PET Scans

[Guest guest]

Somebody asked about PET Scans........

PET Is Most Powerful Imaging Tool In Cancer Management, Nationwide Study

Confirms

(Dec. 7, 2008) — With the most recent release of data from the National

Oncologic PET Registry (NOPR), researchers may have reached the moment of

critical mass by confirming the effectiveness of positron emission tomography

(PET) in the monitoring of tumor activity across a wide range of cancers.

" During the first year of the study, we verified that PET finds more areas of

active cancer than other imaging tools and leads, in some cases, to earlier

initiation of subsequent treatment, " said Bruce E. Hillner, M.D., professor of

medicine at Virginia Commonwealth University in Richmond, Va., and lead author

of the article. " We noted that PET has a clinically significant impact on cancer

management, resulting in a change in treatment in more than one out of three

cases—or 36 percent of the time. "

In the article, published in the December issue of The Journal of Nuclear

Medicine, researchers reported results by cancer type for the first two years of

data collected from nearly 41,000 PET studies conducted at more than 1,300

cancer centers nationwide. Analysis was restricted to the use of PET for

staging, restaging or detection of suspected recurrences in patients with

pathologically proven cancers.

Study data released in March 2008 showed a striking consistency of the impact of

PET on referring physicians' intended management plans. At that time, NOPR

researchers felt that the significance of the evidence was such that they

formally asked the Centers for Medicare and Medicaid Services (CMS) to

reconsider the current National Coverage Determination on oncologic use of PET.

" As a result of the data, the follow-up question for the second year was: Does

the impact of PET vary between cancers? " explained Hillner. " We found that it

did not vary significantly, and that changes in treatment plans for rare

cancers—such as stomach cancer—clustered around the same one-third mark as the

more common cancers. As a result, we believe that coverage for PET in the

staging, restaging and detection of recurrence of cancer should be handled the

same across the board. "

According to the researchers, a substantial body of national and international

literature now exists showing that PET is a highly effective technique for

imaging cancer.

" From the data, we concluded that, although the effectiveness of PET may differ

somewhat between individual cancers, it's in the same ballpark, " said Barry A.

Siegel, M.D., professor of radiology at Mallinckrodt Institute of Radiology in

St. Louis, Mo., and one of the co-authors of the article. " This result was a

little unexpected, but leads us to believe that a continual parsing of PET's

usefulness, cancer by cancer and indication by indication, for purposes of

reimbursement does not make clinical sense. "

The NOPR was launched in 2006 in response to a proposal from CMS to expand

coverage for PET to include cancers and indications not presently eligible for

reimbursement, including cancers of the ovary, uterus, prostate, pancreas,

stomach, kidney and bladder.

" The NOPR has been a collaborative process with CMS, " said Siegel. " The purpose

of our partnership has been to get the best data into the public domain for

decision-making. We are hopeful that a decade-long process leading to an

understanding of the usefulness of PET in cancer management is finally

completed. "

A draft decision by CMS is expected on Jan. 10, 2009. Following a 30-day comment

period, the final National Coverage Determination will be made April 9.

PET imaging, also called PET scanning, is a procedure that images the function

of cells to show differences between healthy tissue and diseased tissue. It is

used to evaluate various neurological and cardiac disorders as well as for

diagnosing, staging and monitoring the treatment of many different cancers.

Coauthors of " Relationship of Cancer Type and the Impact of PET and PET/CT on

Intended Patient Management: Findings of the National Oncologic PET Registry "

include Bruce E. Hillner, department of internal medicine and Massey Cancer

Center, Virginia Commonwealth University, Richmond, Va.; Barry A. Siegel,

division of nuclear medicine, Mallinckrodt Institute of Radiology and Siteman

Cancer Center, School of Medicine, Washington University, St. Louis, Mo.;

F. Shields, Karmanos Cancer Institute, Wayne State University, Detroit,

Mich.; Dawei Liu, Ilana F. Gareen and Ed Hunt, Center for Statistical Sciences,

Brown University, Providence, R.I.; and R. , department of

radiology, School of Medicine, Duke University, Durham, N.C.

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8

[Guest guest]

Hi Louise,

PETs definitely have their good points. But I also know a lot of women who

routinely have biopsies because of benign conditions the PET picks up as

" active. "

I was denied a PET, by the way. I was also denied an MRI for chest, abdomen,

and pelvic area. And that WAS my insurance turning me down. The reason I was

denied was because I hadn't had a CT yet. I am allergic to the CT dye, so I

doubt I will have body scans again for another decade or so.

ar

>

> With all due respect, I disagree. I think PET Scans are quite valuable. I've

had 2 and the 2nd one showed changes and confirmed stage 4 compared to the first

one. The mets were only 7 mm. PET scans also use far less rads than CT. I

would opt for PET over CT. That said, I've led a very quiet life and don't have

much history in the area of injuries. Also, if you decided to go to a clinic

like the ones in Mexico, their test of choice is a PET scan and they will ask

for the DVD of the scan.

>

> Louise

>

[Guest guest]

Hi AR,

This must be a bit confusing for everyone here right now. there are 2 of us

Barbara's. I'm the one with first stage breast cancer and one kidney. The

other Barbara has a spot on her lung and feels let down by her doctor. Both

of us are interested in PET scans!

I'll post using " Barbara (breast cancer) from now on.