Dramatic polarization in genitourinary expert opinions regarding the clinical utility of positron emission tomography (PET) imaging in prostate cancer

Kiri A. Sandler, Shearwood McClelland, Catherine Degnin, Yiyi Chen, Timur Mitin

Research output: Contribution to journalArticle

Abstract

OBJECTIVES: To ascertain the opinions of North American genitourinary (GU) experts regarding inclusion of technologies such as prostate - specific membrane antigen (PSMA) and C - 11 choline positron emission tomography (PET) into routine practice. MATERIALS AND METHODS: A survey was distributed to North American GU experts. Questions pertained to the role of PSMA and C - 11 PET in PCa management. Participants were categorized as "supporters" or "opponents" of incorporation of novel imaging techniques. Opinions were correlated with practice patterns. RESULTS: Response rate was 54% and we analyzed 42 radiation oncologist respondents. 17 participants (40%) have been in practice for > 20 years and 38 (90%) practice at an academic center. 24 (57%) were supporters of PSMA and 29 (69%) were supporters of C - 11. Supporters were more likely to treat pelvic nodes (88% vs. 56%, p < 01) and trended to be more likely to treat patients with moderate or extreme hypofractionation (58% vs. 28%, p = 065). Supporters trended to be more likely to offer brachytherapy boost (55% vs. 23%, p = 09), favor initial observation and early salvage over adjuvant radiation (77% vs. 55%, p = 09), and to consider themselves expert brachytherapists (69% vs. 39%, p = 09). CONCLUSIONS: There is a polarization among GU radiation oncology experts regarding novel imaging techniques. A correlation emerged between support of novel imaging and adoption of treatment approaches that are clinically superior or less expensive. Pre - existing biases among GU experts on national treatment - decision panels and leaders of cooperative group studies may affect the design of future studies and influence the adoption of these technologies in clinical practice.

Original languageEnglish (US)
Pages (from-to)23-31
Number of pages9
JournalInternational braz j urol : official journal of the Brazilian Society of Urology
Volume45
Issue number1
DOIs
StatePublished - Jan 1 2019

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Expert Testimony
Positron-Emission Tomography
Prostatic Neoplasms
Technology
Radiation Oncology
Brachytherapy
Choline
Observation
Radiation
Therapeutics
human glutamate carboxypeptidase II
Surveys and Questionnaires

Keywords

  • Positron-Emission Tomography
  • Prostatic Neoplasms
  • Radiotherapy

ASJC Scopus subject areas

  • Urology

Cite this

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title = "Dramatic polarization in genitourinary expert opinions regarding the clinical utility of positron emission tomography (PET) imaging in prostate cancer",
abstract = "OBJECTIVES: To ascertain the opinions of North American genitourinary (GU) experts regarding inclusion of technologies such as prostate - specific membrane antigen (PSMA) and C - 11 choline positron emission tomography (PET) into routine practice. MATERIALS AND METHODS: A survey was distributed to North American GU experts. Questions pertained to the role of PSMA and C - 11 PET in PCa management. Participants were categorized as {"}supporters{"} or {"}opponents{"} of incorporation of novel imaging techniques. Opinions were correlated with practice patterns. RESULTS: Response rate was 54{\%} and we analyzed 42 radiation oncologist respondents. 17 participants (40{\%}) have been in practice for > 20 years and 38 (90{\%}) practice at an academic center. 24 (57{\%}) were supporters of PSMA and 29 (69{\%}) were supporters of C - 11. Supporters were more likely to treat pelvic nodes (88{\%} vs. 56{\%}, p < 01) and trended to be more likely to treat patients with moderate or extreme hypofractionation (58{\%} vs. 28{\%}, p = 065). Supporters trended to be more likely to offer brachytherapy boost (55{\%} vs. 23{\%}, p = 09), favor initial observation and early salvage over adjuvant radiation (77{\%} vs. 55{\%}, p = 09), and to consider themselves expert brachytherapists (69{\%} vs. 39{\%}, p = 09). CONCLUSIONS: There is a polarization among GU radiation oncology experts regarding novel imaging techniques. A correlation emerged between support of novel imaging and adoption of treatment approaches that are clinically superior or less expensive. Pre - existing biases among GU experts on national treatment - decision panels and leaders of cooperative group studies may affect the design of future studies and influence the adoption of these technologies in clinical practice.",
keywords = "Positron-Emission Tomography, Prostatic Neoplasms, Radiotherapy",
author = "Sandler, {Kiri A.} and Shearwood McClelland and Catherine Degnin and Yiyi Chen and Timur Mitin",
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doi = "10.1590/S1677-5538.IBJU.2018.0208",
language = "English (US)",
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TY - JOUR

