Tracing Patient Outcomes
The chair of the annual PET/CT Symposium discusses today’s trends, the intersection of PET/CT and Imaging 3.0™, and what attendees from any specialty can take from this year’s meeting.
The Bulletin sat down with PET/CT Symposium chair Eric M. Rohren, MD, PhD, chief of PET imaging at the University of Texas MD Anderson Medical Center in Houston, to discuss what’s new in PET/CT, what to expect at this year’s symposium, and how radiologists can create value in PET/CT.
Q: What are some of the hot topics in PET/CT right now?
A: Number one is the expansion of oncologic indications for fluorodeoxyglucose (FDG) PET/CT. In the last year or so, we’ve seen increasing utilization of PET/CT as CMS opens up the indications for using PET/CT imaging to include not only standard tumors, but also the more rare and unusual cases. I’m very excited about the possibility of expanding FDG PET/CT utilization into these new areas.
Another exciting trend is the growth in non-oncologic PET/CT. With some of the newer tracers, we’re seeing broader applications in cardiology and neurology, especially related to neurodegenerative disease and Alzheimer’s disease.
We’re also seeing growth in novel tracers. We’ve relied on tracers like FDG and sodium fluoride for many years, but finally we’re seeing new tracers come to the forefront and gain approval from the FDA. Tracers such as carbon-11 choline for prostate carcinoma and amyloid imaging compounds for the assessment of neurodegenerative disease.
Q: How is this course different from last year’s?
A: The main thing we’ve focused on this year is to make this course as practical as possible. We want people to leave with information that can help them on a day-to-day basis as they interpret PET/CT.
And by staying current on the applications of PET/CT, attendees can provide high-quality care that will lead to increased referrals in their community.
One thing we are keeping from last year’s conference is the presence of referring clinicians. This has been an extremely valuable part of the course in past years. Having neurologists, oncologists, and radiation oncologists share their perspectives on a clinician’s expectations when ordering PET/CT helps attendees anticipate their colleagues’ needs and provide them with clinically valuable information.
In alignment with the Imaging 3.0™ initiative, we’re moving into an era in which imaging is no longer going to be reimbursed on the basis of volume, but instead is going to be reimbursed on the basis of outcome and value. Understanding our stakeholders and their needs really helps us boost quality and impact patient outcomes. And that’s really what it’s all about.
Q: What about radiologists whose work is not entirely focused on reading PET/CT? Is there any content in this course for them?
A: This course has something to offer for everyone! PET/CT has really become the mainstream modality in the evaluation of patients with cancer, neurologic conditions, and cardiac disease. Radiologists with all areas of expertise are now being asked to correlate these studies with their CTs and MRIs. At tumor boards, these cases are coming up during readouts. And what better way to show the value of PET/CT than to have knowledge of what it can offer and convey that knowledge to your referring clinician?
Q: What are some of the common pitfalls of PET/CT interpretation?
A: The biggest pitfall I see is the vague report. PET/CT gathers a lot of information, and synthesizing that information into a cohesive and readable report is a challenge. A report that just describes findings without giving any guidance is going to be perceived as unhelpful for both the patient and the referring clinician. On the other hand, a report that synthesizes the information into something readable and understandable is going to improve patient outcomes and build relationships with referring physicians.
Q: Day Two of the course is focused on the business aspect of PET/CT. Why is it important for radiologists to take a well-rounded view of their PET/CT practice, instead of focusing solely on clinical skills?
A: As much as clinical interpretation and generating a quality report is central to the success of the PET/CT practice, we can’t lose sight of the business aspect either. Understanding the indications, the appropriate utilization, and the ins and outs of insurance reimbursement are significant components of running a successful PET/CT practice.
For this year’s course, we’ve brought in speakers who really understand these reimbursement issues and can demonstrate how you interact with third-party payers and with medical directors to emphasize the value that PET/CT brings to our patients.
Q: How does the content at this course relate to Imaging 3.0?
A: We’re in for big changes in the realm of medical reimbursement. To succeed in the future and to grow our practices, we need to demonstrate that what we do has a direct impact on patient outcomes. And I think PET/CT is the perfect poster child to demonstrate the role of imaging in terms of outcome and patient management. Since the very inception of clinical PET imaging, CMS and third-party payers have asked for data to justify the approval of FDG-PET/CT for reimbursement every step of the way, and we are ready to carry this practice forward into the future.