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PET affects treatment in over one-third of cancer cases

PET affects treatment in over one-third of cancer cases

A study based on nearly 23,000 patients at 1,178 US healthcare facilities has found that FDG-PET or PET/CT led referring physicians to alter their opinion about the optimal treatment for 36.5% of cancer patients.

The results summarize the first-year experience of the National Oncologic PET Registry (NOPR), an effort that is measuring how numerous cancer-related PET applications that have conditional approval for Medicare payment influence patient management.

NOPR was organized in 2005 as a negotiated compromise between the Academy of Molecular Imaging (AMI) and the Centers for Medicare & Medicaid Services (CMS).

AMI supported payment for more cancer-related PET indications beyond the nine procedures already approved for Medicare beneficiaries. CMS responded with a Coverage with Evidence Development ruling that temporarily granted payment but required more research to determine PET’s clinical influence.

The American College of Radiology Imaging Network acted as the research agency for the resulting patient registry. NOPR began compiling data on May 8, 2006, for FDG-PET procedures performed on patients with brain, cervical, ovarian, pancreatic, small-cell lung, testicular, and other cancers not already covered by Medicare. Indications included staging, restaging, diagnosis of suspected recurrence, and therapy monitoring

Medicare paid for individual FDG-PET procedures only after confirmation that the referring physicians had completed and filed two web-based surveys with NOPR. One described the physician’s management plan before FDG-PET was ordered, and the other covered PET’s effect on decision making after its findings were known. About 86% of the studies were performed on a PET/CT scanner, with the remainder scanned on a dedicated PET platform.

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