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Clinical Trials Unit

Paul Strickland PET-CT Response Form

This form is for use by Paul Strickland Scanner Centre to submit the results of the 2nd reading.

Procedure to be Used Upon Receipt of PET-CT Scans - SOP to be used by the Paul Strickland Scanner Centre when receiving scans to be read from other centres

Response in Primary Tumour
Response in Nodes
Distant Metastases Detected (required)
If ‘Yes’, Indicate Type
Is there concordance between readings of Core Lab and Local Report? (required)
If ‘No’, Which report has been accepted?
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The information provided will be used solely for the PET-Neck trial

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