Making Meaning

The Chair of the Annual PET/CT Symposium discuesses making the most out of reports to referring physicians and explains what's new in PET/CT.HiRes

The Bulletin sat down with PET/CT Symposium chair Marc A. Seltzer, MD, associate professor of radiology and director of the PET/CT program at the Dartmouth-Hitchcock Medical Center, to discuss what’s new in PET/CT, what to expect at this year’s symposium, and why it’s important to understand what referring physicians are looking for in reporting.


Q: What will this year’s PET/CT Symposium be like?

A: This is our seventh annual PET/CT Symposium, meant to bring radiologists together to go over the latest advances in PET/ CT. Topics would include appropriate use of the technology, new indications for PET/ CT, and a better understanding of how to integrate PET/CT with other modalities that are used for managing patients with cancer and neurologic disorders. It’s important to attend symposiums like this if you can’t always review the current literature or stay up to date on developments supporting the use of PET/CT in managing patients.

Q: What aspects of the symposium should attendees look forward to?

A: The symposium is multi-disciplinary; we have interactive workshop opportunities to review cases that are led by referring physicians from various clinical specialties in oncology, radiation oncology, surgery, and neurology.

We will also spend some time reviewing the continuing growth of PET/CT in monitoring patient response to therapy. Using PET/CT to get a very early indication of whether the patient is responding to potentially costly and potentially morbid chemotherapy is tremendously important when making management decisions.

There is also the new and upcoming sodium fluoride PET/CT bone scanning technology. We will have a session updating specialists on the broadening utilization of sodium fluoride PET/CT scans for cancer management. We will also explore the possibility of sodium fluoride–based scanning replacing the standard technetium-based bone scan imaging test.

Finally, we are planning to have interactive sessions, in which the audience can submit challenging cases so that our faculty can provide their expert opinions.

"Sometimes radiologists are reading imaging in a vaccum, and they don't always understand how the referring physicians are really utilizing the imaging that they're ordering." - Marc A. Seltzer, MD. 

Q: What are the hot topics for this year’s meeting?

A: For the past few years, we’ve been talking about new PET imaging tracers for evaluating patients with cognitive impairment and suspected dementia. In the last year and a half, the FDA has approved new tracers for imaging amyloid plaque in the brain. It’s still not easily obtained because of reimbursement issues, but CMS has recently announced there will be some limited approval as long as patients are part of a CMS-approved clinical trial. There are millions of people in the United States suffering from cognitive impairment due to dementia. Using these new tracers will hopefully lead to more effective ways to evaluate the cause of cognitive impairment.

PET/CT users should also pay attention to PET/MR. In certain areas of medicine, it might actually replace PET/CT because it can do so many of the things that CT can’t do. For example, it provides very high resolution imaging of the anatomy and characterization of the abnormalities that are also being seen on the PET side of the PET/MR. It also provides a lower radiation dose, which is particularly important in such areas as pediatric radiology. It’s not clear that PET/MR will replace PET/CT in every application, but in certain areas, such as in neurologic oncology, it has that potential.

Q: What is the most important thing for the average radiologist to know about PET/CT right now?

A: I think sometimes radiologists are reading imaging in a vacuum, and they don’t always understand how the referring physicians are utilizing the results of imaging procedures. Radiologists have to understand the appropriate indications for PET/CT. They need to put it in a clinical context, and they need to understand what the referring physicians are looking for in PET/CT so that radiologists can answer their questions. The more the radiologist understands what the referring physician needs, the better the radiologist will be at providing meaningful impressions and reporting to the referring physician. That’s very important and something we often forget about. Anybody can generate a report, but it really may not answer the clinical question. A report has to be thoughtful and meaningful.

By Meghan Edwards, copywriter for the ACR Bulletin

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