PET/CT
As the name implies, PET/CT is a "marriage" of two separate technologies into one imaging device, the PET/CT scanner. PET (Positron Emission Tomography) uses an injected radioactive tracer to measure the metabolism, or function, of both diseased and healthy tissue in the body. CT (Computed Tomography) uses X-Rays to produce high resolution anatomic images of the body. By bringing these two technologies together in a single scan, physicians are able to view high quality 3D images within the body and to more accurately determine the location and extent of disease.
One of the most important factors in the fight against diseases, such as cancer, is early detection and diagnosis. PET/CT can detect changes in cell function long before they are evident as physical or anatomic changes seen on CT or MR.
PET/CT is particularly useful in the evaluation of lung cancer, colon cancer, head and neck cancer, breast cancer, lymphoma, melanoma, and many other types of cancer. Using PET/CT to detect cancer at earlier stages allows in many cases for physicians to plan more effective treatments, whether that involves surgery, chemotherapy or radiation therapy. In many cases, unnecessary surgeries may be avoided. PET/CT imaging is sometimes utilized in radiation therapy treatment planning in order to pinpoint disease location and spare surrounding healthy tissue.
In addition, PET/CT is an excellent tool for distinguishing between Alzheimer’s and other types of dementia.
PATIENT PREPARATION FOR PET/CT
Please adhere to following instructions for a successful PET/CT scan:
- No strenuous physical activity 24 hours prior to exam
- Low Carbohydrate/High Protein dinner the night before exam
- Drink plenty of water the day of exam
- No food or drink (other than water) 4-6 hours prior to exam
- Prescription medicine that does not require food may be taken as usual; insulin may be used if taken 2 hours or more prior to exam
- If you require pain or anti-anxiety medication in order to complete your exam, please make arrangements for a driver. In most cases, you should wait to take these medications until instructed by the technologist; please inform the technologist if you have these types of medicine to take.
- Notify your physician if you are pregnant, breast-feeding, or diabetic
- Wear warm, comfortable clothing (preferably without metal snaps or zippers)
- Do not wear jewelry
WHAT TO EXPECT
On the day of the exam, the technologist will escort you to a preparation area where you will be injected with a radioactive labeled tracer called F-18 FDG (Fluorodeoxyglucose). There are no side-effects associated with this injection. You will receive a diagnostic dose of radiation from the injection.
The tracer material circulates through your body and is metabolized, or "used", by the cells in the body. Highly metabolic, or rapidly growing, cells, such as cancer will take up more of the radioactive tracer than normal cells. The PET scan is able to detect, measure, and visualize these differences in activity. You will be asked to rest quietly in the preparation area for a period of 60-90 minutes, depending on the diagnosis for the test.
After the resting period, you will be instructed to empty your bladder before going to the imaging table. You may be asked to change clothing; scrubs or gowns are provided. Once comfortably positioned on the imaging table, you will be asked to lie still and breathe normally throughout the imaging time, which is typically about 30-45 minutes. The technologist will instruct you throughout the exam.
After the exam is completed, you may resume normal activities in regards to diet, exercise and medications.
The images will be evaluated by the Radiologist and a complete report sent to the ordering physician; your physician will review the results with you.
The National Oncologic PET Registry
Center for Medical Imaging has been performing PET/CT scans and participating in the National Oncologic PET Registry (NOPR) since our doors opened in 2006. The PET Registry has enabled Medicare patients to obtain access to PET/CT scans for cancer diagnoses and indications that would otherwise not have been covered.
On April 3, 2009, the Centers for Medicare and Medicaid Services (CMS) released a National Coverage Determination (NCD) that expands coverage to more cancers than ever before. Although this NCD did not bring about the broad coverage that many hoped to see, it has significantly improved the access process for many Medicare patients.
Key changes to the coverage include:
- 2 level treatment stratification
- Initial Treatment Strategy(formerly Diagnosis and Initial Staging)
- Subsequent Treatment Strategy (formerly Restaging, Treatment Monitoring, and Suspected Recurrence)
- Expanded coverage for Initial Treatment for cancers such as cervical, ovarian, testicular, pancreatic, small cell lung, bladder, sarcoma, and many others.
- Expanded therapy monitoring coverage for lymphoma, melanoma, myeloma, head/neck, esophageal, non-small cell lung, colorectal, cervical, and ovarian cancers
The NOPR continues to function, albeit modified, as the doorway for Medicare reimbursement for such patients as those for initial treatment of leukemia and for subsequent treatment for a myriad of cancers, including prostate. However, it is important to note that initial treatment of prostate cancer is not covered by Medicare or NOPR.
How does this affect our patients and referring physicians? Our hope is that referrals for Medicare covered patients for PET/CT scans will be much easier. Our goal is to continue to provide with exceptional quality imaging with ease of scheduling.
Our knowledgeable staff will provide guidance when a diagnosis or indication requires entry into NOPR. When NOPR is required, Pre- and Post-PET forms will be sent to the referring physician’s office. Patients are not required to complete any paperwork, but will be asked if they will allow data from their exam to be included in the NOPR research project – Medicare coverage of the exam will occur regardless of patient’s answer; only whether the data will be included in the NOPR is affected by patient answer.