From the June 2014 issue of HealthCare Business News magazine


One of the big hurdles thought to stand in PET/MR’s way was the fact that there was no dedicated PET/MR CPT code for reimbursement. But that changed last June when CMS, in response to a request from the National Oncologic PET Registry, issued a decision memo both expanding coverage and clarifying its position on PET/ MR by including FDG PET/MR in their definition of FDG PET.

“In light of this decision, our customers are building business models based on established PET and MR indications, facilitating clinical adoption of the technology where it makes the most sense for the patient,” says Siemens’ Voorhees. Even though research is showing that PET/MR has promise in certain applications and it’s starting to come into the clinical setting, many experts are still critical of it.


“I don’t think it’s going to be something that you’re going to see proliferating like how PET/CT was proliferating initially into the community,” says Dr. Hossein Jadvar, president of the Society of Nuclear Medicine and Molecular Imaging’s PET Center of Excellence and vice president-elect of the society. “I don’t think this is going to happen like that — it’s going to take much longer.”

Its high capital cost is one of its turn-offs. “When it comes back to the cost of MRI — they’re selling for five million dollars-plus, but PET/CT is only two million dollars,” says University of Pennsylvania’s Alavi.

Additionally, hospitals want to know that they will make the money back after purchasing it. “People should be able to buy the device and should be able to in a reasonable amount of time, pay for the initial investment and get paid for those studies,” says Jadvar.

Even though CMS is including FDG PET/MR in its definition of FDG PET, Jadvar questions if they will pay significantly above PET/ CT so that hospitals will be able to justify the purchase of such an expensive machine.

Another drawback is the amount of time it takes to acquire an image. A whole body CT scan takes about 20 to 30 seconds, but an MR scan can take up to an hour.

But Herrmann and her fellow researchers are working to solve that problem. “We are improving and optimizing the process of developing appropriate imaging protocols so that we can perform the two exams within a reasonable amount of time and with the benefit of a better diagnosis,” she says.

A big question that is not answered right now is — who should be interpreting the exams? Should it be the radiologist, nuclear medicine physician or MRI technologist?

Jadvar says he and other doctors are starting to address the question. He is currently co-chairman of the SNMMI-ACR Joint Task Force of PET/MRI Credentialing, which is attempting to come up with that guideline for brain PET/MR interpreters.

June 2014 Magazine

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