Highlights
- •Imaging utilization for SCLC conformed with NCCN guideline changes from 2003 to 2019.
- •Extensive stage SCLC had an increase in emergency imaging based on diagnosis date.
- •Outpatient imaging of SCLC using MRI and FDG-PET increased based on diagnosis date.
Abstract
Purpose
To investigate the differences in small cell lung cancer (SCLC) diagnostic imaging
utilization relative to National Comprehensive Cancer Network (NCCN) guidelines.
Methods
We retrospectively reviewed SCLC records at our institution between January 1, 2003
and August 1, 2019 (n = 529). Patients were grouped by extensive-stage versus limited-stage and diagnosis
date. Clinical, CT, MRI, and nuclear imaging data was collected. Imaging utilization
was compared using Student's t-test or Kruskal-Wallis-test/Wilcoxon-Rank-Sums test. Survival was compared using
Log-rank-test and Kaplan-Meier-curves.
Results
SCLC patients had a median survival of 290 days. Extensive-stage patients with SCLC
demonstrated an increase in emergency imaging utilization when diagnosed in 2011–2019
compared to 2003–2010 (CT abdomen/pelvis p < 0.001, CTA chest for pulmonary embolism p < 0.01, CT head p < 0.003). Limited-stage patients with SCLC demonstrated an increase in inpatient
imaging utilization (CT abdomen/pelvis p < 0.04) and decreased total/outpatient imaging utilization (CT chest-abdomen-pelvis
p < 0.05, CT head p < 0.003) when diagnosed in 2011–2019 compared to 2003–2010. All
patients with SCLC had decreased average number of bone-scan studies when diagnosed
in 2011–2019 compared to 2003–2010 (Extensive-stage p < 0.006, Limited-stage p < 0.0006).
Conclusion
Imaging utilization trends in the management of patients with SCLC at our institution
differed between 2003 and 2010 and 2011–2019 reflecting the changes in the NCCN guidelines.
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Article info
Publication history
Published online: January 22, 2021
Accepted:
January 15,
2021
Received in revised form:
January 10,
2021
Received:
October 3,
2020
Identification
Copyright
© 2021 Elsevier Inc. All rights reserved.
