Essentially, the new Gallium scan (hereby now known commercially as NETSPOT) is the next generation of OCTREOSCAN. While it was good for its time, the gallium scan finally brings our NET community into the 21st century. The way the test works is we inject you with the drug called "68-Gallium-DOTA-OCTREOTATE". It is a form of octreotide (which binds to a receptor on many NETs called the Somatostatin Receptor) with a light bulb on the back. You let it circulate through the body, then lie in the machine where the PET scanner can take pictures of you. In general, many NETs will light up; NOT ALL WILL. However, the resolution and sensitivity is so much better than our old Octreoscan. In fact, as many of you who have seen me know, I'm holding off on many surgeries until I have it here in Denver, it means SO much to me. When I was back in Nashville, many of our patients benefited from this new technology and really had good surgical results thanks to it. That's why I feel if I can do a better surgery for you, then I want the best information possible. I have a couple of YOUTUBE videos on the technology. Take a look and then you'll see what I see.
The other very interesting thing is that the NETSPOT is probably going to be a companion diagnostic test for the coming therapy LUTATHERA, which is the therapeutic radioactive version. Rather than just a light bulb, it's a bomb and gives you internal radiation therapy. Go to PRRTinfo.org to read about it. I hope this new therapy will be available soon here in America.
Now, as far as logistics, just because it is FDA approved doesn't mean that it will be available in your hometown hospital. The most important part is still having the RIGHT EXPERTISE to use the information to help you. As the first NET clinician in the United States to really work closely with NETSPOT, I feel comfortable giving you advice based on the information. My suspicion is that the nuclear medicine physicians will do an excellent job reading the scans, but it is still the NET expert that will apply it to YOUR case. Therefore, it will probably be available first with the NET experts (which makes a lot of sense to me).
As far as insurance coverage, it will come, but it may take a while. I don't know what the details are, but in general new drugs or technology may take a little while to catch on, so you may have to pay cash for the scan up front and then fight with the insurance company to cover. When MEDICARE adopts it, the insurance companies will follow quickly.
My friends, you don't know how excited I am about this new technology. I'm hoping ours will be here in the middle of the summer and then we can really do the best surgery for you. It is the beginning of a new time for us here in our NET world! Be strong, safe, and healthy.