Impact of Nuclear Medicine and Radiopharmaceuticals on Health-care Delivery: Advances, Lessons, and Need for an Objective Value-matrix

The nuclear medicine (NM) growth has gone through both evolutionary and revolutionary changes over decades, mostly attributable to the dynamic and responsive trends in the global development and deployment of radiopharmaceuticals (RPh), as well as the advent of superior technology imaging systems (single-photon emission computed tomography/computed tomography [CT], positron emission tomography [PET]/CT, PET/magnetic resonance) with quantification capability. There are naturally many crucial lessons learnt along the way of NM-RPh progress achieved. It is felt imperative for the NM-RPh community to have consensus-based list(s) of indications for NM, classified on the value-level basis, at NM gross-level and specific medical specialty-wise, and the corresponding RPh needed, to ensure harmonious communication with the referral medical fraternity and health-care policymakers. For this purpose, a “NM value-matrix” is proposed in terms of “NM utility grading” (unique value, significant value, useful value, and others) versus “patient volume” (i.e., large, medium, low, and rare cases), covering the established and emerging indications for NM procedure, and the corresponding RPh product(s) in use. A consensus-based NM Value-Matrix will portray in an unequivocal manner, the merits of NM-RPh options (also limitations, if any) for serving needy patients.