18F-fluorodeoxyglucose pet procedures: Health economic aspects in neurology

Abstract

Whole-body 18 F-FDG PET procedures in oncology have demonstrated utility in patient management in the clinic, especially with the emergence of new hybrid systems such as PET-CT or, more recently, PET-MR. Consequently, the use of 18 F-FDG PET brain procedures, which currently represent on average 5 % of all PET procedures, is expected to increase signifi cantly in the coming years. Indeed, driven mostly by the epidemiological burden of neurodegenerative diseases, principally Alzheimer’s disease, functional neuroimagi g using PET is expected to become an equally important clinical tool as oncological PET procedures. However, before being implemented as a fi rst-line procedure in neurology, 18 FFDG PET brain imaging must face several health economic challenges: For example, the emergence of direct competitors such as PET amyloid imaging, the availability of resources for tracer and image production, the impact of Health Technology Assessment reports and approval and reimbursement issues. Based on a SWOT analysis (Strengths, Weaknesses, Opportunities, and Threats) highlighting uncertainty parameters that may affect neuroimaging policies, the purpose of this chapter is to provide to decision makers some key health economic components which may remove barriers to the development of 18 F-FDG PET in neurology.