The role of radionuclide scans in sarcoma

Images were interpreted and correlated with contemporaneous CT and/or MR imaging studies. Visual qualitative analysis of all images was performed by two or more nuclear medicine physicians expert in reading these studies. Tracer uptake was graded by visual inspection according to the following scale: negative, 0; faint, 1; moderate, 2; marked, 3. The results indicated that there was a statistically significant difference (student T test) in the visual analysis scale obtained with MIBI and FDG, indicating better detection (higher sensitivity) of the sarcoma with FDG (Table 3). However, the number of cases so far studied is small. It is imperative for us to deal with cost effectiveness of our imaging procedures in an environment driven by cost containment and managed care initiatives. The question posed by the analysis of our work is this: Is the significant difference in cost between PET and SPECT justified as far as patient outcome or management is concerned? PET scans cost about $2,500 each. A SPECT scan is about $600. Will the patient benefit $1900 from the PET intervention? This is an important question for which very little objective data are available for evaluation by third-party payers, patients, or health care providers.