Evidence map›Paper›PMID 31119418›Full record

Trial reportEuropean radiology2019

Integrated versus separate reading of F-18 FDG-PET/CT and MRI for abdominal malignancies - effect on staging outcomes and diagnostic confidence.

Lisa A Min, Wouter V Vogel, Max J Lahaye, Monique Maas, Maarten L Donswijk, Erik Vegt, Miranda Kusters, Henry J Zijlmans, Katarzyna Jóźwiak, Sander Roberti and 2 more

Abstract readComparative StudyRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in European radiology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.3field-weighted citation impact, top 37% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 3 citations in OpenAlex.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 1 institution in 1 country.

Lisa A MinDepartment of Radiology, The Netherlands Cancer Institute, POB 90203, 1006 BE, Amsterdam, The Netherlands.
Wouter V VogelDepartment of Nuclear Medicine, The Netherlands Cancer Institute, Amsterdam, The Netherlands.
Max J LahayeDepartment of Radiology, The Netherlands Cancer Institute, POB 90203, 1006 BE, Amsterdam, The Netherlands.
Monique MaasDepartment of Radiology, The Netherlands Cancer Institute, POB 90203, 1006 BE, Amsterdam, The Netherlands.
Maarten L DonswijkDepartment of Nuclear Medicine, The Netherlands Cancer Institute, Amsterdam, The Netherlands.
Erik VegtDepartment of Nuclear Medicine, The Netherlands Cancer Institute, Amsterdam, The Netherlands.
Miranda KustersDepartment of Surgical Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands.
Henry J ZijlmansDepartment of Gynecologic Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands.
Katarzyna JóźwiakDepartment of Epidemiology and Biostatistics, The Netherlands Cancer Institute, Amsterdam, The Netherlands.
Sander RobertiDepartment of Epidemiology and Biostatistics, The Netherlands Cancer Institute, Amsterdam, The Netherlands.
Regina G H Beets-TanDepartment of Radiology, The Netherlands Cancer Institute, POB 90203, 1006 BE, Amsterdam, The Netherlands.
Doenja M J LambregtsDepartment of Radiology, The Netherlands Cancer Institute, POB 90203, 1006 BE, Amsterdam, The Netherlands. d.lambregts@nki.nl.ORCID http://orcid.org/0000-0003-2990-0099
The Netherlands Cancer Institute · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveAbdominal cancer patients increasingly undergo multimodality imaging. This study evaluates effects of integrated reading of PET/CT and abdominal MRI on staging outcomes and diagnostic confidence compared to "routine" separate reading.

methodsIn total, N = 201 patients who underwent abdominal MRI and whole-body F-18 FDG-PET/CT within 14 days were retrospectively analyzed. Original MRI and PET/CT reports were retrieved and reported findings translated into a 5-point confidence score (1 = definitely benign to 5 = definitely malignant) for 7 standardized regions (primary tumor/regional lymph nodes/distant lymph nodes/liver/lung/bone/peritoneum) per patient. Two-reader teams (radiologist + nuclear medicine physician) then performed integrated reading of the images using the same scoring system.

resultsIntegrated reading led to discrepant findings in 59 of 201 (29%) of patients, with potential clinical impact in 25 of 201 (12%). Equivocal scores decreased from 5.7% (PET/CT) and 5.4% (MRI) to 3.2% (p = 0.05 and p = 0.14). Compared to the original PET/CT reports, integrated reading led to increased diagnostic confidence in 8.9% versus decreased confidence in 6.6% (p = 0.26). Compared with the original MRI reports, an increase in confidence occurred in 9.6% versus a decrease in 6.9% (p = 0.18). The effect on diagnostic confidence was most pronounced in lymph nodes (p = 0.08 vs. MRI), cervical cancer (p = 0.03 vs. MRI), and recurrent disease staging (p = 0.06 vs. PET/CT).

conclusionsIntegrated PET/CT+MRI reading alters staging outcomes in a substantial proportion of cases with potential clinical impact in ± 1 out of 9 patients. It can also have a small positive effect on diagnostic confidence, particularly in lymph nodes and cervical cancer, and in post-treatment settings. These findings support further collaboration between radiology and nuclear medicine disciplines. KEY POINTS: • Increasing numbers of patients undergo multimodality imaging consisting of both MRI and PET/CT for staging of abdominal malignancies. • Integrated reading of FDG-PET/CT and abdominal MR images by a team, consisting of a radiologist and a nuclear medicine physician, can alter staging outcomes compared to separate reporting of the exams in a substantial proportion of cases and with potential clinical impact in ± 1 out of 9 patients. • Integrated PET/CT+MRI reading can have a small positive effect on diagnostic confidence.

Indexed as

Fluorodeoxyglucose F18RadiopharmaceuticalsAbdominal NeoplasmsAdultAgedAged, 80 and overBone NeoplasmsFemaleHumansLung NeoplasmsLymphatic MetastasisLymph NodesMagnetic Resonance ImagingMaleMiddle AgedMultimodal ImagingFluorodeoxyglucose F18RadiopharmaceuticalsMagnetic resonance imagingMultimodal imagingNeoplasmsPositron emission tomography computed tomography

Identifiers

PMID31119418
OpenAlexW2945001320

What OpenQuestion holds

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Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.