RESCHEDULING OF 18FDG PET/CT PROCEDURES CAUSED BY HIGHER FASTING BLOOD SUGAR LEVEL: A CLINICAL AUDIT

Abstract

Abstract

Background: Fasting blood sugar (FBS) level is an important confounding factor having an impact on qualitative and quantitative aspects of 18-Flourodeoxy glucose Positron Emission Tomography and Computerized Tomography (¹⁸FDG PET/CT). FBS ≥200 mg% is an indication of rescheduling of procedure as recommended by various guidelines. Purpose of this clinical audit is to find out the frequency of rescheduling due to higher FBS and to explore the reason(s).

Material and Method: This audit was conducted at PET/CT services of Radiology Department Aga Khan University Hospital (AKUH) and consecutive ¹⁸FDG PET/CT data from 1.1.2017 till 30.06.2017 was collected. Cohort was segregated into those having FBS within and beyond institutional benchmark (FBS = <200 mg%). Root cause analyses (RCA) for rescheduled procedures caused by FBS beyond acceptable limits were made.

Results: During study period total 534 18FDG PET/CT procedures were performed (Mean age 52 ± 17 years with male to female ratio was 58:42%). Mean FBS was 109 ± 35 mg% with range of 52-285 mg%). FBS beyond benchmark was found in 12 (02%) patients who were rescheduled. RCA revealed inadequate understanding by patient / attendant and poor compliance to instructions briefed to them at time of appointment.

Conclusion: Frequency of rescheduling of ¹⁸FDG PET/CT procedures during audit period was significantly low. Focused counseling by receptionist and involving treating physician could further reduce the rescheduling incidence and avoid inconvenience to patient and financial loss caused by decay of available dose of ¹⁸FDG.

Background: Fasting blood sugar (FBS) level is an important confounding factor having an impact on qualitative and quantitative aspects of 18-Flourodeoxy glucose Positron Emission Tomography and Computerized Tomography (¹⁸FDG PET/CT). FBS ≥200 mg% is an indication of rescheduling of procedure as recommended by various guidelines. Purpose of this clinical audit is to find out the frequency of rescheduling due to higher FBS and to explore the reason(s).

Material and Method: This audit was conducted at PET/CT services of Radiology Department Aga Khan University Hospital (AKUH) and consecutive ¹⁸FDG PET/CT data from 1.1.2017 till 30.06.2017 was collected. Cohort was segregated into those having FBS within and beyond institutional benchmark (FBS = <200 mg%). Root cause analyses (RCA) for rescheduled procedures caused by FBS beyond acceptable limits were made.

Results: During study period total 534 18FDG PET/CT procedures were performed (Mean age 52 ± 17 years with male to female ratio was 58:42%). Mean FBS was 109 ± 35 mg% with range of 52-285 mg%). FBS beyond benchmark was found in 12 (02%) patients who were rescheduled. RCA revealed inadequate understanding by patient / attendant and poor compliance to instructions briefed to them at time of appointment.

Conclusion: Frequency of rescheduling of ¹⁸FDG PET/CT procedures during audit period was significantly low. Focused counseling by receptionist and involving treating physician could further reduce the rescheduling incidence and avoid inconvenience to patient and financial loss caused by decay of available dose of ¹⁸FDG.