[Diagnostic use of positron emission tomography in France: from the coincidence gamma-camera to mobile hybrid PET/CT devices]. / Application diagnostique de la tomographie par émission de positons en France. De la gamma-caméra modifée à la machine hybride TEP/TDM.

Positron emission tomography (PET) is a well-established medical imaging method. PET is increasingly used for diagnostic purposes, especially in oncology. The most widely used radiopharmaceutical is FDG, a glucose analogue. Other radiopharmaceuticals have recently been registered or are in development. We outline technical improvements of PET machines during more than a decade of clinical use in France. Even though image quality has improved considerably and PET-CT hybrid machines have emerged, spending per examination has remained remarkably constant. Replacement and maintenance costs have remained in the range of 170-190 Euros per examination since 1997, whether early CDET gamma cameras or the latest time-of-flight PET/CT devices are used. This is mainly due to shorter acquisition times and more efficient use of FDG New reimbursement rates for PET/CT are needed in France in order to favor regular acquisition of state-of-the-art devices. One major development is the coupling of PET and MR imaging.

PET imaging using gamma cameras.

This paper will review the recent advances and future developments in the field of coincidence imaging of positron emitters with a conventional Anger-type gamma camera. FDG imaging has shown high clinical importance in cardiology, neurology and especially oncology. Since access to full ring PET is mainly limited to university hospitals, there have been new developments allowing PET imaging on the standard Anger gamma camera. First the principles of coincidence imaging on a gamma camera will be reviewed. We will discuss the limitations of this technique, and the techniques used to partly overcome these limitations. The different configurations of the gamma camera operating in coincidence mode are pointed out. Different corrections for image degrading effects and reconstruction methods are evaluated in the final part.

A Delphi study to establish national cost-effectiveness research priorities for positron emission tomography.

OBJECTIVE: This study aimed to determine the key cost-effectiveness research questions relating to positron emission tomography (PET) in the UK. METHODS: A systematic literature review was conducted to establish the existing knowledge base relating to the cost-effectiveness of PET in the various conditions for which it has been proposed. A three-round postal Delphi study of relevant individuals was used to determine the key cost-effectiveness research questions relating to PET in the UK. The content and structure of the Delphi study was informed by the results of the literature review. RESULTS: The most important cost-effectiveness research priorities for the National Health Service (NHS) relating to PET were in the clinical areas of lung cancer, breast cancer and the assessment of myocardial viability. Gamma camera PET using coincidence imaging was highlighted as a modality whose, clinical role needed to be determined urgently. CONCLUSION: Underlying the cost-effectiveness research priorities which were established is the need for evidence that the use of the various PET modalities as a diagnostic technique will alter patient management as compared to existing diagnostic strategies. The findings of the project provide a contemporary overview of the potential role for PET in the NHS and will be relevant to other countries.

Scintillation camera quality control, Part I: Establishing the quality control program.

This is the first article in a four-part series on scintillation camera quality control. This series of articles will include both theory and practical knowledge on setting up a quality control program, acceptance testing and quality control for planar, SPECT and special imaging procedures. On completion of this article the reader should be able to: (a) discuss the purpose of a quality control program; (b) know how to establish the performance criteria for a scintillation camera; (c) know how to design a quality control program; (d) be able to set up the schedule for the quality control program; (e) understand the economics of quality control; and (f) justify the expenditure of the institution's resources on quality control.

Gamma camera purchasing.

The purchase of a new gamma camera is a major undertaking and represents a long-term commitment for most nuclear medicine departments. The purpose of tendering for gamma cameras is to assess the best match between the requirements of the clinical department and the equipment available and not necessarily to buy the 'best camera' [1-3]. After many years of drawing up tender specifications, this paper tries to outline some of the traps and pitfalls of this potentially perilous, although largely rewarding, exercise.

Starting up stress thallium cardiac imaging services.

This paper presents an evaluation of alternative methods for a hospital to establish stress thallium cardiac imaging services at a group of physicians' office. Volume-cost-profit analysis, break-even analysis and capital budgeting techniques were used to determine the most feasible method from a financial perspective without sacrificing quality of services. The main focus of this evaluation centers upon three alternative methods of procuring an imaging camera: (1) purchasing a new camera, (2) purchasing used equipment, or (3) leasing a new camera. Budgeted income statements were constructed using relevant revenue and cost information for each alternative. The payback period, net present value and the internal rate of return for each method of procuring a camera was computed. In addition, the break-even point was also determined for each alternative. After the analysis was completed, it was concluded that the method of choice, without sacrificing quality of service delivery, was that of purchasing a used camera.

[Economic criteria of comparing radionuclide diagnostic instruments]. / Ekonomicheskii kriterii sopostavleniia radionuklidnykh diagnosti- cheskikh priborov.

Based on a number of general postulates a mathematical equation was derived for computing the economically justified unbalance of the prices of two different instruments for the same uses depending on concrete values of their main technical parameters. The approach thus elaborated can be used for an analysis of instruments for any uses including medical ones. The criterion suggested makes it possible as well to assess, from the economic standpoint, the efficacy of the technical servicing of the equipment.