Prof. Czepczyński: indications for PET/CT examinations should be updated as soon as possible

Indications for PET/CT imaging tests require urgent updating; those that are in force have not been changed for 14 years – says the president-elect of the Polish Society of Nuclear Medicine, Prof. Rafał Czepczyński.

PET/CT scans combine two diagnostic techniques: positron emission tomography (PET) with computed tomography (CT). They enable precise assessment of metabolic changes occurring in cells and identification of pathological foci. Thanks to this, it is possible to detect cancer or its recurrence at an early stage, which increases the chances of effective treatment.

"PET/CT can provide a quick answer to the question of whether the treatment applied to a given patient is working and should be continued, or whether it will not bring the expected results and should be changed immediately. And this is often a chance for better health and a longer life," noted Prof. Rafał Czepczyński from the Department and Clinic of Endocrinology, Metabolism and Internal Medicine of the Poznań University of Medical Sciences in the information provided to PAP.

He recalled that the regulations specifying the possibility of using these tests were published in 2011, i.e. 14 years ago. They cover 23 indications, but since then – according to the president-elect of the Polish Society of Nuclear Medicine – there has been such significant progress in the field of diagnostics and therapy of various diseases, primarily cancer diseases, that the list is currently far from complete.

"One could even say that its current form closes off access to PET tests to many patients who, according to current medical knowledge, could and should benefit from such diagnostics. Hence the appeal from our community and representatives of other fields of medicine to update and expand the indications," he wrote.

He also assured that Polish resources are prepared to carry out PET/CT examinations in accordance with the current guidelines of scientific societies. Patients do not have to travel abroad to have such examinations performed privately. "Our doctors, electroradiologists, technicians and nurses are constantly undergoing training, also at conferences and in international centres, so in terms of content, we lack nothing. We also have the appropriate infrastructure. All that is needed is to update the regulations," he emphasised.

Specialists from various fields of medicine in our country have submitted a proposal for 10 updated indications, which were submitted to the Ministry of Health in 2024. "Unfortunately, the new indications for PET/CT tests have not yet been included in the reimbursement regulations," said the president-elect of the Polish Society of Nuclear Medicine.

He explained that PET/CT examinations in some patients are difficult to replace with other techniques that could provide equally precise and valuable diagnostic information. He also assured that these are procedures used in strictly defined cases and "there is no risk that expanding the indications would cause an avalanche of their performance and increase costs". Quite the opposite - nuclear medicine procedures allow for the optimization of diagnostics and therapy, and thus a reduction in the costs of the diagnostic and therapeutic process in the overall approach.

"We are able to see symptoms of recurrence much earlier than traditional imaging studies would show us. Here, again, the prognosis is much better if we know about abnormalities quickly," argued Prof. Czepczyński.

"We assess whether there is a so-called target in the tissue (for example, cancer tissue), i.e. a target that a given drug is directed at. If so, and the target is well represented, the patient will most likely achieve a greater effect from the treatment. If there is no given target in the tissue, we can predict that the therapy will be less effective or not effective at all. Therefore, spending huge amounts of money on often expensive therapy may turn out to be futile. In other words, using the PET technique, which is a small fraction of the cost of the entire diagnostic and therapeutic process, can help save significant expenses related to inappropriate treatment. The patient will immediately receive the therapy that will bring the greatest clinical benefits," explained Prof. Czepczyński.

In his opinion, the patients who would benefit most from expanding the indications for PET/CT scans are those with prostate cancer, gynecological cancers, patients with so-called paraneoplastic syndromes, neuroendocrine tumors and some patients with cardiological problems, such as infective endocarditis. (PAP)

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