![]() PET scanning is considered investigational in the evaluation of breast cancer for all other applications, including but not limited to the following: Detecting locoregional or distant recurrence or metastasis (except axillary lymph nodes) when suspicion of disease is high and other imaging is inconclusive.PET scanning may be considered medically necessary in the staging or restaging of breast cancer for the following application: PET scanning may be considered medically necessary in the staging or restaging of brain cancer. PET scanning is considered investigational in the staging of chondrosarcoma. PET scanning may be considered medically necessary in the staging or restaging of Ewing sarcoma and osteosarcoma. PET scanning is considered investigational for bladder tumors that have not invaded the muscle (stage ![]() In addition to the clinical situations identified below, benefits may be allowed for indications and criteria recognized in the National Comprehensive Cancer Network Guidelines (NCCN Guidelines) that is supported by NCCN 1 or 2A recommended use. If the results will not influence treatment decisions, these situations would be considered not medically necessary. For follow-up after initial diagnosis and staging have been performed, there are a few situations in which PET can improve detection of recurrence, and lead to changes in management that improve the net health outcome.Īll policy statements apply to both positron emission tomography (PET) scans and PET plus computed tomography (CT) scans, (i.e., PET scans with or without PET/CT fusion).įor the clinical situations indicated that may be considered medically necessary, this assumes that the results of the PET scan will influence treatment decisions. Therefore, PET scanning for diagnosis and staging of malignancies can be considered medically necessary when specific criteria are met for specific cancers, as outlined in the policy statements. In general, PET scanning can distinguish benign from malignant masses in certain circumstances and improve the accuracy of staging by detecting additional disease not detected by other imaging modalities. The utility of PET scanning for the diagnosis, staging and restaging, and surveillance of malignancies varies by type of cancer. The radionuclide tracers simultaneously emit two (2) high-energy photons in opposite directions that can be simultaneously detected (referred to as coincidence detection) by a PET scanner, comprising multiple stationary detectors that encircle the area of interest. Positron emission tomography (PET) scans are based on the use of positron-emitting radionuclide tracers coupled to organic molecules, such as glucose, ammonia, or water.
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