra Ayman, Konety Badrinath
Department of Urology, University of Minnesota, Minneapolis, MN.
Department of Urology, University of Minnesota, Minneapolis, MN.
Clin Genitourin Cancer. 2016 Feb;14(1):38-47.e1. doi: 10.1016/j.clgc.2015.09.002. Epub 2015 Oct 14.
The precise utility of positron emission tomography (PET) scanning for urologic cancers is not well defined. We examined the trends of usage in a population-based data set. PET scans were performed in 3.60% of patients with bladder cancer, 1.09% of those with prostate cancer, and 5.32% of those with renal cell carcinoma. This selective usage might be driven by reimbursement constraints or identification of appropriate medical indications.
Positron emission tomography (PET) scanning is increasingly being used for imaging a variety of cancers, including urologic cancers. The precise utility of PET scanning for bladder cancer, prostate cancer, and renal cell carcinoma (RCC) is not yet well known. We examined the trends in PET scan usage for 3 cancers using a large population-based data set.
We analyzed all individuals identified with a diagnosis of nonmetastatic bladder cancer, prostate cancer, and RCC from the Surveillance, Epidemiology, and End Results-Medicare data set for 2004 to 2009 with follow-up data available to 2010. Logistic regression analysis and χ(2) and trend tests were performed to determine the predictors of performing PET scanning. Separate models were run for each of the cancer diagnoses. All analyses were performed using SAS, version 9.3, and P < .05 was considered significant.
We identified 20,865, 70,414, and 7007 patients with a diagnosis of bladder cancer, prostate cancer, and RCC, respectively, from 2004 to 2009. PET scans had been performed for 3.60% of patients with bladder cancer, 1.09% of those with prostate cancer, and 5.32% of those with RCC. On regression analysis, a more recent year of diagnosis, younger age, and high stage or grade were predictors of PET scan usage for patients with bladder cancer and RCC. A higher Gleason score and higher D'Amico risk group predicted imaging with prostate cancer.
The usage of PET scanning for bladder cancer, prostate cancer, and RCC is increasing but still very selective. The selective use might be driven by a combination of reimbursement constraints and careful identification of the appropriate medical indication.
正电子发射断层扫描（PET）在泌尿系统癌症中的具体效用尚未明确界定。我们在基于人群的数据集里研究了其使用趋势。膀胱癌患者中3.60%进行了PET扫描，前列腺癌患者中1.09%进行了PET扫描，肾细胞癌患者中5.32%进行了PET扫描。这种选择性使用可能是由报销限制或合适医学指征的确定所驱动。
正电子发射断层扫描（PET）越来越多地用于多种癌症的成像，包括泌尿系统癌症。PET扫描在膀胱癌、前列腺癌和肾细胞癌（RCC）中的具体效用尚不为人所知。我们使用一个基于大量人群的数据集研究了这三种癌症的PET扫描使用趋势。
我们分析了2004年至2009年从监测、流行病学和最终结果 - 医疗保险数据集中确诊为非转移性膀胱癌、前列腺癌和RCC且有随访数据至2010年的所有个体。进行了逻辑回归分析以及χ²和趋势检验以确定进行PET扫描的预测因素。针对每种癌症诊断分别运行模型。所有分析均使用SAS 9.3版进行，P < 0.05被视为具有统计学意义。
我们在2004年至2009年期间分别确定了20865例、70414例和7007例膀胱癌、前列腺癌和RCC患者。膀胱癌患者中3.60%进行了PET扫描，前列腺癌患者中1.09%进行了PET扫描，RCC患者中5.32%进行了PET扫描。回归分析显示，诊断年份更近、年龄较小以及高分期或高分级是膀胱癌和RCC患者进行PET扫描的预测因素。较高的Gleason评分和较高的达米科风险组预测前列腺癌患者会进行成像检查。
PET扫描在膀胱癌、前列腺癌和RCC中的使用正在增加，但仍然非常具有选择性。这种选择性使用可能是由报销限制和对合适医学指征的谨慎确定共同驱动的。
