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Pharmacology / Nuclear Medicine

UCLA offers PET/CT with sodium fluoride tracer for bone scans


PET-CT Bone ScansPatients with cancers that are prone to spread to the bones typically receive bone scans using Single-Photon Emission Computed Topography (SPECT) technology. But published studies suggest that physicians may get more accurate information in less time from Positron Emission Tomography with Computed Tomography (PET/CT) using a new kind of tracer called F-18 sodium fluoride (NaF). UCLA Radiology and the Ahmanson Biological Imaging Center are proud to offer NaF PET/CT scans, which are now eligible for Medicare reimbursement, in both their Westwood and Santa Monica locations.

Advantages of NaF PET/CT bone scans

Bone scans using radioactive tracers can provide detailed information on the spread of cancer to the bones. Conventional bone scans using SPECT technology use the radioactive isotope of technetium as a tracer. A shortage of technetium, which is produced in only a handful of nuclear reactors around the world, can lead to delays for patients needing to undergo such exams. By contrast, there are no waits for the PET/CT scans because sodium fluoride can be produced on demand in a cyclotron.

PET/CT scans are also more patient-friendly than conventional scans. While both require patients to receive an injection of a radioactive tracer, the uptake period (the amount of time the substance needs to circulate in the patient’s system before the scan) is just 30 minutes for sodium fluoride, compared to three hours for technetium-based tracers. Patients also spend just 20 minutes in the scanner with PET/CT technology compared to 45 minutes for conventional SPECT exams. Although NaF PET/CT scans deliver a slightly higher dose of radiation than technetium-based SPECT scans (5 mSv versus 7.4 mSv), the overall radiation exposure is still low and NaF PET/CT may prove accurate enough to reduce the need for additional imaging tests, leading to lower overall radiation exposure with NaF PET/CT scans.

How to order NaF PET/CT bone scans for Medicare reimbursement

The National Oncologic PET Registry (NOPR) is currently collecting data on the usefulness of PET with sodium fluoride for the evaluation of proven or strongly suspected metastatic disease to the bone. Medicare-eligible patients can receive reimbursement for the scans from the Centers for Medicare & Medicaid Services under the “coverage with evidence development” program. To qualify for reimbursement, referring physicians must complete data collection forms both before and after the scans. The pre-scan form must be returned to the PET facility before the scan takes place. The post-scan form must be returned to the PET facility within 30 days for Medicare reimbursement. There is no charge to physicians who refer patients to the study. Forms are available at the NOPR website at http://www.cancerpetregistry.org/naf-petform.htm

Better than conventional bone scans

Until recently, Medicare and Medicaid reimbursed only for conventional bone scans in patients whose cancers were suspected to have spread to their bones. But a research program run by the Centers for Medicare & Medicaid Services now allows eligible Medicare patients to receive reimbursement for NaF PET/CT scans.

“It’s important for referring physicians to be aware that this type of scan exists, and that the data available to date from various studies show that a PET/CT scan with the NaF tracer is actually a better test for bone imaging,” says Martin Allen-Auerbach, M.D., clinical director of the Division of Nuclear Medicine in UCLA’s Department of Molecular & Medical Pharmacology.

The test is particularly helpful in determining the presence of bone metastases in patients with cancers of the prostate, breast, lung kidneys and thyroid — cancers that are prone to spread to the bones, he says.

“From the scientific data that’s available, PET/CT with NaF is the better exam,” Dr. Auerbach says. “It’s more sensitive and more specific than a regular bone scan.”

Contact Information UCLA
Nuclear Medicine Services

200 UCLA Medical Plaza Suite B114
Los Angeles, CA 90095
(310) 794-1005
Santa Monica
1245 16th Street, Suite 105
Santa Monica, CA 90404
(310) 319-4970

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