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: 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
[Show abstract][Hide abstract] ABSTRACT: Recent developments in neuroimaging have allowed better qualification and quantification of the effects of hypertension (HTN)
on the brain in vivo. Although magnetic resonance imaging (MRI) is generally recognized to be the most sensitive imaging modality
to the effects of HTN, computerized tomography (CT), positron emission tomography (PET), and single photon emission tomography
(SPECT) still provide useful information in many circumstances. CT is the most prevalent imaging modality used throughout
the world due to both its availability and relatively low cost. The recent introduction of multislice rapid CT scanners has
increased its sensitivity to many of the effects of HTN on the brain, and it has reinvigorated interest in the use of CT not
only for clinical assessment but also in basic and applied clinical research. Similarly, there has been an increase in the
use of PET to characterize the metabolic effects of HTN with the relatively recent advances and use of 2-[18F] fluoro-2-deoxy-d-glucose (FDG) PET (FDG-PET). The purpose of the current chapter is to describe the advances in CT, MRI, and PET for characterizing
these effects on the brain.
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.