How to scan who: the delicate balance between selecting the patient and selecting the imaging protocol

Excerpt

In this issue of the EJNMMI, Spadafora et al. propose shortening the FDG PET/CT acquisition for evaluating a solitary pulmonary nodule. The rationale is to design a strategy with a better cost-effectiveness ratio. There is a lot to like in the paper, as it discusses various aspects highly relevant to clinical nuclear medicine, such as clinical impact, patients’ selection, imaging methodology, radiation safety, and costs. The objective is quite ambitious, as the proposed strategy could increase the number of FDG PET/CT performed for characterizing lung nodules, improve its effectiveness while reducing the cost and the radiation burden, and finally, increase the diagnostic accuracy. While some of these objectives may very well be achieved through this new strategy, it appears difficult to reach all, and there remain many question marks preventing the straight passage from the idea to the routine implementation. …