Contribution of Imaging to Cancer Care Costs

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FIGURE 1.
Estimated contribution of all imaging modalities and PET alone to total Medicare cancer care expenditures in 2006. Estimates are based on data from Dinan et al. (6) and Potetz and DeWilde (15). These data reflect sample from study of Dinan et al. (6) and do not represent HOPPS or non–hospital-based imaging use data.

TABLE 1

Medicare-Approved Indications for PET in Oncology

Tumor type	Initial treatment strategy	Subsequent treatment strategy
Colorectal	Covered	Covered
Esophagus	Covered	Covered
Head and neck (not thyroid or central nervous system)	Covered	Covered
Lymphoma	Covered	Covered
Non–small cell lung	Covered	Covered
Ovary	Covered	Covered
Brain	Covered	CED
Cervix	Covered with exception^*	Covered
Small cell lung	Covered	CED
Soft-tissue sarcoma	Covered	CED
Pancreas	Covered	CED
Testis	Covered	CED
Breast (female and male)	Covered with exception^†	Covered
Melanoma	Covered with exception^‡	Covered
Prostate	Not covered	CED
Thyroid	Covered	Covered with exception or CED^§
All other solid tumors	Covered	CED
Myeloma	Covered	Covered
All other cancers not listed	CED	CED

↵* Cervical cancer nationally not covered for initial diagnosis.
↵† Breast cancer nationally not covered for initial diagnosis or staging of axillary lymph nodes.
↵‡ Melanoma nationally not covered for initial staging of regional lymph nodes.
↵§ Thyroid cancer nationally covered for subsequent treatment strategy for recurrent or residual thyroid cancer of follicular cell origin, previously treated by thyroidectomy and radioiodine ablation, with serum thyroglobulin level of greater than 10 ng/mL, and negative ¹³¹I whole-body scan results.
CED = coverage with evidence development.
(Adapted from (55).)