The National Oncologic PET Registry (NOPR) reported in the Journal of Nuclear Medicine that PET scanning has an impact on the intended treatment of patients with cancer in one third of all cases. The latest results show that PET has a similar impact across all of these cancer types, especially multiple myeloma.

A positron emission tomography (PET) scan is an imaging process that uses a radioactive tracer to depict the organs and tissues in a body. The PET scanner converts the energy from the tracer to a three-dimensional picture. A doctor can then look at cross-sectional images of the organ from any angle to detect any functional problems. For multiple myeloma, a PET scan may be used to supplement an MRI or a CT scan.

Currently, the Center for Medicare & Medicaid Services (CMS) restricts the reimbursement of PET scans to only nine types of cancers. The NOPR was originally launched in response to a proposal to expand coverage of PET to other cancers.

The study looked at PET for 18 cancer types, none of which are currently on the list for CMS reimbursement. The experiment looked at three indications: initial staging, restaging, and detection of recurrence.

Coauthor Barry Seigel, professor of radiology at Mallinckrodt Institute of Radiology in St. Louis, Missouri admits that "This result was a little unexpected, but it 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."

Siegel says that his research was an attempt to inform CMS policy. In light of the recent developments, he recommends that PET be covered for all cancers.

The CMS is expected to decide on the reimbursement of PET scans in other cancers soon. A draft is expected on January 10, 2009, and the final National Coverage Determination will be made on April 9, 2009.

The full article can be found in the December issue of the Journal of Nuclear Medicine. A summary of the finding can also be found at Medscape.