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Purpose: In the present review, we aimed to underline the importance of a clinically oriented PET reporting through the discussion of critical aspects that affect the impact of PET in NSCLC patients. Methods: Cornerstones for PET reporting related to staging of NSCLC after the publication of the new 8th edition of TNM and emerging issues related to locally advanced disease, to restaging and to response evaluation to innovative therapies are listed and specifically commented. Results: 18F-FDG PET/CT imaging has a prominent role in NSCLC patients both prior to surgery and when evaluating for metastatic disease. The benefit is even most marked in patients at greater risk of distant metastases. In this framework, for patients with stage III, PET imaging has the potential to result in a stage-shift through the identification of asymptomatic occult distant metastases, thus highlighting unexpected stage IV patients. The final PET report is influenced by factors that lie outside the acquired images, from the clinical information available at the time of reporting to the capability of linking these clinical details to further decision-making especially in the settings of response to new therapies. Conclusion: A multidisciplinary approach to cancer patients has a significant impact in their management and outcome. A clinically-oriented report is needed to transfer the relevant information to the clinician to fully exploit PET potential in NSCLC.

Purpose: In the present review, we aimed to underline the importance of a clinically oriented PET reporting through the discussion of critical aspects that affect the impact of PET in NSCLC patients. Methods: Cornerstones for PET reporting related to staging of NSCLC after the publication of the new 8th edition of TNM and emerging issues related to locally advanced disease, to restaging and to response evaluation to innovative therapies are listed and specifically commented. Results: 18F-FDG PET/CT imaging has a prominent role in NSCLC patients both prior to surgery and when evaluating for metastatic disease. The benefit is even most marked in patients at greater risk of distant metastases. In this framework, for patients with stage III, PET imaging has the potential to result in a stage-shift through the identification of asymptomatic occult distant metastases, thus highlighting unexpected stage IV patients. The final PET report is influenced by factors that lie outside the acquired images, from the clinical information available at the time of reporting to the capability of linking these clinical details to further decision-making especially in the settings of response to new therapies. Conclusion: A multidisciplinary approach to cancer patients has a significant impact in their management and outcome. A clinically-oriented report is needed to transfer the relevant information to the clinician to fully exploit PET potential in NSCLC.

Multidisciplinary cancer meetings (MDMs) are treatment planning meetings where a group of health professionals regularly meet to review patients’ histories, pathology and radiology results and formulate a management plan. They were developed and implemented in an attempt to standardise and improve cancer outcomes and have become a fundamental component of quality cancer care. National and international guidelines on MDM conduct exist. Such guidelines are based on expert opinion, since there is a paucity of evidence available in the area. There remain a number of areas of MDM conduct where little is known, including: patients’ views on this model of care and their preferences for interaction with the MDMs, the role of supportive care within MDMs, and how disagreements around recommended treatment plans should and are being managed. The research presented in this thesis used a mixed methods approach to explore and understand the conduct and dynamics of cancer MDMs in order to develop evidence based guidelines for their conduct. These guidelines were refined through a Delphi consensus process involving Australian leaders in cancer care. Finally, after identifying potential deficiencies in the functioning of MDMs, a pilot study was performed to test a new model of care whereby the provision of comorbid and psychosocial details was standardised during MDM treatment planning. Health professionals and patients were strongly supportive of MDMs. They believed discussion at MDMs improved patient outcomes, increased likelihood that patients would receive evidence-based care and were an efficient means of treatment planning. Secondary benefits of MDMs include improved interdisciplinary communication and teamwork, education and peer support. Both health professionals and patients reported the primary goal of MDM was to develop a single consensual recommendation of an individualised, evidence based treatment plan. There were substantive differences in the reported role of support