POSITRON EMISSION TOMOGRAPHY - A FINANCIAL AND OPERATIONAL ANALYSIS

Positron emission tomography (PET) is an emerging clinical imaging tec hnique that is facing the challenges of expansion in a period of immin ent health care contraction and reform. Although PET began showing uti lity in clinical medicine in the mid-1980s [1], its proliferation into mainstream medical practice has not matched that of other new imaging technologies such as MR imaging. Many factors have contributed to thi s, including the changing health care economy, the high cost of PET, t he length of time it takes to develop a PET facility, and its inherent complexity. In part because of the proliferation of the use of other technologies and the general explosion of costs, insurance carriers ar e now holding diagnostic techniques, including PET, to stricter standa rds of efficacy. New techniques must show improvement in long-term out come of patients, a difficult task for diagnostic tools. In addition t o these issues, PET is an expensive technology that requires highly tr ained multidisciplinary personnel. Questions have also been raised abo ut the most appropriate mechanism for regulation of PET isotope prepar ation, leading to speculation about future regulatory requirements. Th e current pioneers of PET must meet these challenges in order for it t o become a routine imaging technique. Because of its clinical value, P ET will probably survive despite the challenges. For many reasons, tho ugh, not every hospital should necessarily develop PET services. Conve rsely, many hospitals without this technology should consider acquirin g PEI. The purpose of this article is to identify the financial, opera tional, and clinical challenges facing PET centers today, describe pot ential organizational configurations that may enable PET to survive in an antitechnology environment, and delineate which institutions shoul d consider this new technology.