NOPR to CMS: Lift remaining restrictions for oncologic PET exams

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Pretherapeutic axial 68Ga-DOTATATE PET (A) and CT (B) slices, compared with posttherapeutic 68Ga-DOTATATE PET (C) and CT (D) slices, showing abdominal lymph node metastasis (arrow) of patient progress - 433.41 Kb
Pretherapeutic axial 68Ga-DOTATATE PET (A) and CT (B) slices, compared with posttherapeutic 68Ga-DOTATATE PET (C) and CT (D) slices, showing abdominal lymph node metastasis (arrow) of patient progression-free for 28 months.
The co-chairs of the National Oncologic PET Registry (NOPR) Working Group have requested a formal reconsideration of the Centers for Medicare & Medicaid Services’ (CMS) National Coverage Analyses on FDG-PET for oncologic indications. Specifically, they are requesting to end the remaining prospective data collection requirements under Coverage with Evidence Development (CED) for all oncology indications for FDG-PET imaging, and revise the National Coverage Determination (NCD) for PET scans.

The NOPR said that the group “has demonstrated through its published research of the CED evidence that PET is both reasonable and necessary for subsequent treatment strategy of oncologic indications.” While CMS ended the CED requirements in 2009 for initial treatment strategy of most oncologic indications, the agency continued to require CED for subsequent treatment strategy evaluations for many cancer types.

“In light of the robust NOPR data collected since 2009, we are now convinced that there remains no clinical need to continue CED data collection for FDG-PET oncologic indications,” stated the group, citing its study in the May issue of the Journal of Nuclear Medicine comparing the NOPR 2006 and 2009.

In its letter, the co-chairs urged CMS to review the existing NCD in light of the published evidence, “which we believe supports our conclusion that the remaining CED restrictions pertaining to FDG-PET for oncologic indications should be removed.”

The NOPR is sponsored by the World Molecular Imaging Society (formerly the Academy of Molecular Imaging) and managed by the American College of Radiology.