Home

Cover Story

Table of Contents

E-Newsletter

Article Archive

Editorial Calendar

Datebook

Writers' Guidelines

Orgs/Links

Opinion Polls

Reprints

Forum

Search

March 25 - Data Confirm FDG-PET Impacts Care Management of Cancer Patients

Clinicians changed the intended care of more than one in three cancer patients as the result of fluorodeoxyglucose (FDG)-PET scan findings, according to a study of data from the National Oncologic PET Registry (NOPR), published online March 24 in the Journal of Clinical Oncology. The study analyzed data regarding nearly 23,000 patients from more than 1200 facilities nationwide.

Analysis of data collected found that FDG-PET is associated with a 36.5% change in the decision of whether or how to treat a patient’s cancer. NOPR working group cochair R. Edward Coleman, MD, professor of radiology and chief of the Division of Nuclear Medicine at Duke University School of Medicine, comments, “We were especially surprised by the impact of the PET findings on patients who were originally planned to have a biopsy. The procedure was avoided in approximately three quarters of these patients.”

The NOPR was launched in May 2006 in response to the Centers for Medicare & Medicaid Services’ (CMS) novel “Coverage with Evidence Development” policy to inform the center’s FDG-PET coverage determination decisions for currently noncovered cancer indications by collecting data through a clinical registry. Cancer types Medicare currently covers for reimbursement only through the NOPR include those of the ovary, uterus, prostate, pancreas, stomach, kidney, and bladder.

Oncologist and NOPR working group cochair, Anthony Shields, MD, professor of medicine and oncology at the Karmanos Cancer Institute at Wayne State University, says, “These results confirm what we suspected from increasing experience with PET. However, we lacked the significant data required to prove the benefit of PET for many uncovered indications. It’s very encouraging that oncologists and other clinicians may have access to the valuable information PET affords for ensuring the best patient care.”

Sponsored by the Academy of Molecular Imaging and managed by the American College of Radiology and the ACR Imaging Network, the NOPR was designed to collect questionnaire data from referring physicians on intended patient management before and after an FDG-PET scan. The NOPR participating PET facility collects from referring physicians a pre-PET questionnaire (documenting study indication, cancer type, and anticipated stage and planned management if PET was not available) and one of several post-PET questionnaires that assess the referring physician’s planned management in light of the FDG-PET findings.

”The NOPR working group sought to measure the impact of PET findings on patient management in a manner minimally intrusive to care providers. This was critical for successfully collecting the large amount of data required for a robust analysis,” says Bruce Hillner, MD, lead author for the study and professor in the Department of Internal Medicine at Virginia Commonwealth University.

NOPR has formally asked CMS to reconsider the current national coverage decision on FDG-PET to end the data collection requirements for diagnosis, staging, and restaging. Medicare will review the published data and determine the next steps related to reimbursement for PET scans now only covered through the NOPR. For more information about the NOPR and a complete list of NOPR covered cancer types and indications, visit http://www.cancerpetregistry.org/.

Source: The American College of Radiology

(View the Daily News Archive)

Survey

Is teleradiology more of a help or a threat to your facility? Help     Threat     We do not use teleradiology in our facility.     View results