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  • March 2008

    The Beneficial Impact of PET Scanning on Cancer Management

    Journal of Clinical Oncology | Bruce E. Hillner et al.


    Impact of Positron Emission Tomography/Computed Tomography and Positron Emission Tomography (PET) Alone on Expected Management of Patients with Cancer: Initial Results from the National Oncologic PET Registry


    Bruce E. Hillner; Barry A. Siegel; Dawei Liu; Anthony F. Shields; Ilana F. Gareen; Lucy Hanna; Sharon Hartson Stine; R. Edward Coleman


    Journal of Clinical Oncology, March 2008


    Positron emission tomography (PET) is widely used in clinical oncology as one of the most impactful and effective means of diagnostic imaging methodology. However, Medicare reimbursement for PET scanning is currently only approved by the Center for Medicaid and Medicare Services (CMS) for nine (9) specific oncology tumor types. Given that clinical oncologists deal with far more than nine tumor types, many patients with non-approved cancers such as pancreatic, ovarian and prostatic are being denied access to the complete spectrum of diagnostic measures they deserve. With this in mind, a group of doctors (in conjunction with CMS) set out to explore the potential benefits of PET scanning for patients with tumors not covered by Medicare. Employing a unique coverage with evidence development (CED) method, the study included data from more than 22,000 cases compiled over the span of one calendar year, with the participation of more than 80% of all PET centers in the United States. This marks the first time CMS has used CED for a national coverage decision (NCD) pertaining to diagnostic imaging methodology.

    In the aggregate of cases with an initial treatment plan, referring physicians reported that PET scanning allowed them to avoid additional tests or procedures 77% of the time. Furthermore, for approximately three quarters of cases in which a biopsy was the initial pre-PET recommendation, the procedure was ultimately avoided as a result of PET scanning. In over 36% of cases, PET scanning led to a change in the physician’s decision to treat or not treat.

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