This short review focuses on practical, present day, clinical application of FDG PET, a technology available to practicing neurologists for managing their patients. Indications in the disease states of dementia, neuro-oncology, epilepsy, parkinsonism, and other less common settings are reviewed. Many third-party payers currently make reimbursements based on these indications. By measuring an aspect of brain function, PET provides information that often is unobtainable from other sources, thus facilitating more rationale and cost-effective management, which can only benefit the patient, the referring physician, and the health care system as a whole.
[Show abstract][Hide abstract] ABSTRACT: The most significant finding to date is the identification of what potentially may prove to be a central mechanism of cognitive impairment following traumatic brain injury. Although data collection is on-going as is data analysis, we focused in year 1 on validating and implementing analysis of integrity of thalamic projection fibers in a subgroup of 12 controls and 24 patients with TBI. The data show that cortical damage, long thought to be the underlying mechanism of impairment, does not account for cognitive impairment. Instead, our data demonstrate a strong relationship between thalamic projection fibers and executive function. A version of the manuscript is included. The data has been presented at the military research health conference, society for neurotrauma, and will be presented at the upcoming society for neuroscience. The manuscript received positive reviews at the first submission to Neurology and a revision is presently undergoing peer review at that journal.
[Show abstract][Hide abstract] ABSTRACT: Hypoxic-ischemic brain injury (HI-BI) is a common cause of neurological morbidity in children and adults. Recent developments in neuroimaging techniques may permit in vivo identification of the structural and functional anatomy of HI-BI, and offer opportunities for the development of neuroimaging-guided prognosis. This article provides an update on the types and possible roles of currently-available neuroimaging techniques. The applications and limitations of these techniques to the study and clinical evaluation of persons with HI-BI are discussed, and the need of further research is highlighted.
[Show abstract][Hide abstract] ABSTRACT: Emerging technologies, changing diagnostic and treatment patterns, and changes in Medicare reimbursement are contributing to increasing use of imaging in cancer. Imaging is the fastest growing expense for Medicare but has not been examined among beneficiaries with cancer.
To examine changes in the use of imaging and how those changes contribute to the overall cost of cancer care.
Analysis of a nationally representative 5% sample of claims from the US Centers for Medicare & Medicaid Services from 1999 through 2008. Patients were Medicare beneficiaries with incident breast cancer, colorectal cancer, leukemia, lung cancer, non-Hodgkin lymphoma, or prostate cancer.
Use and cost of imaging by modality, year, and cancer type.
There were 100,954 incident cases of breast cancer, colorectal cancer, leukemia, lung cancer, non-Hodgkin lymphoma, and prostate cancer from 1999 through 2006. Significant mean annual increases in imaging use occurred among all cancer types for positron emission tomography (35.9%-53.6%), bone density studies (6.3%-20.0%), echocardiograms (5.0%-7.8%), magnetic resonance imaging (4.4%-11.5%), and ultrasound (0.7%-7.4%). Conventional radiograph rates decreased or stayed the same. As of 2006, beneficiaries with lung cancer and beneficiaries with lymphoma incurred the largest overall imaging costs, exceeding a mean of $3000 per beneficiary within 2 years of diagnosis. By 2005, one-third of beneficiaries with breast cancer underwent bone scans and half of beneficiaries with lung cancer or lymphoma underwent positron emission tomography scans. Mean 2-year imaging costs per beneficiary increased at a rate greater than the increase in mean total costs per beneficiary for all cancer types.
Imaging costs among Medicare beneficiaries with cancer increased from 1999 through 2006, outpacing the rate of increase in total costs among Medicare beneficiaries with cancer.
JAMA The Journal of the American Medical Association 04/2010; 303(16):1625-31. DOI:10.1001/jama.2010.460 · 35.29 Impact Factor
Data provided are for informational purposes only. Although carefully collected, accuracy cannot be guaranteed. The impact factor represents a rough estimation of the journal's impact factor and does not reflect the actual current impact factor. Publisher conditions are provided by RoMEO. Differing provisions from the publisher's actual policy or licence agreement may be applicable.