PET vs CT

jtl
jtl Member Posts: 456
in Head and Neck Cancer #1
I just returned from a visit to my rad onc and he scheduled my next PET for Sept which will be 7 months since my last one which was 3 months post rt. After that it will be annual. I know there have been discussions in the past about CT vs PET so I asked why not CT. In his opinion PET is the best for determining if there is scchn. I know that in my case the original CT missed the cancer but the PET picked it up. He did a visual and papable exam of the cancer site and said it looked good. Next week same thing with my ENT, nothing like another finger down the throat.
John

Comments

  • ratface
    ratface Member Posts: 1,337 Member
    #2
    John, try this
    type, "Choosing an Imaging Test" in the search box of this forumn.
  • Skiffin16
    Skiffin16 Member Posts: 8,305 Member
    #3
    PET vs CT
    What's the difference....about $6000...LOL.

    I would always opt for a PET versus a CT if I had a choice.

    I'm not sure of the reasoning of scheduling another at less than a year, unless the first had residual or something of interest.

    In my scenario, I like you had one at about three months out, then annual since. But that also goes with a CT at six months...

    Pet, six months later, PET...six months later, CT....

    JG
  • jtl
    jtl Member Posts: 456
    #4
    Skiffin16 said:

    PET vs CT
    What's the difference....about $6000...LOL.

    I would always opt for a PET versus a CT if I had a choice.

    I'm not sure of the reasoning of scheduling another at less than a year, unless the first had residual or something of interest.

    In my scenario, I like you had one at about three months out, then annual since. But that also goes with a CT at six months...

    Pet, six months later, PET...six months later, CT....

    JG

    The first was clean, but I
    The first was clean, but I agree it may be unecessary to repeat so soon. He made a comment that if the cancer is the result of HPV that in the future they may only do a PET once. They being the medical community. Theory is that the chance of recurrence is very low. The cost is more like $1600 for the PET, I have not a clue what a CT would cost. I will see what my ENT doc says next week, but I think he is going to say wait for at least the first year post treatment.
  • Skiffin16
    Skiffin16 Member Posts: 8,305 Member
    #5
    jtl said:

    The first was clean, but I
    The first was clean, but I agree it may be unecessary to repeat so soon. He made a comment that if the cancer is the result of HPV that in the future they may only do a PET once. They being the medical community. Theory is that the chance of recurrence is very low. The cost is more like $1600 for the PET, I have not a clue what a CT would cost. I will see what my ENT doc says next week, but I think he is going to say wait for at least the first year post treatment.

    Costs...
    I'm sure they are all dependant upon the facility.

    At mine, for the PET, "billed" is around $6,000 - $8,000 and around $1,500 - $2,000 for the CT.

    Of course that's not what I'm billed as it goes through a contracted price, then my personal coverage amounts.

    For me that's something like a $750 deductible and max out of pocket at around $3,750 which includes the $750 deductible.

    JG
  • jtl
    jtl Member Posts: 456
    #6
    Skiffin16 said:

    Costs...
    I'm sure they are all dependant upon the facility.

    At mine, for the PET, "billed" is around $6,000 - $8,000 and around $1,500 - $2,000 for the CT.

    Of course that's not what I'm billed as it goes through a contracted price, then my personal coverage amounts.

    For me that's something like a $750 deductible and max out of pocket at around $3,750 which includes the $750 deductible.

    JG

    There is a HUGE difference
    There is a HUGE difference in prices but I think we discussed this another time. I just looked at my summary sheet from Medicare. My PET is actually a PET/CT and it was billed at $1740 and Medicare approved $1292. Maybe the rates for private insurance are higher.
  • Tonsil Dad
    Tonsil Dad Member Posts: 488
    #7
    jtl said:

    There is a HUGE difference
    There is a HUGE difference in prices but I think we discussed this another time. I just looked at my summary sheet from Medicare. My PET is actually a PET/CT and it was billed at $1740 and Medicare approved $1292. Maybe the rates for private insurance are higher.

