Increasing use of positron emission tomography among medicare beneficiaries undergoing radical cystectomy.

Journal Article (Journal Article)

OBJECTIVE: To examine factors associated with PET scan use in the pre-operative evaluation of patients diagnosed with bladder cancer. METHODS: Using SEER-Medicare data, we identified bladder cancer patients who underwent radical cystectomy from 2006 to 2011 (n = 4,138). The primary outcome was PET scan use within 6 months before surgery. To examine predictors of PET scan use, we fit a mixed logit model with health service area as a random effect to account for patients nested within health service areas. We also calculated the adjusted probability of use over time and examined variation among the highest volume surgeons. RESULTS: Among the 4,138 patients, 406 (10%) received a pre-operative PET scan. The adjusted probability of a patient undergoing a PET scan increased from 0.04 in 2004 to 0.10 in 2011 (p < .001). Among the 78 highest volume surgeons, there was significant variation in PET scan use (p < .001). Patients with non-urothelial histology, measurement of alkaline phosphatase levels, and receipt of neoadjuvant chemotherapy were more likely to receive PET scan (all p < .05). CONCLUSION: Use of PET prior to radical cystectomy doubled over a 5-year period, suggesting its increased use in patients with muscle-invasive bladder cancer, particularly those with high-risk disease. Whether its use is warranted and improves patient outcomes is not clear and requires further studies.

Full Text

Duke Authors

Cited Authors

  • Maganty, A; Turner, RM; Yabes, JG; Heron, DE; Gingrich, JR; Davies, BJ; Jacobs, BL

Published Date

  • July 2020

Published In

Volume / Issue

  • 29 / 4

Start / End Page

  • e13230 -

PubMed ID

  • 32026559

Pubmed Central ID

  • PMC7387176

Electronic International Standard Serial Number (EISSN)

  • 1365-2354

Digital Object Identifier (DOI)

  • 10.1111/ecc.13230


  • eng

Conference Location

  • England