CancerNOPRNCT00868582
The National Oncologic PET Registry
An observational study of Cancer, run by American College of Radiology Imaging Network at 1 site in United States.
Trial summary
The Centers for Medicare \& Medicaid Services (CMS), as the Federal agency that administers the Medicare program, only pays for positron emission tomography (PET) scans in patients with cancer for certain reasons and for certain types of cancer. Read more about this study
- Who is it for?
- Any age
- Conditions the study is for
- Cancer
- What is being tested?
- PET scanning in cancer
- How many people
- 333,000 participants
- Where
- 1 siteUnited States
- Study dates
- May 2006to Jun 2021
- Phase
- Observational
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages Any age
- All sexes
- No healthy volunteers
- Child, Adult, Older adult
Study population: Medicare beneficiaries who are referred for NaF-18 PET (the FDG-PET arm of NOPR has completed enrollment)
Who may be able to join
- All Medicare beneficiaries who are referred for NaF-18 PET to identify bone metastasis are eligible to be included in the NOPR.
Who cannot join
- NaF-18 PET for other (non-oncologic) indications.
- NaF-18 PET performed as part of a clinical trial approved by CMS.
Trial locations and contacts
1 site in 1 country.
United States1 site
American College of Radiology Imaging Network
Philadelphia, Pennsylvania, 19103
About this study
The Centers for Medicare \& Medicaid Services (CMS), as the Federal agency that administers the Medicare program, only pays for positron emission tomography (PET) scans in patients with cancer for certain reasons and for certain types of cancer. This study was developed to help CMS determine if they should pay for PET scans for additional reasons and additional types of cancer. In order to collect the information needed to decide which other types of cancer should be covered by Medicare, CMS will provide payment for the otherwise non-covered PET scans of patients who are properly registered with the National Oncologic PET Registry (NOPR). This information will then be analyzed to determine the effect PET scans had on the way physicians planned to treat their patients.
Read the detailed description
The National Oncologic PET Registry (NOPR) was developed in response to the Centers for Medicare \& Medicaid Services (CMS) proposal to expand coverage for positron emission tomography with F-18 fluorodeoxyglucose (FDG-PET) to include cancers and indications not presently eligible for Medicare reimbursement. Under this coverage with evidence development (CED) program, Medicare reimbursement for these cancers can be obtained if the patient's referring physician and the provider submit data to a clinical registry to assess the impact of PET on cancer patient management. The NOPR implemented this registry for CMS. The NOPR is sponsored by the World Molecular Imaging Society (formerly the Academy of Molecular Imaging), and managed by the American College of Radiology through the American College of Radiology Imaging Network.
The original goal of the National Oncologic PET Registry was to assess the effect of positron emission tomography with F-18 fluorodeoxyglucose (FDG-PET) on referring physicians' plans of intended patient management for those cancers and indications not currently eligible for reimbursement from CMS. Data were collected from the referring physician before and after the PET study. If complete and timely data are reported to the NOPR within 30 days of the PET scan, the PET facility and interpreting physician (nuclear physician/radiologist) are eligible for reimbursement by CMS. Based in part on data obtained from the NOPR, CMS expanded coverage for FDG-PET in patients with cancer on April 3, 2009 and further expanded coverage on June 11, 2013. Specifically, on June 11, 2013, CMS issued a final decision memorandum ending the prospective data collection requirements under CED for all oncologic indications for FDG-PET. Overall accrual to the FDG-PET registry was nearly 288,000 scans.
On February 26, 2010, CMS announced its decision to cover the use NaF-18 PET to identify bone metastasis. Under this new policy, the use of NaF-18 PET would be covered only under an approved (CED) program. The NOPR obtained CMS approval to develop a registry for NaF-18 as an amendment to the then-existing NOPR for FDG-PET. The NaF-18 PET registry component of NOPR was activated for accrual on February 7, 2011. Estimated total accrual to the NaF-PET registry is 45,000 cases.
