A recent study from the Johns Hopkins School of Medicine supports the value of using fourth and subsequent positron emission tomography/computed tomography (PET/CT) scans for the clinical assessment of patients with lung cancer. The research, also published in the February 2015 issue of The Journal of Nuclear Medicine, follows a decision from the Centers for Medicare & Medicaid Services (CMS) that allows coverage for only three fluorodeoxyglucose (FDG) PET/CT scans after completion of initial anticancer therapy. The findings could hold implications for future reimbursement policies for patients with lung cancer.
“Although the value of FDG PET/CT has been established in the follow-up of patients with lung cancer, this study specifically looks at the value of the fourth and subsequent follow-up PET/CT studies, which has not been addressed in any prior studies,” said Rathan Subramaniam, MD, PhD, lead author of the study.
The retrospective study followed 1,171 patients with lung cancer who received PET scans with a radioactive tracer (18F-FDG) between 2001 and 2013. Of these, 85 patients received four or more PET/CT scans, for a total of 285 fourth and subsequent scans. Forty-seven patients (55.3%) died during the study period.
Among the 285 follow-up scans, 149 (52.28%) were found positive for recurrence or metastasis and 136 (47.7%) were interpreted as negative. The scans identified recurrence or metastasis in 44.3% of cases without prior clinical suspicion and ruled out recurrence or metastasis in 24.2% of cases without prior clinical suspicion. The PET/CT scans also effected treatment change in 28.1% of the patients: new treatment was initiated for 20.4% (58/285) of the scans, treatment was changed for 5.6% (16/285), and ongoing treatment was stopped in 2.1% (6/285).
Lung cancer is the leading cause of cancer deaths in the United States. In 2014, approximately 224,210 new diagnoses of the disease were expected, according to the American Lung Association.
Authors of the article “FDG PET/CT & Lung Cancer: Value of Fourth and Subsequent Post Therapy Follow up Scans for Patient Management” include Alexander Antoniou, Charles Marcus, Vasavi Paidpally, Rathan M. Subramaniam, Richard L. Wahl, and Atif Zaheer of the Russell H. Morgan Department of Radiology and Radiological Sciences Johns Hopkins School of Medicine in Baltimore.
For more information, visit The Journal of Nuclear Medicine.
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