Dr. Peter Herscovitch, the Society of Nuclear Medicine and Molecular Imaging’s president-elect, is also the director of the PET Department at the National Institutes of Health (NIH). DOTmed HealthCare Business News spoke with Herscovitch about advances in the field of nuclear medicine and molecular imaging as well as the upcoming show, taking place June 7-11 in St. Louis, Mo.

HCBN: When you were elected as president-elect in 2013, you said you wanted to focus on the development of new radiopharmaceuticals, particularly for brain amyloid imaging. Why do you see such potential in this area, and how has that goal played-out for you and the industry this year?
PH: A major focus of SNMMI has been the translation to the clinic of FDA-approved radiopharmaceuticals for PET imaging of brain amyloid in patients being evaluated for cognitive decline or possible Alzheimer’s disease. Two new radiopharmaceuticals for amyloid imaging were approved by the FDA in 2013 and April 2014. In partnership with the Alzheimer’s Association, in 2013 we published appropriate use criteria for these agents, defining the clinical scenarios in which they should or should not be used. We are also developing procedure guidelines for performing amyloid brain imaging. We were disappointed with the CMS decision last year to approve only coverage with evidence development (CED) for amyloid imaging rather than full coverage. However, we are working with the Alzheimer’s Association and other stakeholders to develop a study that will demonstrate the clinical usefulness of amyloid imaging.

HCBN: Do you think neurodegenerative imaging will be just as big a presence this year as it was last year at the SNMMI Annual Meeting?
PH: Yes, there will be several scientific and continuing education sessions focusing on imaging neurodegenerative diseases as well as other neuropsychiatric disorders. Molecular imaging has dramatically transformed how clinical research in neurodegeneration is being performed. This year’s Neurosciences track includes clinical research on Alzheimer’s disease with radiotracers for not only amyloid but also tau protein. Research on Parkinson’s disease, as well as relationships between degenerative disease and other factors, such as sleep disorders and depression, also will be presented.



HCBN: What other accomplishments has SNMMI been a part of as relates to the growth of molecular imaging this year?
PH: The past year has been very productive. Our outreach and communication programs are raising awareness of nuclear medicine and molecular imaging, and also radionuclide therapy, among both health care providers and patients. Our Clinical Trials Network (CTN) continues to promote the use and approval of new radiopharmaceuticals. An important focus has been 68Ga-labeled DOTA agents for imaging neuroendocrine tumors. The CTN has helped sites to obtain INDs and has standardized radiochemistry and imaging methodology. It received Orphan Drug Designation for 68Ga-DOTATOC from the FDA in October 2013.

SNMMI has a new Department of Quality and Evidence. It will develop evidence-based guidelines, appropriate use criteria, technical standards and quality measures for established, as well as new, molecular imaging radiopharmaceuticals. Our flagship journal, The Journal of Nuclear Medicine, is now reaching a wider audience of medical professionals and researchers and is receiving record numbers of submissions each month.

Looking forward, we are collaborating with academia, industry, other imaging associations and government to advance the use of new molecular imaging radiopharmaceuticals. SNMMI will host a stakeholder meeting to clarify the regulatory situation and recommend ways to improve existing approval pathways. In addition, we will be cosponsoring workshops with the World Molecular Imaging Society and the American Society of Nuclear Cardiology to identify barriers to the translation of new molecular imaging technologies to the clinic and how to overcome them.

HCBN: What do you anticipate will be some other highlights at the show?
PH: The annual meeting exhibits will include everything from the most sophisticated, cutting-edge imaging systems and software to equipment for producing radiopharmaceuticals. Last year’s popular “Hot Spot” and scavenger hunt games will be repeated for a variety of rewards. And the 2014 SNMMI Annual Meeting App will help attendees search our scientific and educational programs as well as help them locate exhibitors and even build a custom exhibitor list.




HCBN: How have any legislative measures, the SGR patch for instance, had an impact — if at all — on nuclear medicine and molecular imaging?
PH: The SGR fix was temporary for many areas, but it permanently tied physician reimbursement for advanced imaging to appropriate use criteria. Now referring physicians will need to consult appropriate use criteria before ordering a molecular imaging procedure, in order to determine whether it is clinically appropriate for a patient’s condition. As long as the appropriate use criteria utilized reflect the established value of nuclear medicine procedures, this is a positive development.

HCBN: You served as a professor of neurology and radiology at the Washington University School of Medicine in St. Louis, Mo. Are you excited the show will take place in St. Louis this year?
PH: Yes, I was fortunate to work at the Mallinckrodt Institute of Radiology at Washington University School of Medicine for several years. This institution was the source of numerous advances in nuclear medicine. The earliest PET scanners were developed there by Mike Phelps and the late Michel Ter-Pogossian in the 1970s. Time-of-flight PET imaging was also implemented there. Marcus Raichle applied methods for using oxygen-15 labeled PET radiopharmaceuticals for clinical research, especially in the areas of functional brain mapping and cerebrovascular disease. The late Mike Welch was a leader in the field of radiochemistry. He was a president of our society, and we have an important award at our annual meeting given in his memory. We are looking forward to having members of his family in attendance. And we are delighted that this year’s Cassen Prize Lecturer, Dr. Barry Siegel, is from Washington University School of Medicine, where he has been director of nuclear medicine for many years.