PET possibilities continue to expand

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The big news that is still reverberating within the molecular imaging community is the long-anticipated decision by the Centers for Medicare & Medicaid Services (CMS) to expand its reimbursement coverage for PET scans.

Before this ruling, CMS only covered PET scanning for the initial diagnosis of nine types of cancer: breast, cervical, colorectal, esophageal, head and neck, lymphoma, melanoma, non-small-cell lung and thyroid. Medicare coverage has now been expanded to a total of 11 indications; both the initial diagnostic evaluation and subsequent treatment strategies for ovarian cancer and myeloma are now covered.

Now, PET scans can be used in the initial treatment-strategy evaluation of patients with most types of solid tumors and CMS now will allow for use of PET in subsequent treatment-strategy evaluations for an expanded number of cancer types. And clinicians are continuing research that seeks to expand PET’s possibilities even further.

Although the latest breaking research from Stanford University Medical Center did not feature Tom Cruise and Bryan Brown flipping silver shakers at one another, it did showcase the efficacy of a next-generation of PET/CT cocktail, sodium 18F and 18F-FDG.

Instead of patients having to get separate SPECT and PET/CT studies, usually on different days, this strategy allows for one combined PET/CT study with potentially more utility, lower costs, lower radiation dose, and much greater patient convenience, according to the authors.

Researchers at the University of California, Los Angeles, Jonsson Comprehensive Cancer Center have employed PET/CT results to better predict outcomes, and determine the appropriate course of treatment, for sarcoma patients.

Over the course of two years, they determined that a 35% reduction in tumor FDG uptake at early follow-up is a sensitive predictor of histopathologic tumor response.

Dr. Fritz Eilber, MD, senior author of the study, said that the significance of the study was that it identified people--more than half of those in the study--who were not going to benefit from the treatment early in the course of their therapy. “Although this study was performed in patients scheduled for surgery, I think these findings will have an even greater impact on patients with inoperable tumors or metastatic disease as you get a much quicker evaluation of treatment effectiveness and can make decisions that will hugely impact quality of life,” he said.

In other news, if you or your group is interested in finding out more about the possibilities for molecular imaging in your practice head over to our Healthcare TechGuide and check out the variety of systems offered there.

Lastly, if you have a comment or report to share about the utilization of molecular imaging and nuclear medicine in your practice, please contact me at the address below. I look forward to hearing from you.

Jonathan Batchelor, Web Editor