As with the registry for FDG-PET, the goal of the NaF-18 PET registry component is to assess the impact of this imaging examination on referring physicians' plans of intended management of patients with known or suspected osseous metastatic disease. Data are collected from the referring physician before and after the PET study, as well as from the interpreting physician. If complete and timely data are reported to the NOPR within 30 days of the PET scan, the PET facility and interpreting physician (nuclear physician/radiologist) are eligible for reimbursement by CMS.
- Conditions
- Cancer
- Being tested
- PET scanning in cancer
- Keywords
- Patients with proven or suspected cancer referred for NaF-18 PET to identify bone metastasis
- Medical subject headings
- Neoplasms
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
PET scanning in cancerOther
Also called NOPR
Collection of institutional practice PET imaging data
| Study group | Role | What they receive |
|---|---|---|
| FDG-PET | F-18 fluorodeoxyglucose (FDG-PET) Receives: Other: PET scanning in cancer | |
| NaF-18 PET | F-18 sodum-fluoride (NaF-18 PET) Receives: Other: PET scanning in cancer |
What is being measured
The primary outcome is the main question the study is designed to answer.
To assess the effect of PET on referring physicians' plans of intended patient management of patients with cancer types eligible for inclusion in the National Oncologic PET Registry.
Measured: PET Scans as ordered by treating physician per CMS frequency guidelines
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted25 Mar 2009 (estimated)
- Study startMay 2006
- Primary completionDec 2020 (estimated)
- Study completionJun 2021 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (10)Papers the sponsor has linked to this study.
- Other trials for CancerStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Observational
- Observational model
- Other
- Time perspective
- Prospective
- Enrolment
- 333,000 participants (estimated)
Sponsor and investigators
- Lead sponsor
- American College of Radiology Imaging Network
- Sponsor type
- Research network
- Collaborators
- World Molecular Imaging Society (formerly Academy of Molecular Imaging)
- Responsible party
- Sponsor
- Investigators
- Bruce Hillner, MD, Principal investigator, Virginia Commonwealth University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT00868582
- Sponsor's protocol ID
- NOPR
- Acronym
- NOPR
- Status last verified
- Aug 2020
- First submitted
- 24 Mar 2009
- Last updated
- 25 Aug 2020
- Results posted
- No
- Data monitoring committee
- No
Publications
Hillner BE, Siegel BA, Liu D, Shields AF, Gareen IF, Hanna L, Stine SH, Coleman RE. Impact of positron emission tomography/computed tomography and positron emission tomography (PET) alone on expected management of patients with cancer: initial results from the National Oncologic PET Registry. J Clin Oncol. 2008 May 1;26(13):2155-61. doi: 10.1200/JCO.2007.14.5631. Epub 2008 Mar 24.
PubMed 18362365Hillner BE, Siegel BA, Shields AF, Liu D, Gareen IF, Hunt E, Coleman RE. Relationship between cancer type and impact of PET and PET/CT on intended management: findings of the national oncologic PET registry. J Nucl Med. 2008 Dec;49(12):1928-35. doi: 10.2967/jnumed.108.056713. Epub 2008 Nov 7.
PubMed 18997054Hillner BE, Siegel BA, Shields AF, Liu D, Gareen IF, Hanna L, Stine SH, Coleman RE. The impact of positron emission tomography (PET) on expected management during cancer treatment: findings of the National Oncologic PET Registry. Cancer. 2009 Jan 15;115(2):410-8. doi: 10.1002/cncr.24000.
PubMed 19016303Hillner BE, Siegel BA, Shields AF, Duan F, Gareen IF, Hanna L, Coleman RE. Impact of dedicated brain PET on intended patient management in participants of the national oncologic PET Registry. Mol Imaging Biol. 2011 Feb;13(1):161-5. doi: 10.1007/s11307-010-0427-5.
