Looking Beyond FDG PET

The reintroduction of 18F-NaF Sodium Fluoride for PET Bone Imaging is providing new opportunities for PET imaging programs, including positive impact on patient care and growth in scan volumes. It has also brought challenges, including unique scan protocols and interpretation issues. Physician specialists, including urologists, who may not be familiar with the imaging modality, are now key potential referrers. Sodium Fluoride PET is also associated with different reimbursement requirements and uneven coverage by CMS contractors and private insurance providers. For PET imaging programs, introducing this service represents a unique opportunity, but one which must be developed with proper preparation and follow-through.

IBA Molecular is aware of the unique requirements of this PET program, and the unique needs of the PET imaging site, and has created a wide-ranging, yet scalable package of training, education, outreach and administrative modules which can successfully prepare and support your site for 18F-NaF PET Bone Imaging. Working with IBA staff, you will be able to employ the key resources needed to introduce and sustain this segment of your PET business.

Ensuring a Quality Service to your Referrers
The IBA Sodium Fluoride PET Imaging Program begins with a range of onsite and online resources to help you assure the high quality of service your site must provide to its referring community. For physicians and technologists, that includes in-depth education on scan protocols, patient preparation and scan interpretation. Our NaF customers have access to this and much more in a comprehensive ¹⁸F NaF Tool Kit on PETLinQ IQ.

Did you know that clinical studies suggest that Sodium Fluoride (18F-NaF) PET and PET/CT imaging can impact the management of patient care for bone metastases?
 

• 18F-NaF PET and PET/CT are more accurate than 99mTc-diphosphonate SPECT for identifying malignant lesions of the skeleton^{2, 4, 6}
• 18F-NaF PET scans have shown a 25% improvement in sensitivity and specificity over conventional bone scans³
• 18F-NaF PET can allow accurate, early detection of breast cancer bone metastases, impacting patient therapy and improving care⁵
• 18F-NaF PET Scans typically reduce the preparation/uptake time for the patient, as well as the overall scanning time, compared to traditional bone scans (approx. 90 minutes overall vs. 4 hrs) ²

Streamlining Workflow and Ensuring Appropriate Reimbursement
Effective February 7, 2011, 18F-NaF is covered by Medicare for PET scans to detect bone metastases under the Coverage with Evidence Development (CED) framework. Under CED, facilities must register with the National Oncologic PET Registry (NOPR, at www.cancerpetregistry.org and enroll patients in the trial as specified by NOPR.  Available soon, IBA Molecular will be releasing our 2012 18F-NaF PET Bone Scan Reimbursement Guide for all customers.

To successfully complete the cycle of quality service and educated, engaged referrers, we need to ensure that the NaF PET imaging program has the information and processes in place to properly code procedures, submit claims and receive appropriate reimbursement. IBA has put in place staff and resources designed to assist your site in accessing the information you need to process these PET scans.

Making an Impact
Working together with IBA, 18F-NaF PET Bone Imaging Programs can make a significant impact on patient care in their community. Scientific literature suggests that this modality has the ability to detect metastatic bone lesions in more patients than SPECT or radionuclide bone imaging. That can result in better, earlier diagnosis and more effective treatments. The IBA 18F-NaF PET Imaging Support Program can provide your site the tools needed to set up, develop and maintain a high quality PET Bone imaging program, helping ensure its success and value in the medical community.

References

1. American Cancer Society, 2007 Facts, available at: www.cancer.org. Accessed July 1, 2009.
2. Grant FD, et.al. Skeletal PET with 18F-fl uoride: Applying New Technology to an old Tracer. J Nucl Med 2008 Jan;49(1):68-78.
3. A Bridges RL, et.al. An Introduction to Na18F Bone Scintigraphy: Basic Principles, Advanced Imaging Concepts and Case Examples. J Nucl Med Tech 2007;35:64-76.
4. Schirrmeister H, et.al. Sensitivity in Detecting Osseous Lesions Depends on Anatomic Localization: Planar Bone Scintigraphy Versus 18F PET. JNucl Med 1999 Oct;40(40):1623-9.
5. Schirrmeister H, et.al. Early Detection and Accurate Description of Extent of Metastatic Bone Disease in Breast Cancer with Fluoride Ion andPositron Emission Tomography. J ClinOncol 1999 August ;17(8):2381.
6. Petren-Mallmin M, et.al. Skeletal Metastases From Breast Cancer: Uptake of 18F-Fluoride Measured with PET in Correlation with CT. Skeletal Radiol 1998;27:72-76.

**Image provided courtesy of Grant FD, Fahey FH, Packard AB, Davis RT, Alavi A, Treves ST. Skeletal PET with 18F Fluoride: applying new technology to an old tracer. Journal of Nuclear Medicine. 2008 Jan;49(1):68-78.