News | November 12, 2009

CMS to Cover FDG-PET for Initial Staging of Cervical Cancer

November 12, 2009 - Centers for Medicare & Medicaid Services' (CMS) will expand coverage of FDG-PET for the initial staging of cervical cancer without previously imposed restrictions.

Under the decision, CMS will cover one FDG-PET scan for the staging of cervical cancer. In these cases, physicians can determine the precise location of the tumor and identify the extent to which the tumor has grown. Physicians can then use this information to determine the optimal initial treatment strategy for each individual patient. Additionally, this can help physicians determine whether or not the patient would benefit from further diagnostic tests or therapeutic procedures. Through expanded coverage, physicians can provide patients with an individualized course of therapy—meaning the right treatment at the right time.

The Society for Nuclear Medicine (SNM) applauds this decision. "CMS' decision to expand coverage of FDG-PET for the initial treatment strategy evaluation of cervical cancer is important for patient care," said Michael M. Graham, Ph.D., M.D., president of SNM. "Over the years, the body of scientific evidence has proven the value of molecular imaging scans for diagnosing, staging, restaging and monitoring treatment for many cancers."

SNM and other medical societies encouraged CMS to end the prospective data collection requirements for FDG PET for the initial staging of some patients with cervical cancer. Previously, patients needing PET for initial staging of cervical cancer had to have this performed under the CMS coverage with evidence development policy, if the patient had not first had CT or MRI performed or if other imaging was done but showed evidence of metastatic disease outside of the pelvis. Based on the strong body of evidence, CMS concluded that FDG PET can provide physicians with important information for how to treat patients with cervical cancer without the need for these restrictions.

The recent decision from CMS derives in part from data collected by the National Oncologic PET Registry (NOPR)—a comprehensive study to assess the value of FDG PET for the initial diagnosis, staging and treatment of many common types of cancer. In April 2009, CMS made a decision to expand coverage of FDG PET for breast, cervical, colorectal, esophageal, head and neck, lymphoma, melanoma, non-small cell lung and thyroid cancers.

NOPR is sponsored by the Academy of Molecular Imaging (AMI) and managed by the American College of Radiology (ACR) and ACR Imaging Network (ACRIN). The registry received input from—and is endorsed by—ACR, the American Society for Clinical Oncology (ASCO) and SNM. The NOPR Working Group is chaired by Bruce Hillner, M.D., of Virginia Commonwealth University and co-chaired by Barry Siegel, M.D., Washington University; R. Edward Coleman, M.D., Duke University; and Anthony Shields, M.D., Wayne State University.

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