Assessment of interfractional prostate motion in patients ...
01 PROSTATE IMAGING VCC POSTER - Fred Hutch · prostate cancer patients Clinic variation in use of...
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HUTCHINSON INSTITUTE FOR CANCER OUTCOMES RESEARCH / fredhutch.org/HICOR PROSTATE IMAGING METRIC RESULTS BACKGROUND The use of advanced imaging for staging of low risk prostate cancer patients Clinic variation in use of advanced imaging for staging of low risk prostate cancer patients ranges from no use at all to use in 100% of patients. There was very little PET used during the staging of prostate cancer, however both CT and radionuclide bone scans were used in 15% or more of patients. Many research studies have shown that ordering PET, CT, MRI, or bone scans for men with low-risk prostate cancer provides no benefit. Prostate cancers are considered low risk when Gleason scores and PSA level results fall below specific thresholds, indicating it is highly unlikely that the cancer has spread to other organs. Unnecessary imaging can lead to patient harm when they lead to unnecessary invasive procedures, overtreatment, misdiagnosis, and increased cost. The 2012 ABIM/ASCO Choosing Wisely 1 Recommendation #2 identifies prostate cancer staging as an opportunity to improve care. 1 Schnipper LE, Smith TJ, Raghavan D, et al. American Society of Clinical Oncology identifies five key opportunities to improve care and reduce costs: the top five list for oncology. J Clin Oncol 2012;30:1715-24. 0% 100% Mean 23.7% UTILIZATION: 24% UTILIZATION BY IMAGING TYPE 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% UTILIZATION There is very little variation in imaging across age, with a slight increase in the over 60 population. UTILIZATION BY AGE UTILIZATION BY CLINIC 10.0% 25th percentile 75th percentile 41.7% POPULATION N = 1391 Inclusion criteria: › Local stage prostate cancer diagnosis › Diagnosis January 1, 2007 to May 31, 2014 › Enrolled +/- 2 months of diagnosis › First primary tumor › <= T1c/T2a or T2NOS Exclusion criteria: › Known high risk patients (Gleason>6 or PSA>10) DEFINITIONS › Advanced imaging: PET, CT, or radionuclide bone scans › Time period: 2 months prior to diagnosis through 2 months following diagnosis PET BONE SCAN 30% 0% <50 50-59 60+ 30% 0% CT 1% 15% 18% Any imaging: 24% Average: 24% 20% 20% 26% Regional average: 24% DIAGNOSIS High Medium Low Clinic volume
Transcript of 01 PROSTATE IMAGING VCC POSTER - Fred Hutch · prostate cancer patients Clinic variation in use of...
HUTCHINSON INSTITUTE FOR CANCER OUTCOMES RESEARCH / fredhutch.org/HICOR
PROSTATE IMAGINGMETRIC
RESULTSBACKGROUND
The use of advanced imaging for staging of low risk prostate cancer patients
Clinic variation in use of advanced imaging for staging of low risk prostate cancer patients ranges from no use at all to use in 100% of patients.
There was very little PET used during the staging of prostate cancer, however both CT and radionuclide bone scans were used in 15% or more of patients.
Many research studies have shown that ordering PET, CT, MRI, or bone scans for men with low-risk prostate cancer provides no benefit. Prostate cancers are considered low risk when Gleason scores and PSA level results fall below specific thresholds, indicating it is highly unlikely that the cancer has spread to other organs.
Unnecessary imaging can lead to patient harm when they lead to unnecessary invasive procedures, overtreatment, misdiagnosis, and increased cost. The 2012 ABIM/ASCO Choosing Wisely1 Recommendation #2 identifies prostate cancer staging as an opportunity to improve care.1Schnipper LE, Smith TJ, Raghavan D, et al. American Society of Clinical Oncology identifies five key opportunities to improve care and reduce costs: the top five list for oncology. J Clin Oncol 2012;30:1715-24.
0% 100%Mean
23.7%
UTILIZATION: 24%
UTILIZATION BY IMAGING TYPE
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
UTI
LIZA
TION
There is very little variation in imaging across age, with a slight increase in the over 60 population.
UTILIZATION BY AGE
UTILIZATION BY CLINIC
10.0%25th percentile 75th percentile
41.7%
POPULATIONN = 1391
Inclusion criteria:
› Local stage prostate cancer diagnosis
› Diagnosis January 1, 2007 to May 31, 2014
› Enrolled +/- 2 months of diagnosis
› First primary tumor
› <= T1c/T2a or T2NOS
Exclusion criteria:
› Known high risk patients (Gleason>6 or PSA>10)
DEFINITIONS › Advanced imaging: PET, CT, or radionuclide bone scans
› Time period: 2 months prior to diagnosis through 2 months following diagnosis
PET BONE SCAN
30%
0%
<50 50-59 60+
30%
0%
CT
1%
15%18%
Any imaging: 24%
Average:24%20% 20%
26%Regional average: 24%
DIAGNOSIS
HighMediumLow
Clinic volume