    Cheap !!!!
    You guys got off pretty cheap, my PET at the U of Miami billed my insurance
    For $17,000 and $1800 for the glucose injection (contrast). My insurance paid
    $6,600. I have deductables and out of pocket but they haven't come after me
    For any differences. (Thank God.)
    I guess they can bill what they want but the insurance companys only pay
    What their guidlines say its worth, I don't know or care as long as they don't
    Want me to pay the differance.

    God bless
    Tonsil Dad,

    Dan.
  • Skiffin16
    Skiffin16 Member Posts: 8,305 Member
    #8
    Tonsil Dad said:

    Cheap !!!!
    You guys got off pretty cheap, my PET at the U of Miami billed my insurance
    For $17,000 and $1800 for the glucose injection (contrast). My insurance paid
    $6,600. I have deductables and out of pocket but they haven't come after me
    For any differences. (Thank God.)
    I guess they can bill what they want but the insurance companys only pay
    What their guidlines say its worth, I don't know or care as long as they don't
    Want me to pay the differance.

    God bless
    Tonsil Dad,

    Dan.

    Hear Ya...
    My Dx year...2009, total billed was around $257,000

    Redongulous.....

    JG
  • Tim6003
    Tim6003 Member Posts: 1,514 Member
    #9
    Skiffin16 said:

    Hear Ya...
    My Dx year...2009, total billed was around $257,000

    Redongulous.....

    JG

    Hmmmm Pet I think
    Based on all my info (unless I just read and heard everything wrong) I'd go with the PET. :)

    Glad you got the all clear ......many more to come my friend.

    Tim / Idaho
  • patricke
    patricke Member Posts: 570 Member
    #10
    PET/CT COMBO SPECIAL
    Hey John, since you are getting the PET/CT combo, it is my understanding, at least from my docs, that that is the top of the line imaging for catching the little cancer boogers; so, you have the best of both worlds. As a matter of fact, I am scheduled to have my follow-up PET/CT done within the next couple of weeks. I'm so looking forward to it, always one of my favorite activities.

    PATRICK
  • jtl
    jtl Member Posts: 456
    #11
    patricke said:

    PET/CT COMBO SPECIAL
    Hey John, since you are getting the PET/CT combo, it is my understanding, at least from my docs, that that is the top of the line imaging for catching the little cancer boogers; so, you have the best of both worlds. As a matter of fact, I am scheduled to have my follow-up PET/CT done within the next couple of weeks. I'm so looking forward to it, always one of my favorite activities.

    PATRICK

    You have been going through
    You have been going through this for a long time and there is no reason to think this PET/CT will be any different. Still using the Vitamix? We use ours almost daily if not multiple times per day. Smoothies in the AM and I became addicted to shakes in the PM during my sore throat days.
  • jtl
    jtl Member Posts: 456
    #12
    Since they scheduled my next
    Since they scheduled my next PET in September I looked up the PET/CT combination scan and it certainly looks like that is the way to do it. I don't pretend to know much about this but apparently the combined scan helps to determine what is going on if there is an indication of residual disease on the PET. Fortunately I had none, so maybe if you don't have any residual issues the PET alone is sufficient. Also read a couple of articles that questioned the value of scans vs direct observation.
  • longtermsurvivor
    longtermsurvivor Member Posts: 1,842 Member
    #13
    jtl said:

    Since they scheduled my next
    Since they scheduled my next PET in September I looked up the PET/CT combination scan and it certainly looks like that is the way to do it. I don't pretend to know much about this but apparently the combined scan helps to determine what is going on if there is an indication of residual disease on the PET. Fortunately I had none, so maybe if you don't have any residual issues the PET alone is sufficient. Also read a couple of articles that questioned the value of scans vs direct observation.

    it really is a conundrum
    The basic charge to medicare is the same as it is ti private insurance. What is reimbursed by thentwo isnquitendifferent. My PET scans are billed at 5500 apiece. The CT scans about 1700.who knows what is the right frequencyband type. Well, the shadow knows.

    btw, I had my first PET scan in Early 1998, when the first generation equipmentnwas brand new. It took 4 hours and 45 minutes, att the while strapped to that damn gurney. The software has improved a bit since then. i have never had a positive CT scan, not once.

