Status of and Trends in Nuclear Medicine in the United States

Abstract

Nuclear medicine in the United States has grown because of advances in technology, including hybrid imaging, the introduction of new radiopharmaceuticals for diagnosis and therapy, and the development of molecular imaging based on the tracer principle, which is not based on radioisotopes. Continued growth of the field will require cost-effectiveness data and evidence that nuclear medicine procedures affect patients' outcomes. Nuclear medicine physicians and radiologists will need more training in anatomic and molecular imaging. New educational models are being developed to ensure that future physicians will be adequately prepared.Key Words: nuclear medicine; statistics; status; trends J Nucl Med 2011; 52:24S-28S DOI: 10.2967/jnumed.110.085688Nucl ear medicine has a history of decades of strong growth, particularly in nuclear cardiology and PET/CT. In the United States, the number of nuclear medicine procedures has grown from approximately 14 million in 1999 to almost 20 million in 2005 (1). After 2005, however, it dropped to about 17 million. Most nuclear medicine procedures are performed in hospital-based settings, but the number performed in nonhospital settings has grown over time to one third of all nuclear medicine procedures in 2008.In the United States, the growth of nuclear medicine procedures is due primarily to nuclear cardiology, which has grown from about 7 million procedures in 1999 to about 11 million in 2005 (1). Nuclear cardiology represents more than 50% of the nuclear medicine procedures done in the United States but represents only 14% of those done in Europe. A study performed in 2007 investigated the worldwide use of nuclear cardiology (2). The study findings indicated that nuclear cardiology procedures were used most extensively in the United States, with 1,000 or more procedures performed per 100,000 people (Fig. 1).Bone scintigraphy is the next most common nuclear medicine procedure performed in the United States, but it represents only 17% of procedures (1). Bone scintigraphy represented 36% of procedures performed in Europe in 2008.The volume of PET procedures in the United States is approximately 1.5 million per year (3). Oncology accounts for more than 90% of the PET and PET/CT procedures performed, whereas cardiology and neurology account for about 4% each (3). According to the National Oncology PET Registry, about 84% of the slightly more than 1,600 PET facilities in the United States have PET/CT systems (4). The emergence of molecular imaging with new radiopharmaceuticals and new technologies is likely to result in continued growth in the coming decades.Efforts to control spiraling health care costs have resulted in decreased reimbursement for medical imaging and the need to provide evidence that patients' outcomes are improved by diagnostic tests and therapies. Radiology benefit managers have become gatekeepers for insurance plans, but without evidence to ensure the appropriate use of medical imaging, coverage decisions are frequently based on cost. Downward pressure on nuclear me...

Targeted Radionuclide Therapy: Proceedings of a Joint Workshop Hosted by the National Cancer Institute and the Society of Nuclear Medicine and Molecular Imaging

“…One challenge that should be considered by stakeholders is to identity ways to propel existing data on TRT forward more quickly in support of U.S. approvals. Another challenge is to directly address the various logistic problems cited in the workshop: limited access to TRT for patients and providers, perceived high cost, turf issues, patient perceptions and fears, and the need for multidisciplinary teams supported by strong TRT education efforts (123)(124)(125)(126)(127)(128)(129)(130)(131)(132).…”

Introduction

“…PET/CT (1) has become the state of the art in diagnostic oncology; SPECT/CT is increasingly used in several fields of nuclear medicine; and a further hybrid imaging technology, PET/MRI, is entering initial clinical studies. Delbeke et al (2) and Dondi et al (3) provide overviews of how these new technologies are affecting the practice of nuclear medicine in the United States and in developing countries, respectively. The implementation and adoption of hybrid imaging approaches mandate fundamental changes in the nuclear medicine training curricula for both physicians and technologists.…”

PET Measurement of Renal Glomerular Filtration Rate: Is There a Role in Nuclear Medicine?

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