Pattern of Imaging after Lung Cancer Resection. 1992-2005

Area of Science:

• Medical Imaging
• Oncology
• Health Services Research

Background:

• The intensity of imaging surveillance following lung cancer resection for curative purposes remains largely undefined.
• Understanding post-surgical imaging patterns is crucial for optimizing patient care and resource allocation.

Purpose of the Study:

• To delineate the patterns and trends in the utilization of computed tomography (CT) and positron emission tomography (PET) scans in patients undergoing resection for early-stage lung cancer.
• To analyze changes in surveillance imaging intensity over time.

Main Methods:

• Retrospective analysis of the Surveillance, Epidemiology and End Results (SEER)-Medicare database.
• Inclusion of 8,621 Medicare beneficiaries (age ≥66) who had lung cancer resection with curative intent (1992-2005).
• Definition of surveillance CT/PET as outpatient imaging without preceding chest radiography.

Main Results:

• Surveillance CT scan use rose sharply from 13.7% to 57.3% between 1996-1997 and 2004-2005.
• PET scan utilization tripled from 6.2% to 19.6% during 2000-2005.
• A 32% increase in odds of surveillance CT/PET imaging per year of diagnosis (1998-2005) was observed, with no decline in intensity over 5 years post-surgery.

Conclusions:

• Significant increases in CT and PET imaging for surveillance post-lung cancer resection were observed in the US (1997-2005).
• This rise in imaging likely reflects clinical practice guidelines and expert opinion, not necessarily outcome-driven evidence.
• Further research is essential to establish the optimal role and methods for thoracic imaging surveillance after lung cancer resection.