Content area
Full Text
Learning Objectives: On successful completion of this activity, participants should be able to (1) describe clinical PET/CT indications for which cost-effectiveness has already been demonstrated; (2) recognize the need for future prospective studies to evaluate cost-effectiveness of PET/CT for multiple clinical indications; (3) apply suggested protocols of economic evaluation to future clinical trials assessing cost-effectiveness of PET/CT.
Financial Disclosure: The authors of this article have indicated no relevant relationships that could be perceived as a real or apparent conflict of interest.
CME Credit: SNM is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to sponsor continuing education for physicians. SNM designates each JNM continuing education article for a maximum of 1.0 AMA PRA Category 1 Credit. Physicians should claim only credit commensurate with the extent of their participation in the activity.
For CE credit, participants can access this activity through the SNM Web site (http://www.snm.org/ce_online) through March 2011.
PET and PET/CT have changed the diagnostic algorithm in oncology. Health care systems worldwide have recently approved reimbursement for PET and PET/CT for staging of non-small cell lung cancer and differential diagnosis of solitary pulmonary nodules because PET and PET/CT have been found to be cost-effective for those uses. Additional indications that are covered by health care systems in the United States and several European countries include staging of gastrointestinal tract cancers, breast cancer, malignant lymphoma, melanoma, and head and neck cancers. Regarding these indications, diagnostic effectiveness and superiority over conventional imaging modalities have been shown, whereas cost-effectiveness has been demonstrated only in part. This article reports on the current knowledge of economic evaluations of PET and PET/CT in oncologic applications. Because more economic evaluations are needed for several clinical indications, we also report on the methodologies for conducting economic evaluations of diagnostic tests and suggest an approach toward the implementation of these tests in future clinical studies.
Key Words: positron emission tomography; computerized tomography; cost-effectiveness; image fusion; tumor staging; response to therapy; treatment individualization
J Nucl Med Technol 2010; 38:6-17
DOI: 10.2967/jnmt.108.059584
The introduction of PET to clinical oncology in the early 1990s, and, more recently, combined imaging with CT, have substantially influenced the management of patients with cancer (1-6). The combination of a dedicated PET scanner and multislice helical CT enables...