Target

To assess the compliance of PET CT requests within the local Rheumatology Department with national guidelines and compare audit findings with results from a BNMS national audit. 

Methodology

Data was collected on all PET CT scans which were requested by the Rheumatology Department over a 12-month period. Collected data included patient age, time taken from clinician request to performing the scan, clinical indication, patient diagnosis, findings on PET CT scan and whether these findings directly influenced patient management or not. Information was collected from EPR and PACS. Microsoft excel was used to perform downstream data analysis.

Results & Discussion

A total of 98 PET CT scans were performed over a 12-month period.

There were nine times more PET CT scans performed for suspected inflammation/infection than the national average.^4-5 Most scans were for assessing granulomatous inflammation (43%), whereas the national audit reported most scans in this category were for other inflammatory disorders (31%) and large vessel vasculitis (31%).^4-5 This is not surprising, given that the department is a referral centre for Sarcoidosis.

In the national audit, 90% of PET CT scans performed for “Suspected inflammation/infection directly influenced patient management.

In this audit 55% of PET CT scans performed directly influenced patient management. There was no change in management in 14% of patients. It was unclear whether PET CT scans performed directly influenced management in 31% of patients.

The increased utilization of PET CT in this audit could account for the relatively low yield for directly influencing patient management compared to the national audit (55% compared to 90%).

There was deviation from guidelines, with a significant number of scans for small or medium vessel vasculitis, suspected (but not yet confirmed) sarcoidosis, scleroderma and rheumatoid arthritis.

Utility of PET CT in Sarcoidosis