The PET debate is a hot topic. Below are two of the comments we received about Wayne Webster's article in last week's DOTmed News, "Is There Life After PET?" The first response is from Scott A. Welpe, CNMT. The second is from Douglas J. Wagenaar, PhD.

From: Scott A. Welpe, CNMT --
In response to the Wayne Webster article published January 25, 2007, Is there life After PET? I ask has plain film been replaced by CT? Has MR been run out of town by the more cost effective CT? Has nuclear medicine been abolished by PET? Obviously the answer is no to all of the above and the reply will be the same in 60 months for the proposition that SPECT/CT will replace PET/CT. As each modality emerges or expands it creates a stir, inevitably it encroaches on territory of another, and eventually finds its place and acceptance in the physicians arsenal of diagnostic abilities to accurately stage and treat their patients.


Access to PET Radiopharmaceuticals:
PETNET Pharmaceuticals is the largest of all vendors supplying FDG through a network of radiopharmacies that is capable of supplying PET isotopes to 98% of all the hospital beds in the United States. Add to the mix two other large pharmaceutical companies and the host of independent pharmacies, I feel justified dismissing the notion that there is an issue with accessibility to FDG. Additionally the Bracco Rb82 generator can be supplied to the most remote of regions and enables 24/7 access to PET cardiac imaging. These two radiopharmaceuticals cover 99% of the Oncology, Neurology and Cardiology clinical imaging done in PET/CT today. As market leaders, PETNET, Bracco and others certainly "participate and support the market with product, distribution, education and regulatory" at clinical through congressional levels. Development and FDA approval of the PET pharmaceuticals is not inexpensive, and I believe there is not one pharmaceutical manufacturer that will disagree with the statement, though we see the introduction of dozens of new drugs every year. It is the NIH grants and the large corporations within the industry that use their revenue to fund the innovators that bring about the next generation.

Life Cycles:
The life cycle of PET did not occur over just the last 6 years. The first commercial PET scanner was offered in 1976 resulting in the first life cycle being two decades old before the introduction of CT, which offered a cleaner and faster form of attenuation correction as well as superior anatomical correlation. This adaptation came on the heels of multi-slice CT and the ensuing CT slice war. Why would PET not take advantages of multi-slice? The ability to utilize the system as an efficient PET scanner as well to perform the most advanced CT functions. Cardiac CTA, radiation therapy integration and respiratory gating open new avenues of revenue generation, clinical efficiency and diagnostic use.

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