Presentation (CTI)

OBJECTIVES: Oligometastatic disease (OMD) refers to a state of metastatic cancer, characterized by a limited number of metastatic lesions. Local treatments such as ablative therapy could potentially be curative to OMD. OMD is diagnosed exclusively based on imaging findings. This paradigm is relatively novel in cancer treatment, as it challenges the older binary view of cancer as localized or metastatic. Given the importance of imaging findings for diagnosing OMD, we explored the use of OMD in real world radiological practice.
METHODS: We evaluated radiology reports from healthcare systems located in the United States that were produced in clinical practice. Healthcare providers ranged between imaging centers, small and medium sized hospitals, to academic and oncology focused providers. A real-world imaging data platform was used to search, filter, and select radiology reports (Segmed, Palo Alto, CA).
RESULTS: A total of 33,747,977 reports of 11 radiology modalities (including X-ray, MRI, CT, and PET) from healthcare providers in 40 states were included in the search. OMD was mentioned in 164 radiology reports from 109 different patients. Clinicians provided OMD information in the indication and history in 148 radiology reports of 95 patients, while radiologists mentioned OMD in 18 reports of 17 patients. OMD was mentioned in 20 different primary tumor types, most commonly breast cancer (n=39 reports of 22 patients), lung cancer (n=33 reports of 26 patients), and prostate cancer (n=16 reports of 13 patients). Modalities with OMD mention included CT (n=58), X-ray Angiography (n=44), PET/CT (n=35), MRI (n=26), and X-ray (n=1). The first mention of OMD was in 2017 (n=2 reports), which increased to n=33 in 2024.
CONCLUSIONS: In this large-scale observational study, we found that despite the importance of imaging, the term OMD is rarely used in routine radiology practice. These results suggest the need to improve the OMD definition and guidelines.