    Pat
  • jtl
    jtl Member Posts: 456
    #14
    longtermsurvivor said:

    it really is a conundrum
    The basic charge to medicare is the same as it is ti private insurance. What is reimbursed by thentwo isnquitendifferent. My PET scans are billed at 5500 apiece. The CT scans about 1700.who knows what is the right frequencyband type. Well, the shadow knows.

    btw, I had my first PET scan in Early 1998, when the first generation equipmentnwas brand new. It took 4 hours and 45 minutes, att the while strapped to that damn gurney. The software has improved a bit since then. i have never had a positive CT scan, not once.

    Pat

    I am amazed at the variation
    I am amazed at the variation in not only lets call it "retail" pricing but also the contract rates for the same test in different locations. I would think since there is only one Medicare and only a handfull of large private insurers this would be very standardized. I told the story many times when I had prostate cancer, the total bills from day one starting with the biopsy through the laparoscopic surgery was $65K, the amount that was actually paid out by Aetna was $10,300. Quite a difference.

    You may find my urologists site interesting, then again maybe not. If you click on patient stories you may even find a guy in a red t-shirt with a couple of birds on his shoulders that you know. In any event he is a wonderful, caring person that did me good.

    John
  • jtl
    jtl Member Posts: 456
    #15
    jtl said:

    I am amazed at the variation
    I am amazed at the variation in not only lets call it "retail" pricing but also the contract rates for the same test in different locations. I would think since there is only one Medicare and only a handfull of large private insurers this would be very standardized. I told the story many times when I had prostate cancer, the total bills from day one starting with the biopsy through the laparoscopic surgery was $65K, the amount that was actually paid out by Aetna was $10,300. Quite a difference.

    You may find my urologists site interesting, then again maybe not. If you click on patient stories you may even find a guy in a red t-shirt with a couple of birds on his shoulders that you know. In any event he is a wonderful, caring person that did me good.

    John

    Residual indications after a PET seem to be the strong suit for CT since they can pick up "mass". I know when I was first diagnosed the CT scan showed nothing, zip, nada. However the PET found an uptake. It turned out that I had an area of active cancer, but not a mass in the sense that it would be detected by a CT scan or a visual observation unless you knew where to look. Once the site was located both the ENT and Rad Onc could see the slight difference in tissue. The PET is pretty amazing when it comes to finding active cancer.
    John
  • longtermsurvivor
    longtermsurvivor Member Posts: 1,842 Member
    #16
    jtl said:

    Residual indications after a PET seem to be the strong suit for CT since they can pick up "mass". I know when I was first diagnosed the CT scan showed nothing, zip, nada. However the PET found an uptake. It turned out that I had an area of active cancer, but not a mass in the sense that it would be detected by a CT scan or a visual observation unless you knew where to look. Once the site was located both the ENT and Rad Onc could see the slight difference in tissue. The PET is pretty amazing when it comes to finding active cancer.
    John

    Bang
    that is the sound of John hitting the nail on the head. CT is good for mass lesion. PET is good for surface lesion. The are complimentary scans.
  • jtl
    jtl Member Posts: 456
    #17
    longtermsurvivor said:

    Bang
    that is the sound of John hitting the nail on the head. CT is good for mass lesion. PET is good for surface lesion. The are complimentary scans.

    Pat
    I may have hit a nail on the head but in the process I forgot the link for the urologist site that I mentioned. Check it out.

    http://laprp.com/
  • jtl
    jtl Member Posts: 456
    #18
    Scan Frequency
    I asked both my Rad Onc and my ENT recently about the frequency of scans and it appears there may be some suggested changes based on current studies at I believe Johns Hopkins and some other big name facility. They both said one PET-CT at 3 months post, then at one year, then one at 2yrs and then another in 5 years. This of course assumes no evidence of recurrent or residual disease. The jump from 2 years to 5 years is based on statistics that say a very high percentage of recurrence is in the first 2 years, something like 80%.

    I have even read where some researchers question the value of PET/CT vs just a physical exam. For me I would want the first couple of years to include a physical exam every 6 weeks and annual PET-CT maybe even semi-annual in the second year. After that maybe periodic physical exams and annual PET-CT. The eyes to thighs PET-CT is good for spotting more than just scchn.
    John

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