Comparative effectiveness of follow-up imaging approaches in pancreatic cancer

J Comp Eff Res. 2014 Sep;3(5):491-502. doi: 10.2217/cer.14.35.

Abstract

Aim: Although PET imaging is sometimes used in follow-up of pancreatic cancer, evidence regarding comparative effectiveness of PET and older imaging modalities is limited.

Patients & methods: Linked cancer registry and Medicare claims data were analyzed to examine patterns of imaging and effects on treatment patterns and survival among newly diagnosed pancreatic cancer patients from 2003 to 2007.

Results: 12% of patients received PET during follow-up. In a time-varying exposure model, computed tomography/MRI was associated with lower mortality risk relative to PET in surgical patients (HR: 0.66; 95% CI: 0.52-0.83). In a subset analysis, type of follow-up imaging before 180 days was not associated with mortality after 180 days (computed tomography/MRI vs PET; hazard ratio: 0.98; 95% CI: 0.84-1.16).

Conclusion: Follow-up PET is uncommon among Medicare beneficiaries with pancreatic cancer, and is generally used late in the disease course. This pattern of PET use was not associated with decreased mortality risk compared with conventional imaging.

Keywords: PET; comparative effectiveness; imaging; pancreatic cancer.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Aged
  • Aged, 80 and over
  • California / epidemiology
  • Cohort Studies
  • Comparative Effectiveness Research / methods*
  • Comparative Effectiveness Research / statistics & numerical data
  • Female
  • Follow-Up Studies
  • Humans
  • Magnetic Resonance Imaging / methods*
  • Male
  • Medicare
  • Multimodal Imaging / methods
  • North Carolina / epidemiology
  • Pancreas / diagnostic imaging
  • Pancreas / pathology
  • Pancreatic Neoplasms / diagnosis*
  • Pancreatic Neoplasms / epidemiology*
  • Positron-Emission Tomography / methods*
  • Registries / statistics & numerical data
  • Retrospective Studies
  • Survival Analysis
  • Tomography, X-Ray Computed / methods*
  • United States
  • Utah / epidemiology