MITA Comments to AHRQ on Imaging for Pre-Treatment Staging of Small Cell Lung Cancer

RE: Requests for Scientific Information: Imaging for Pretreatment Staging of Small Cell Lung Cancer

Dear Dr. Kronick:

The Medical Imaging & Technology Alliance (MITA) is pleased to submit comments on the Agency for Healthcare Research and Quality (AHRQ) Requests for Scientific Information: Imaging for Pretreatment Staging of Small Cell Lung Cancer (“Requests for Scientific Information”).1 MITA has extensive knowledge of the substantial benefits afforded by medical imaging and radiation therapy to the health of Americans due to our role as the leading trade association representing medical imaging, radiation therapy, and radiopharmaceutical manufacturers. We support quality efforts that foster appropriate use of these technologies for the early detection, diagnosis, staging, therapy monitoring, and surveillance of many diseases.

Medical imaging encompasses X-ray imaging, computed tomography (CT) scans, diagnostic ultrasound, nuclear imaging (including positron emission tomography (PET)), magnetic resonance imaging (MRI), and related imaging acquisitions. Medical imaging is used to diagnose patients with disease, often reducing the need for costly medical services and invasive surgical procedures. In addition, medical imaging equipment often is used to select, guide, and facilitate effective treatment, for example, by using image guidance for surgical or radiotherapeutic interventions. MITA’s members also develop and manufacture innovative radiotherapy equipment used in cancer treatment.

It is MITA’s position that PET should be used as a pre-treatment strategy tool to determine an appropriate course of treatment as well a tool during treatment to inform and guide the ongoing course of treatment for lung cancer. Last September, we provided comments to AHRQ4; however, we would also like to provide a recent publication in the Journal of Nuclear Medicine, “F-FDG PET/CT and Lung Cancer: Value of Fourth and Subsequent Posttherapy Follow-up Scans for Patient Management.”

With lung cancer and other complex diseases, there are multiple decision nodes during the course of diagnosis and treatment. PET/CT is informative and value-additive at all stages including diagnosis and treatment planning strategy. During the course of treatment, “the results of PET/CT studies can affect the treatment plan, resulting in a change in treatment strategy in up to one third (30.12%) of the patients.” After initial diagnosis, PET/CT can provide ongoing data on the effectiveness of a treatment plan, thereby allowing for changes in treatment strategy to be implemented so as to provide the patient with the most appropriate treatment.


Click here to read the full comment letter.