Medicare approves FDG-PET for cervical cancer staging

Medical imagers can now expect Medicare to routinely cover FDG-PET for initial staging of cervical cancer, thanks to a national coverage ruling announced Nov. 10.

The Centers for Medicare and Medicaid Services reconsidered an earlier decision against coverage. Ruling on an appeal, it concluded that enough clinical evidence has been published to show that FDG-PET helps guide the clinical management of cervical cancer patients and has a positive effect on patient outcomes.

Because of the ruling, Medicare will reimburse providers for a single FDG-PET procedure for staging Medicare beneficiaries with biopsy-proven cervical cancer. The findings are to be used to determine the location and extent of the cervical carcinoma for any of the three following therapeutic roles: :

• To judge if the patient is a good candidate for invasive diagnostic or therapeutic procedures

• To determine the anatomic site for an intervention

• And to measure the anatomic extent of tumors targeted for therapy.

Dr. Michael M. Graham, SNM president, welcomed the decision.

"It makes excellent sense to approve reimbursement for using FDG-PET to stage cervical cancer," he said in an interview. "Just as it has proved useful for other malignancies, it is going to become the standard of care in staging carcinoma of the cervix."

Previously, patients needing PET for initial staging of cervical cancer had to have the scan performed under the CMS coverage with evidence development policy if the patient had not first had CT or MRI performed or if other imaging was done but showed evidence of metastatic disease outside the pelvis. Based on the strong body of evidence, CMS concluded that FDG-PET can provide physicians with important information on how to treat patients with cervical cancer without the need for these restrictions, according to the SNM.

About 11,000 newly diagnosed cases and 4000 deaths are attributed to cervical cancer annually. Recommended treatment depends on the cancer stage, which is determined by the metastatic status of the disease.