PubMed 21080232Hillner BE, Siegel BA, Hanna L, Shields AF, Duan F, Gareen IF, Quinn B, Coleman RE. Impact of 18F-FDG PET used after initial treatment of cancer: comparison of the National Oncologic PET Registry 2006 and 2009 cohorts. J Nucl Med. 2012 May;53(5):831-7. doi: 10.2967/jnumed.112.103911. Epub 2012 Mar 23.
PubMed 22448033Hillner BE, Tosteson TD, Tosteson AN, Wang Q, Song Y, Onega T, Hanna LG, Siegel BA. Intended versus inferred management after PET for cancer restaging: analysis of Medicare claims linked to a coverage with evidence development registry. Med Care. 2013 Apr;51(4):361-7. doi: 10.1097/MLR.0b013e318287d860.
PubMed 23481033Hillner BE, Tosteson AN, Tosteson TD, Wang Q, Song Y, Hanna LG, Siegel BA. Intended versus inferred care after PET performed for initial staging in the National Oncologic PET Registry. J Nucl Med. 2013 Dec;54(12):2024-31. doi: 10.2967/jnumed.113.123430. Epub 2013 Nov 12.
PubMed 24221994Hillner BE, Siegel BA, Hanna L, Duan F, Shields AF, Coleman RE. Impact of 18F-fluoride PET in patients with known prostate cancer: initial results from the National Oncologic PET Registry. J Nucl Med. 2014 Apr;55(4):574-81. doi: 10.2967/jnumed.113.130005. Epub 2014 Feb 27.
PubMed 24578240Hillner BE, Siegel BA, Hanna L, Duan F, Shields AF, Quinn B, Coleman RE. Impact of (18)F-Fluoride PET on Intended Management of Patients with Cancers Other Than Prostate Cancer: Results from the National Oncologic PET Registry. J Nucl Med. 2014 Jul;55(7):1054-61. doi: 10.2967/jnumed.113.135475. Epub 2014 May 12.
PubMed 24819422Hillner BE, Siegel BA, Hanna L, Duan F, Quinn B, Shields AF. 18F-fluoride PET used for treatment monitoring of systemic cancer therapy: results from the National Oncologic PET Registry. J Nucl Med. 2015 Feb;56(2):222-8. doi: 10.2967/jnumed.114.150391. Epub 2015 Jan 15.
PubMed 25593113
Study at a glance
From the registry record, last updated by the sponsor on 25 Aug 2020. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- The National Oncologic PET Registry
- ClinicalTrials.gov ID
- NCT00868582
- Acronym / sponsor ID
- NOPR / NOPR
- Conditions
- Cancer
- Keywords
- Patients with proven or suspected cancer referred for NaF-18 PET to identify bone metastasis
- Study type
- Observational
- Recruitment status
- Unknown status
- Enrolment
- 333,000 participants (estimated)
- Lead sponsor
- American College of Radiology Imaging NetworkResearch network
- Collaborators
- World Molecular Imaging Society (formerly Academy of Molecular Imaging)
- Study start
- May 2006
- Primary completion
- Dec 2020 (estimated)
- Study completion
- Jun 2021 (estimated)
- First posted
- 25 Mar 2009 (estimated)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The Centers for Medicare \& Medicaid Services (CMS), as the Federal agency that administers the Medicare program, only pays for positron emission tomography (PET) scans in patients with cancer for certain reasons and for certain types of cancer. This study was developed to help CMS determine if they should pay for PET scans for additional reasons and additional types of cancer. In order to collect the information needed to decide which other types of cancer should be covered by Medicare, CMS will provide payment for the otherwise non-covered PET scans of patients who are properly registered with the National Oncologic PET Registry (NOPR). This information will then be analyzed to determine the effect PET scans had on the way physicians planned to treat their patients.
Detailed description
The National Oncologic PET Registry (NOPR) was developed in response to the Centers for Medicare \& Medicaid Services (CMS) proposal to expand coverage for positron emission tomography with F-18 fluorodeoxyglucose (FDG-PET) to include cancers and indications not presently eligible for Medicare reimbursement. Under this coverage with evidence development (CED) program, Medicare reimbursement for these cancers can be obtained if the patient's referring physician and the provider submit data to a clinical registry to assess the impact of PET on cancer patient management. The NOPR implemented this registry for CMS. The NOPR is sponsored by the World Molecular Imaging Society (formerly the Academy of Molecular Imaging), and managed by the American College of Radiology through the American College of Radiology Imaging Network.
