Clinicians’ perspectives on PET/CT in oncological patients: an Italian National Survey

Introduction The present web-based national survey aims to assess the clinician's perspective toward (1) the indications to perform positron emission tomography/computed tomography (PET/CT) in cancer patients, (2) the utility of the interaction with the referring nuclear medicine physician, and (3) their perception of the clarity, usefulness, and the impact of the PET/CT report. Methods We conducted a prospective web-based survey consisting of 31 multiple-choice questions and an open-text field. The questionnaire was administered to Italian clinicians or surgeons who managed oncological patients. Data were analyzed using standard diagrams and the values were expressed as numbers (percentages). Results A total of 373 physicians completed the questionnaire. Among the 360 responses finally included in the analysis, the majority came from radiation oncologists (46%), followed by oncologists. For half of the respondents (53%), indications to perform PET/CT examination were “often” clear and easily accessible, but only 16% considered them “absolutely” clear and accessible. Additionally, most respondents (43%) considered “absolutely” necessary to facilitate access to PET/CT indications and their update. The interaction with the referring nuclear medicine physician was generally useful and satisfying. Regarding the nuclear medicine report, 74% considered “absolutely” useful to standardize the report structure, and the presence of semi-quantitative parameters was considered of great importance. Finally, in about half of the cases (53%), PET/CT report impacts patient management with major changes. Conclusion To sum up, a “still not” complete confidence with PET/CT indications and the need to facilitate access to indications and their update emerged from our results. Moreover, a structured PET/CT report with a clarification on essential PET features is warranted. In this scenario, the participation of nuclear medicine physicians in guideline oncological committees, national and international oncological conferences as well as continuous training among all specialists involved in cancer patients’ management could be effective strategies to resolve clinicians' concerns about PET/CT, thereby improving the management of cancer patients.