Orlando Heart Center, a 23-physician four-office practice close to Orlando, Fla., prepared for the 2010 reimbursement cuts by investing in a PET scanner. The center since has shifted more SPECT patients to PET, resulting in multiple benefits for the practice and patients.

The nuclear medicine community learned many lessons from the shortage of molybdenum-99 (Mo-99), the mother radioisotope of technetium-99m (Tc-99m), during the recent shutdowns of  the Canadian National Research Universal (NRU) reactor in Chalk River, Ontario, and High Flux Reactor (HFR) in Petten, the Netherlands.

In this issue, we address several important issues related to the quality of care and the business of molecular imaging. The recent 99mTc shortage made it clear that long established imaging studies will eventually be replaced by more robust and higher quality alternatives. This will foremost affect two major applications of nuclear medicine, myocardial perfusion and bone imaging.

Evidence has clearly shown the impact of PET/CT imaging in initial treatment strategiesdiagnosis and initial staging as well as in the subsequent treatment strategiestreatment monitoring and restaging/detection of suspected recurrence in various cancers. The molecular imaging community needs to work with industry and regulators to emphasize that patient-focused care benefits everyone.

Prostate cancer is the most common cancer among men worldwide and is the second leading cause of death in men after lung cancer in the U.S.

PET/CT is emerging as the pre-radiotherapy planning imaging study of choice for patients with non-small cell lung cancer (NSCLC), usurping the territory of standalone PET and CT.

The nuclear medicine community has learned many lessons from the shortage of molybdenum-99 (99Mo), the mother radioisotope of technetium-99m (99mTc) during the recent shut down of both the Canadian National Research Universal (NRU) reactor in Chalk River, Ontario, and High Flux Reactor (HFR) in Petten, the Netherlands. Both these reactors are back online, but are nearing the end of their lifecycle. How are we positioned for the future?

As disease treatment becomes more individualized, the spectrum of molecular imaging expands. The role of molecular imaging varies from management of various cancers and differential diagnosis of neurological disorders to identifying patients for cardiac revascularization. Four experts discuss the current and future trends in imaging for individualized treatments in oncology, neurology and cardiology.