The original goal of the National Oncologic PET Registry was to assess the effect of positron emission tomography with F-18 fluorodeoxyglucose (FDG-PET) on referring physicians' plans of intended patient management for those cancers and indications not currently eligible for reimbursement from CMS. Data were collected from the referring physician before and after the PET study. If complete and timely data are reported to the NOPR within 30 days of the PET scan, the PET facility and interpreting physician (nuclear physician/radiologist) are eligible for reimbursement by CMS. Based in part on data obtained from the NOPR, CMS expanded coverage for FDG-PET in patients with cancer on April 3, 2009 and further expanded coverage on June 11, 2013. Specifically, on June 11, 2013, CMS issued a final decision memorandum ending the prospective data collection requirements under CED for all oncologic indications for FDG-PET. Overall accrual to the FDG-PET registry was nearly 288,000 scans.
On February 26, 2010, CMS announced its decision to cover the use NaF-18 PET to identify bone metastasis. Under this new policy, the use of NaF-18 PET would be covered only under an approved (CED) program. The NOPR obtained CMS approval to develop a registry for NaF-18 as an amendment to the then-existing NOPR for FDG-PET. The NaF-18 PET registry component of NOPR was activated for accrual on February 7, 2011. Estimated total accrual to the NaF-PET registry is 45,000 cases.
As with the registry for FDG-PET, the goal of the NaF-18 PET registry component is to assess the impact of this imaging examination on referring physicians' plans of intended management of patients with known or suspected osseous metastatic disease. Data are collected from the referring physician before and after the PET study, as well as from the interpreting physician. If complete and timely data are reported to the NOPR within 30 days of the PET scan, the PET facility and interpreting physician (nuclear physician/radiologist) are eligible for reimbursement by CMS.
Study design
- Observational model
- Other
- Time perspective
- Prospective
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| FDG-PET | – | Other: PET scanning in cancerF-18 fluorodeoxyglucose (FDG-PET) |
| NaF-18 PET | – | Other: PET scanning in cancerF-18 sodum-fluoride (NaF-18 PET) |
Who may qualify
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Child, Adult, Older adult
- Study population
- Medicare beneficiaries who are referred for NaF-18 PET (the FDG-PET arm of NOPR has completed enrollment)
Key inclusion criteria (1 listed)
- All Medicare beneficiaries who are referred for NaF-18 PET to identify bone metastasis are eligible to be included in the NOPR.
Key exclusion criteria (2 listed)
- NaF-18 PET for other (non-oncologic) indications.
- NaF-18 PET performed as part of a clinical trial approved by CMS.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| PET scanning in cancerAlso: NOPRCollection of institutional practice PET imaging data | Other | FDG-PET, NaF-18 PET |
Primary outcome
To assess the effect of PET on referring physicians' plans of intended patient management of patients with cancer types eligible for inclusion in the National Oncologic PET Registry.
Time frame: PET Scans as ordered by treating physician per CMS frequency guidelines
Results and safety
Results are not available in the source record.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 25 Aug 2020.
- Results publication: PubMed 18362365Hillner BE, Siegel BA, Liu D, Shields AF, Gareen IF, Hanna L, Stine SH, Coleman RE. Impact of positron emission tomography/computed tomography and positron emission tomography (PET) alone on expected management of patients with cancer: initial results from the National Oncologic PET Registry. J Clin Oncol. 2008 May 1;26(13):2155-61. doi: 10.1200/JCO.2007.14.5631. Epub 2008 Mar 24.
