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Recent data show consistent change of treatment for one out of three cancer patients, according to article in the Journal of Nuclear Medicine 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. In the words of Bruce E. Hillner, M.D., professor of medicine at Virginia Commonwealth University in Richmond, "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,"

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. 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. December issue of The Journal of Nuclear Medicine, researchers reported results for the first two years of data from 41,000 PET studies conducted at more than 1,300 cancer centers nationwide by cancer in the article. 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 and it was referring physicias 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.

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.

A question arised after the results of data was, does the impact of PET vary between cancers and it was replied by Hillner. He said that "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. In the words of 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, "From the data, we concluded that, although the effectiveness of PET may differ somewhat between individual cancers, it's in the same ballpark.” Siegel says "The NOPR has been a collaborative process with CMS," "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."

About SNM
SNM is an international scientific and medical organization dedicated to raising public awareness about what molecular imaging is and how it can help provide patients with the best health care possible. SNM members specialize in molecular imaging, a vital element of today's medical practice that adds an additional dimension to diagnosis, changing the way common and devastating diseases are understood and treated. SNM's more than 17,000 members set the standard for molecular imaging and nuclear medicine practice by creating guidelines, sharing information through journals and meetings and leading advocacy on key issues that affect molecular imaging and therapy research and practice.

Source: Society of Nuclear Medicine