Specialized second-opinion radiology review of PET/CT examinations for patients with diffuse large B-cell lymphoma impacts patient care and management Journal Article


Authors: Sawan, P.; Rebeiz, K.; Schoder, H.; Batlevi, C.; Moskowitz, A.; Ulaner, G. A.; Dunphy, M.; Mannelli, L.
Article Title: Specialized second-opinion radiology review of PET/CT examinations for patients with diffuse large B-cell lymphoma impacts patient care and management
Abstract: To identify discrepancies in fludeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) reports generated by general radiologists and subspecialized oncological radiologists for patients with diffuse large B-cell lymphoma (DLBCL), and to assess if such discrepancies impact patient management. Two radiologists retrospectively reviewed 72PET/CT scans of patients with DLBCL referred to our institutions between 2009 and 2011, and recorded the discrepancies between the outside and second-opinion reports regarding multiple preset criteria using kappa statistic (K), including the disease stage. A multidisciplinary staging that considered all patient clinical data, pathology, and follow up radiological scans, was considered as standard of reference. A hemato-oncologist, blinded to the reports' origin, subjectively graded the quality and structure of these reports for each patient to determine if clinical stage and disease activity could be derived accurately from these reports. Agreement was not, or slightly, achieved between the reports regarding the binary and multilevel criteria (K<0-0.2 and weighted K=0.082, respectively). Second-opinion reviews of PET/CT scans were concordant with the multidisciplinary staging in 78% of cases with an almost perfect agreement (K=0.860). A change in staging was demonstrated in 36% of cases. In addition, 68% of second-opinion reports were assigned the highest grades on quality (grades 4 and 5) by the hemato-oncologist, compared with 15% of outside reports, with no noted agreement (weighted K=-0.007). Second-opinion review of PET/CT scans by sub-specialized oncological radiologists increases accuracy of initial staging, posttreatment evaluation and also the clinical relevance of the radiology reports. © 2017 the Author(s).
Keywords: major clinical study; cancer patient; comparative study; cancer staging; follow up; diagnostic accuracy; retrospective study; health insurance; patient care; medical record; fdg pet/ct; diffuse large b-cell lymphoma; non-hodgkin lymphoma; patient management; diffuse large b cell lymphoma; second opinion; human; priority journal; article; radiology report; positron emission tomography-computed tomography
Journal Title: Medicine
Volume: 96
Issue: 51
ISSN: 0025-7974
Publisher: Wolters Kluwer Health, Inc  
Date Published: 2017-12-01
Start Page: e9411
Language: English
DOI: 10.1097/md.0000000000009411
PROVIDER: scopus
PMCID: PMC5758264
PUBMED: 29390562
DOI/URL:
Notes: Article -- Export Date: 1 February 2018 -- Source: Scopus
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MSK Authors
  1. Gary Ulaner
    145 Ulaner
  2. Heiko Schoder
    489 Schoder
  3. Mark Phillip Dunphy
    77 Dunphy
  4. Alison Moskowitz
    290 Moskowitz
  5. Connie Wing-Ching Lee Batlevi
    172 Batlevi
  6. Karim Jean Rebeiz
    11 Rebeiz
  7. Peter Sawan
    20 Sawan