- Results publication: PubMed 18997054Hillner BE, Siegel BA, Shields AF, Liu D, Gareen IF, Hunt E, Coleman RE. Relationship between cancer type and impact of PET and PET/CT on intended management: findings of the national oncologic PET registry. J Nucl Med. 2008 Dec;49(12):1928-35. doi: 10.2967/jnumed.108.056713. Epub 2008 Nov 7.
- Results publication: PubMed 19016303Hillner BE, Siegel BA, Shields AF, Liu D, Gareen IF, Hanna L, Stine SH, Coleman RE. The impact of positron emission tomography (PET) on expected management during cancer treatment: findings of the National Oncologic PET Registry. Cancer. 2009 Jan 15;115(2):410-8. doi: 10.1002/cncr.24000.
- Results publication: PubMed 21080232Hillner BE, Siegel BA, Shields AF, Duan F, Gareen IF, Hanna L, Coleman RE. Impact of dedicated brain PET on intended patient management in participants of the national oncologic PET Registry. Mol Imaging Biol. 2011 Feb;13(1):161-5. doi: 10.1007/s11307-010-0427-5.
- Results publication: PubMed 22448033Hillner BE, Siegel BA, Hanna L, Shields AF, Duan F, Gareen IF, Quinn B, Coleman RE. Impact of 18F-FDG PET used after initial treatment of cancer: comparison of the National Oncologic PET Registry 2006 and 2009 cohorts. J Nucl Med. 2012 May;53(5):831-7. doi: 10.2967/jnumed.112.103911. Epub 2012 Mar 23.
- Results publication: PubMed 23481033Hillner BE, Tosteson TD, Tosteson AN, Wang Q, Song Y, Onega T, Hanna LG, Siegel BA. Intended versus inferred management after PET for cancer restaging: analysis of Medicare claims linked to a coverage with evidence development registry. Med Care. 2013 Apr;51(4):361-7. doi: 10.1097/MLR.0b013e318287d860.
- Results publication: PubMed 24221994Hillner BE, Tosteson AN, Tosteson TD, Wang Q, Song Y, Hanna LG, Siegel BA. Intended versus inferred care after PET performed for initial staging in the National Oncologic PET Registry. J Nucl Med. 2013 Dec;54(12):2024-31. doi: 10.2967/jnumed.113.123430. Epub 2013 Nov 12.
- Results publication: PubMed 24578240Hillner BE, Siegel BA, Hanna L, Duan F, Shields AF, Coleman RE. Impact of 18F-fluoride PET in patients with known prostate cancer: initial results from the National Oncologic PET Registry. J Nucl Med. 2014 Apr;55(4):574-81. doi: 10.2967/jnumed.113.130005. Epub 2014 Feb 27.
- Results publication: PubMed 24819422Hillner BE, Siegel BA, Hanna L, Duan F, Shields AF, Quinn B, Coleman RE. Impact of (18)F-Fluoride PET on Intended Management of Patients with Cancers Other Than Prostate Cancer: Results from the National Oncologic PET Registry. J Nucl Med. 2014 Jul;55(7):1054-61. doi: 10.2967/jnumed.113.135475. Epub 2014 May 12.
- Results publication: PubMed 25593113Hillner BE, Siegel BA, Hanna L, Duan F, Quinn B, Shields AF. 18F-fluoride PET used for treatment monitoring of systemic cancer therapy: results from the National Oncologic PET Registry. J Nucl Med. 2015 Feb;56(2):222-8. doi: 10.2967/jnumed.114.150391. Epub 2015 Jan 15.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Bruce Hillner, MD principal investigator
Virginia Commonwealth University
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
An observational study of Cancer, run by American College of Radiology Imaging Network at 1 site in United States.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 1 inclusion and 2 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: status not confirmed, as of the sponsor's last update on 25 Aug 2020. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
Results are not available in the source record.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
To assess the effect of PET on referring physicians' plans of intended patient management of patients with cancer types eligible for inclusion in the National Oncologic PET Registry. (time frame: PET Scans as ordered by treating physician per CMS frequency guidelines). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT00868582, which also lists 10 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 25 Aug 2020.