From the June 2015 issue of HealthCare Business News magazine


In addition to doing similar things to SPECT, in some ways PET imaging with sodium fluoride is an improvement. “[It has] two times the uptake in the bone and the blood clearance is faster,” says Alvarez, “and because of the advancements of PET imaging technology, you get a higher resolution image.”

CMS currently covers sodium fluoride scans through participation in the National Oncologic PET Registry (NOPR), a requirement under the agency’s “coverage with evidence development” approach to evaluating products. Alvarez says he is optimistic that the clinical value of sodium fluoride PET will encourage CMS to offer national coverage for these studies, adding that the availability of sodium fluoride throughout the U.S. could provide an added incentive.


“Do I see it replacing SPECT bone imaging completely? I don’t think so. But it is realistic to see its utilization for the evaluation of metastatic disease for certain cancers, such as prostate cancer, being higher than SPECT bone imaging,” says Alvarez.

Zebrick agrees that sodium fluoride for PET has tremendous potential, but stresses the expense of PET, an emerging technology, compared to the relative low cost – and significantly larger install base – of SPECT.

For Atcher, the high level government nature of conversations about Tc-99m deal too heavily in the back-end of the conversation. “It’s always frustrating for the people actually doing these procedures – the physicians and technologists – to realize they are incredibly dependent on decision making that leaves them out of the process.”


EDIT: An earlier version of this story indicated SHINE had entered an agreement with Lantheus Medical that was "similar" to the non-exclusive letter of intent that NorthStar had signed with GE. The revised version clarifies that SHINE has entered supply agreements with Lantheus Medical and GE.

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