The leading cause of cancer-related death in the United States is lung cancer. According to a study published in the Journal of Nuclear Medicine in January, roughly half of Medicare patients with Non-Small Cell Lung Cancer (NSCLC) do not receive the appropriate imaging before radiation treatment. 

Research has shown that up to 72 percent of patients with lung cancer who receive NSCLC with FDG PET/CT imaging have seen various treatment changes. Compared to patients who underwent CT imaging alone, patients with FDG PET/CT imaging had substantially improved cancer-specific survival rates. 

As a result, National Comprehensive Cancer Network (NCCN) guidelines have changed to suggest all recurrent NSCLC patients receive FDG PET/CT to evaluate for metastatic disease. 

The study conducted by researchers examined over 5,000 patients with NSCLC requiring radiation therapy. Those who received only CT imaging were in one group, and those who received additional FDG PET/CT were in another. Scientists investigated the overall and cancer-specific survival rates of both groups. 

When comparing survival rates after three years, those who received only CT imaging had substantially lower overall and cancer-specific survival rates compared to patients who underwent FDG PET/CT imaging. 

In total, 56.3 percent of patients experienced FDG PET/CT before radiation therapy, and 43.6 percent had CT imaging alone. 

Rustain Morgan, MD, MS, a nuclear radiologist at the University of Colorado in Aurora, Colorado, said, “This research shows a clear lack of adherence to guidelines and raises important questions as to why. We believe these findings are the tip of the iceberg for guideline nonadherence. More work needs to be done in order to better understand the scope of the issue, with further work focused on interventions which ensure guideline adherence.”


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