2057 UTILIZATION PATTERNS OF RADIOGRAPHIC IMAGING IN MEN WITH NEWLY DIAGNOSED PROSTATE CANCER AT A TERTIARY REFERRAL CENTER

Abstract

You have accessJournal of UrologyProstate Cancer: Detection & Screening (IV)1 Apr 20132057 UTILIZATION PATTERNS OF RADIOGRAPHIC IMAGING IN MEN WITH NEWLY DIAGNOSED PROSTATE CANCER AT A TERTIARY REFERRAL CENTER Samuel Nickles, James Rosoff, Alisa Tykal, Sandip Prasad, and Stephen Savage Samuel NicklesSamuel Nickles Charleston, SC More articles by this author , James RosoffJames Rosoff Charleston, SC More articles by this author , Alisa TykalAlisa Tykal Charleston, SC More articles by this author , Sandip PrasadSandip Prasad Charleston, SC More articles by this author , and Stephen SavageStephen Savage Charleston, SC More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.2476AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Prior population-based research has demonstrated a high rate of inappropriate imaging (CT, MRI or bone scan for low- and intermediate-risk patients or lack of imaging for high-risk patients) for men newly diagnosed with prostate cancer. We sought to determine if these patterns occurred at a tertiary referral center and if referred patients had a higher rate of inappropriate imaging compared to those who underwent their entire workup in a tertiary care center. METHODS 1245 men newly diagnosed with prostate cancer from 2001 to 2011 and who received all or part of their diagnostic workup and subsequent treatment at the NCI-designated Hollings Cancer Center were included in the study. Demographic and clinical variables were analyzed using the Pearson chi-square and Fisher exact tests. RESULTS 77% of men underwent appropriate pre-treatment imaging. Significantly fewer men with intermediate-risk prostate cancer underwent appropriate imaging (61%) compared to those with low-risk (86%) or high-risk cancer (88%), (p < 0.001 between groups). Age, year of diagnosis, race, marital status, income, insurance status, and treatment modality were not associated with receiving appropriate imaging. However, men undergoing minimally invasive prostatectomy were less likely to receive appropriate imaging than those undergoing open surgery (68% vs. 77%, p < 0.01). Men initially evaluated by an outside urologist and then referred to our institution were equally likely to undergo appropriate imaging as those diagnosed at our institution (76% vs. 78%, p = 0.49). Of men who received a single inappropriate scan, significantly more underwent MRI (52%) as compared to CT (17%) and bone scan (31%) (p < 0.001 between groups). Among men with intermediate-risk cancer, those with Gleason pattern 4+3 were equally likely to receive appropriate imaging as those with Gleason 3+4 (59% vs. 65%, p = 0.44). CONCLUSIONS Men diagnosed with prostate cancer presenting to an NCI-designated cancer center undergo inappropriate imaging prior to treatment, although less often than reported in population-based studies. Men with intermediate-risk disease have a higher rate of inappropriate imaging than men in the low-risk and high-risk categories, and MRI is performed inappropriately more frequently than either CT or bone scan. Those men who underwent a staging workup by a community urologist are equally likely to receive appropriate imaging as those evaluated at a referral center. Communication among physicians is paramount to aid in further reduction of inappropriate and costly imaging. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e844 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Samuel Nickles Charleston, SC More articles by this author James Rosoff Charleston, SC More articles by this author Alisa Tykal Charleston, SC More articles by this author Sandip Prasad Charleston, SC More articles by this author Stephen Savage Charleston, SC More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...