Truly Frugal Pet: Is It Possible?

Abstract

A pivotal issue in this post-election year concerns the containment of health care costs, currently absorbing about 14% of the GDP. This is clearly an inopportune time to promote a diagnostic technique at a seemingly staggering cost, for widespread public acceptance. This note addresses the question: must PET always be “big science”? (1) Our conclusion is simple: it needn’t be. With a realistic institutional self-perception, a hospital can chart a sensible course to contain the capital outlays and operating expenses for the in-house cyclotron, scanner and the oft-forgotten radiochemical facility that bridges production and the user. Only a few years ago, the target was to provide a $2 million PET center. Today, most new installations are requesting $5–10 million to start up from scratch, with promise of a three-year forgiveness before coming up to clinical speed. Staffing, service contracts and equipment amortization drive up the PET center’s operating budget toward a million dollars a year, necessitating thousands of thousand dollar scans per year to break even. No PET center in the world has even remotely approached this performance.