Molecular Imaging Insight - May 2008 - (Page 7) for Expanded PET Use in Oncology or how to treat a patient’s cancer. The study also found that PET is associated with a management change in almost 75 percent of patients when the addition or deletion to specific modes of therapy was included. In addition, the NOPR data revealed that for patients with a pre-PET plan of biopsy, the post-PET plan had a significant impact on care, with these patients avoiding biopsy in about 75 percent of the cases analyzed. NOPR working group co-chair R. Edward Coleman, MD, professor of radiology and chief of the division of nuclear medicine at Duke University School of Medicine in Durham, N.C., and study author, observed, “We were especially surprised by the impact of the PET findings on patients who were originally planned to have a biopsy.” Oncologist, NOPR working group co-chair and study author Anthony F. Shields, MD, professor of medicine and oncology at the Karmanos Cancer Institute at Wayne State University in Detroit and chair of ACRIN’s Oncology Committee said of the research findings, “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.” “These data confirm what we have known for some time: molecular imaging is a powerful tool in diagnosing, treating, and monitoring disease and is capable of dramatically changing the course of patient care,” commented SNM President Alexander J. McEwan, MD, professor and chair of the department of oncology, faculty of medicine, at the University of Alberta and director of oncologic imaging at Cross Cancer Institute in Edmonton, Canada. “For oncologists, we’re getting a much better idea of how to use this technology in patients with cancer,” McEwan said. “The NOPR study demonstrates that PET has a role in a number of cancers for which we now have evidence we didn’t have before.” To further a better understanding of the NOPR results and their meaning for clinical practice, as well as the appropriate use of PET technology in cancer imaging, McEwan said that SNM is closely working with both ASCO and the American Society for Therapeutic Radiology and Oncology (ASTRO) to develop more teaching courses for their members as well as ongoing involvement in one another’s conferences. On the basis of its research findings, NOPR has formally asked CMS to reconsider its current National Coverage Determination MolecularImaging.net “These data confirm what we have known for some time: molecular imaging is a powerful tool in diagnosing, treating, and monitoring disease and is capable of dramatically changing the course of patient care. For oncologists, we’re getting a much better idea of how to use this technology in patients with cancer.” SNM President Alexander J. McEwan, MD, professor and chair of the department of oncology, faculty of medicine, at the University of Alberta and director of oncologic imaging at Cross Cancer Institute in Edmonton, Canada (NCD) on FDG-PET and requested that it provide Medicare coverage of FDG-PET for diagnosis, staging and restaging across all oncologic indications. CMS is expected to issue a formal response to the NOPR request by October this year. “The NOPR Working Group was careful to consider the impact of including or excluding in their analysis cases where the pre-PET treatment plan was already imaging,” said AMI president Timothy McCarthy, PhD, in a letter to Steve Purrough, MD, CMS director, coverage and analysis group. “Yet, even assuming that PET provided no advantages for those patients with pre-PET imaging plans, the NOPR Working Group’s ‘worst-case estimate’ [in their words] was that PET would nevertheless be associated with a major change in treatment in nearly 20 percent of patients.” “NOPR afforded oncologists and nuclear medicine physicians a unique opportunity to make PET available to Medicare beneficiaries and to improve our understanding of the role of PET in oncology practice,” said study author Barry A. Siegel, MD, professor of radiology and chief of the division of nuclear medicine at the Mallinckrodt Institute of Radiology at Washington University in St. Louis, chair of ACRIN’s PET Imaging Core Laboratory, and NOPR working group co-chair. “Based on these data, Medicare should strongly consider opening up the coverage to include diagnosis, staging and restaging for all cancers.” May 2008 | Molecular Imaging Insight http://MolecularImaging.net
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