Cost Containment Corner – Nuclear medicine increasing patient safety at a lower cost

Cost Containment Corner – Nuclear medicine increasing patient safety at a lower cost

June 03, 2015
Yossi Srour
From the June 2015 issue of HealthCare Business News magazine
Over the past decade, much focus has been put on the high dose in nuclear medicine – and subsequent efforts to lower the dose. Devastating stories in the news media have called attention to it, and well-known initiatives like Image Wisely and Image Gently have, for years, been advocating for increased safety and lower dose.

As of Jan. 1, 2014, the American Society of Nuclear Cardiology guidelines to reduce total patient radiation exposure to less than 9 mSv per entire SPECT/PET myocardial perfusion imaging study in 50 percent of studies went into effect, and are the primary indication that nuclear medicine is looking to a safer future.

Guidelines are often the first step before a standard is mandated. But it’s not just the guidelines doing the talking; patients are also taking an increasingly active role in their health care – and that is extending to nuclear medicine.


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Today, it is the norm for patients to be more educated about their health, to do research, and question medical solutions presented to them. When it comes to low-dose nuclear medicine, health care organizations across the country are already experiencing the influx of educated and informed patients who are aware of the high radiation exposure and asking for the lowest dose possible. This trend hasn’t been ignored.

At the approaching annual Society of Nuclear Medicine and Molecular Imaging conference, a unique Patient Education Day has been entirely dedicated to exploring issues and concerns from a patient perspective.

Low cost can equate to increased safety
Safer imaging means a lower dose. Hospitals and health systems need to identify solutions that will enable the lowest dose possible without compromising the image quality that physicians so much depend upon. When it comes to low dose, there are currently three available options. The first requires an investment in a brand new SPECT/CT camera.

While physicians can acquire high-quality myocardial perfusion SPECT scans with half the radiopharmaceutical activity and with a half-time acquisition, at a capital investment of $500,000 and upwards per scanner, this solution is prohibitive for most. There are, however, two options where increased patient safety equates to low cost.

For some facilities, that solution is the implementation of a stress-only imaging protocol. In general, both the stress and rest parts of the exam are necessary, but for certain patients the stress-only part of the study can be done; as a result, radiation dose is cut nearly in half. But to do stress-only imaging well, attenuation correction is needed, and only a few labs have this capability.

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