Can positron emission tomography be more than a diagnostic tool? A survey on clinical practice among radiation oncologists in India.

ABSTRACT

AIM: The purpose of the survey was to understand the role of positron emission tomography (PET) in clinical radiotherapy practice among the radiation oncologists’ in India. SETTINGS AND DESIGN: An online questionnaire was developed to survey the oncologists on their use of PET, viewing protocols, contouring techniques practiced, the barriers on the use of PET and the need for training in use of PET in radiotherapy. The questionnaire was sent to about 500 oncologists and 76 completed responses were received. RESULTS: The survey shows that radiation oncologists use PET largely to assess treatment response and staging but limitedly use it for radiotherapy treatment planning. Only manual contouring and fixed threshold based delineation techniques (e.g. 40% maximum standard uptake value [SUVmax] or SUV 2.5) are used. Cost is the major barrier in the wider use of PET, followed by limited availability of FDG radionuclide tracer. Limited or no training was available for the use of PET. CONCLUSIONS: Our survey revealed the vast difference between literature suggestions and actual clinical practice on the use of PET in radiotherapy. Additional training and standardization of protocols for use of PET in radiotherapy is essential for fully utilizing the capability of PET.