Current Market State:
The effect of the Deficit Reduction Act (DRA) is significantly more responsible for the very recent flattening of the PET/CT market than the suggestion that the rapid development of PET/CT technology has any impact whatsoever. The January 1 enactment of the DRA slashed PET reimbursement by 25-75% causing an understandable hesitation in the market's willingness to purchase new systems until the effects are fully understood. Technology has become more affordable with a health care provider now able to purchase as much as a 40 slice PET/CT for what they would have paid for a capable dedicated PET system five years ago. A system which now offers significantly more utilization in both PET/CT and diagnostic CT, the model for PET has changed with the ability to utilize the PET/CT as a dual modality imaging device. Over 1.1 million PET scans were performed in 2005 and experts estimate over 2 million exams to be performed in the year 2010. PET/CT continues its acceptance with its well established history of tumor imaging while growth in Radiation Oncology and Cardiology secure its future for more broad utilization.

What's Next?

Yes, SPECT/CT is next. As PET had done over 7 years ago, nuclear medicine is enjoying all of the benefits that the integration of CT offers in the way of efficient and effective attenuation correction and accurate anatomical correlation. The increased ability to accurately detect disease presence and localization enable accurate diagnosis and staging and offer more effective treatment decisions in SPETC/CT over SPECT alone. MR/PET is next, integration of PET imaging for neurology and body imaging is on the roadmap for further utilization of the benefits brought about by positron imaging.

Why SPECT/CT can not replace PET:
PET/CT's superior sensitivity and specificity and the significantly better resolution make it the obvious choice for tumor imaging. The ability to quantitate PET data which is as critical clinically as it is in research for the evaluation of response to therapy, coronary flow, tumor thresholding and so on is unmatched. SPECT is functional, not metabolic as there is no FDA approved drug for metabolic SPECT. Clinical efficiency plays an important factor, count for count it would take hours to accomplish the same exam with SPECT as in an eleven minute whole body PET exam which coincidentally is directly related to the wonderfully short half-life pharmaceuticals used in PET. Compare the image quality of an F-18 ion bone scan with that of a SPECT with MDP. SPECT/CT works at a body system level where PET/CT works at a cellular level. And of course, PET/CT will not replace many of the effective functional exams that only SPECT and SPECT/CT currently provide.

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