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Similar a 2009 PET Review And NOPR Update
Similar a 2009 PET Review And NOPR Update (20)
2009 PET Review And NOPR Update
- 1. The Role of PET in Oncology & Review of NCCN/NOPR Study by Vimal T. Patel Senior Sales Consultant
- 3. “ Cat Scan vs PET Scan”
- 5. Radiopharmaceutical (Isotope) 18 FDG 2-deoxy-2-[ 18 F]fluoro-D-glucose FDG Metabolism :
- 6. Positron Decay and Annihilation 180 degrees (coincidence imaging)
- 7. Patient prep for exam CNMT injects patient w/ FDG Imaged on scanner laying flat on back CNMT monitors patient image acquisition CNMT processes image and transfers/uploads image for MD Patient notified to follow-up w/ referring MD Typical PET Workflow & Procedure 45-60 minutes wait post-injection (uptake)
- 8. PET-CT versus PET or CT alone Antoch et al. Radiology 2003 93% 63% 89% Accuracy 94% 77% 94% NPV 89% 50% 80% PPV 94% 59% 89% Specificity 89% 70% 89% Sensitivity PET-CT CT PET
- 10. What is NCCN/NOPR? How do they share our Vision ? Value ? $$$ ?
- 14. *Excluded Scans done for treatment monitoring Major Cancer Types vs. Incidence (Patients Over Age 65) Cancer Type Total NOPR Scans (2007)* Incidence (CDC 2004) Scans per Incidence (2007) Prostate 3,769 116,659 3.2% Ovary and Adnexa 3,706 9,625 38.5% Pancreas 3,561 21,962 16.2% Bladder 2,665 44,570 6.0% Kidney/Other Urinary Tract 2,623 20,886 12.6% Small Cell Lung 2,390 19,657 12.2% Stomach 2,349 13,048 18.0% Myeloma 1,336 10,194 13.1%
- 15. Referring MD requests PET Pre-PET Form PET done PET interpreted & reported Post-PET Form sent, including question for referring MD consent Post-PET Form completed. Claim submitted Ongoing patient management NOPR/NCCN Workflow Ask patient for consent
Notas del editor
- Hi. I am Vimal Patel and I will discuss the role of PET scanning in oncology and review the recent NOPR Updates (in the context of the NCCN article)
- PET or Positron Emission Tomography is a technology where physiologic processes in the body are imaged. PET is not an anatomic image, such as CT or MRI, but structural or anatomic images are generally complimentary and used in conjunction with PET for interpretation.
- This is a picture of FDG or fluoro-deoxy-glucose. A normal glucose molecule is modified, so that the hydroxyl group in the 2 position is replaced with a fluorine atom. The fluorine atom used is the F-18 isotope, which is a positron emitter.
- A PET scanner has an array of crystals that detect these two 511 KEV photons simultaneously. As you saw in the previous slide, it is similar in appearance to a CAT scanner. The major difference, from the patient’s point of view, is that prior to scanning, there is an uptake period of 45 to 60 minutes, while the patient is resting in a comfortable recliner chair, and image acquisition can take 30 to 60 minutes. Patients are informed before the study, that the entire procedure will take approximately two hours. The patient typically fasts four hours prior to the study.
- CMS is the Centers for Medicare and Medicaid Sevices, formerly known as HCFA. In addition to breast cancer, CMS has approved FDG-PET reimbursement for: … Private insurers will reimburse for additional indications.