The National Oncologic PET Registry

摘要

The National Oncologic PET Registry (NOPR) is a nationwide registry that allows for expanded Medicare coverage of positron emission tomography (PET) with fluorine 18 (~(18)F) fluorodeoxyglucose (FDG) for the diagnosis and management of patients with malignancies. The NOPR is sponsored by the Academy of Molecular Imaging (AMI) and is administered by the American College of Radiology (ACR) through the American College of Radiology Imaging Network. The NOPR was one of the first programs established in response to the "coverage with evidence development" (CED) approach announced by the Centers for Medicare & Medicaid Services (CMS) in January 2005. Under CED, the agency links Medicare coverage of certain promising technologies to the novel requirement for prospective collection of clinical, demographic, and outcome data. The NOPR provides, for the first time, nearly comprehensive coverage for oncologic applications of FDG PET, although there are some remaining noncovered conditions. Historically, CMS had declined to provide coverage for FDG PET for many cancer types and indications because of insufficient evidence to support those uses of PET in the peer-reviewed literature and documentation that such use would lead to improved health outcomes. Without coverage by either Medicare or private payers, it has been difficult to perform the clinical research necessary to demonstrate to CMS that broader coverage is appropriate. Under CED, coverage of a particular service is contingent on the collection of specific clinical data, which will assist CMS in evaluating whether the service is "reasonable and necessary," the statutory threshold for coverage under Medicare (1).