Nuclear Medicine

Nuclear medicine (also called molecular imaging) includes positron emission computed tomography (PET) and single photon emission computed tomography (SPECT) imaging. Nuclear imaging is achieved by injecting small amounts of radioactive material (radiopharmaceuticals) into patients before or during their scan. These can use sugars or chemical traits to bond to specific cells. The radioactive material is taken up by cells that consume the sugars. The radiation emitted from inside the body is detected by photon detectors outside the body. Computers take the data to assemble images of the radiation emissions. Nuclear images may appear fuzzy or ghostly rather than the sharper resolution from MRI and CT.  But, it provides metabolic information at a cellular level, showing if there are defects in the function of the heart, areas of very high metabolic activity associated with cancer cells, or areas of inflammation, data not available from other modalities. These noninvasive imaging exams are used to diagnose cancer, heart disease, Alzheimer’s and Parkinson’s disease, bone disorders and other disorders. 

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CMS coverage decision for Alzheimer's drug, related PET scans sparks concern in imaging community

In a statement released on April 14, MITA cautioned that the coverage decision will “severely limit patient access” to amyloid PET diagnostics and anti-amyloid monoclonal antibodies treatment.

The ASNC is one of several medical imaging societies asking Congress to repeal the appropriate use criteria (AUC) criteria mandate. They say it poses issues for clinicians and is becoming outdated by changes in CMS payment systems. The AUC requirements call for documentation using CVMS authorized software in order to show advanced imaging such as nuclear and CT is justified, or else Medicare payments might be withheld.

American Society of Nuclear Cardiology urges Congress to speed prior authorizations, repeal AUC mandate 

Over the past few weeks, members of ASNC’s Health Policy Committee have held meetings with their members of Congress.

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New imaging technique could provide cheaper alternative to costly PET scanners

Resource-challenged providers in rural areas and elsewhere may not always have access to this technology, given the hefty price tag, experts wrote Monday. 

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Imaging industry advocate slams feds’ failure to address PET coverage gap in recent ruling

The Society for Nuclear Medicine & Molecular Imaging expressed "strong opposition" following CMS' decision, arguing there is no evidence to support limiting pay for such scans. 

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CMS finalizes decision to limit coverage for controversial Alzheimer’s drug, related imaging

The agency has maintained the same pay restrictions in its final policy, only covering PET scans if required by a clinical trial protocol. 

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FDA approves new therapy, complementary imaging agent for treating metastatic prostate cancer

Provider advocates praised the decision, calling it “one of the greatest success stories in nuclear medicine history.”

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Metastatic prostate cancer cases surge following USPSTF-recommended slowdown in screenings

New PET imaging techniques with higher sensitivity may have also contributed to these trends, USC experts wrote in JAMA Open Network. 

American College of Radiology joins other medical societies in speaking out over Ukraine crisis

“The ACR and its members stand ready to assist and support our radiologic colleagues and other medical providers in Ukraine," the group said March 4. 

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Around the web

Cardiovascular Business
Global shortage of nuclear imaging isotopes may be over

The nuclear imaging isotope shortage of molybdenum-99 may be over now that the sidelined reactor is restarting. ASNC's president says PET and new SPECT technologies helped cardiac imaging labs better weather the storm.

Cardiovascular Business
‘A huge win’: CMS significantly increases Medicare payments for cardiac CT

CMS has more than doubled the CCTA payment rate from $175 to $357.13. The move, expected to have a significant impact on the utilization of cardiac CT, received immediate praise from imaging specialists.

Cardiovascular Business
GE HealthCare moves PET/CT scanner production to United States

The all-in-one Omni Legend PET/CT scanner is now being manufactured in a new production facility in Waukesha, Wisconsin.