T1 - Dramatic polarization in genitourinary expert opinions regarding the clinical utility of positron emission tomography (PET) imaging in prostate cancer

AU - Sandler, Kiri A.

AU - McClelland, Shearwood

AU - Degnin, Catherine

AU - Chen, Yiyi

AU - Mitin, Timur

PY - 2019/1/1

Y1 - 2019/1/1

N2 - OBJECTIVES: To ascertain the opinions of North American genitourinary (GU) experts regarding inclusion of technologies such as prostate - specific membrane antigen (PSMA) and C - 11 choline positron emission tomography (PET) into routine practice. MATERIALS AND METHODS: A survey was distributed to North American GU experts. Questions pertained to the role of PSMA and C - 11 PET in PCa management. Participants were categorized as "supporters" or "opponents" of incorporation of novel imaging techniques. Opinions were correlated with practice patterns. RESULTS: Response rate was 54% and we analyzed 42 radiation oncologist respondents. 17 participants (40%) have been in practice for > 20 years and 38 (90%) practice at an academic center. 24 (57%) were supporters of PSMA and 29 (69%) were supporters of C - 11. Supporters were more likely to treat pelvic nodes (88% vs. 56%, p < 01) and trended to be more likely to treat patients with moderate or extreme hypofractionation (58% vs. 28%, p = 065). Supporters trended to be more likely to offer brachytherapy boost (55% vs. 23%, p = 09), favor initial observation and early salvage over adjuvant radiation (77% vs. 55%, p = 09), and to consider themselves expert brachytherapists (69% vs. 39%, p = 09). CONCLUSIONS: There is a polarization among GU radiation oncology experts regarding novel imaging techniques. A correlation emerged between support of novel imaging and adoption of treatment approaches that are clinically superior or less expensive. Pre - existing biases among GU experts on national treatment - decision panels and leaders of cooperative group studies may affect the design of future studies and influence the adoption of these technologies in clinical practice.

AB - OBJECTIVES: To ascertain the opinions of North American genitourinary (GU) experts regarding inclusion of technologies such as prostate - specific membrane antigen (PSMA) and C - 11 choline positron emission tomography (PET) into routine practice. MATERIALS AND METHODS: A survey was distributed to North American GU experts. Questions pertained to the role of PSMA and C - 11 PET in PCa management. Participants were categorized as "supporters" or "opponents" of incorporation of novel imaging techniques. Opinions were correlated with practice patterns. RESULTS: Response rate was 54% and we analyzed 42 radiation oncologist respondents. 17 participants (40%) have been in practice for > 20 years and 38 (90%) practice at an academic center. 24 (57%) were supporters of PSMA and 29 (69%) were supporters of C - 11. Supporters were more likely to treat pelvic nodes (88% vs. 56%, p < 01) and trended to be more likely to treat patients with moderate or extreme hypofractionation (58% vs. 28%, p = 065). Supporters trended to be more likely to offer brachytherapy boost (55% vs. 23%, p = 09), favor initial observation and early salvage over adjuvant radiation (77% vs. 55%, p = 09), and to consider themselves expert brachytherapists (69% vs. 39%, p = 09). CONCLUSIONS: There is a polarization among GU radiation oncology experts regarding novel imaging techniques. A correlation emerged between support of novel imaging and adoption of treatment approaches that are clinically superior or less expensive. Pre - existing biases among GU experts on national treatment - decision panels and leaders of cooperative group studies may affect the design of future studies and influence the adoption of these technologies in clinical practice.

KW - Positron-Emission Tomography

KW - Prostatic Neoplasms

KW - Radiotherapy

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