The Reporter: June 1996, Vol.7, No.3
PET Center Launches Clinical Outreach

The Kreitchman PET Center was opened at CPMC in 1994 but until recently was used almost exclusively for research purposes. Medical literature and research have increasingly supported the use of PET (positron emission tomography) for clinical situations in which difficult treatment alternatives can be a matter of life or death, so PET's clinical applications have been increased.

To build the clinical side of the PET center, Dr. Herbert Pardes, vice president and dean, invited Dr. Ernest J. De Salvo to be the PET clinical coordinator. Dr. De Salvo, who was affiliated with Columbia from 1972 to 1976 as assistant professor of medicine at Harlem Hospital Center, has been a private practice physician and a businessman. In 1981 he started Medical Resources, now a public company that designs, builds, and manages outpatient MRI sites and imaging centers for hospitals.

That experience proved to be successful for Dr. De Salvo, who likes to be involved in laying the foundation for use of cutting-edge medical technology. "PET fascinated me and I wanted to be involved in building what is a very exciting clinical diagnostic tool."

Within a month's time, Dr. De Salvo and his team organized a staff, arranged for an office with a patient reception area, and began educating physicians on the clinical uses of PET. A professional services coordinator serves as a liaison between physicians and the center and provides doctors with background information on PET technology. A general manager handles patient billing and collections, and a receptionist schedules appointments.

The two most important goals of the staff are to focus on patient care and to encourage physicians to use PET when appropriate. As a physician himself, Dr. De Salvo understands what information doctors need to make decisions about using PET. With his experience in building and planning outpatient imaging clinics, he knows how patients like to be treated and what approach works to get physicians to incorporate a service into their diagnostic algorithm.

"My goal is to make Columbia's name synonymous with PET in the New York metropolitan area," says Dr. De Salvo. Columbia's PET center is the only one of its kind in the metropolitan area that offers clinical applications to all three subspecialties of cardiology, oncology, and neurology. Yet he believes that may change in the next few years. "We hope to build up the PET center's name and image before other institutions begin to offer this service. That way the technology will be established as Columbia's." Because in some cases PET is the only way to diagnose certain conditions, the technology is rapidly gaining acceptance with managed care organizations, which recognize the potential cost savings of non-invasive diagnostic studies. Most private insurance companies will reimburse PET on a case-by-case basis, and Medicare is studying broader reimbursement; it already covers certain types of cardiac PET studies. As a service to patients and their physicians, the PET center handles all necessary preapproval with insurance companies.

The PET center serves approximately 10 patients a week (each scan takes from one to four hours). The scanner is shared half-time with Columbia researchers. By the time Columbia needs another scanner to meet increasing demands, Dr. De Salvo hopes to have established the Kreitchman PET Center as the premier place in the New York metro- politan area for the best in diagnostic imaging. "If we can show that the University can deliver high-quality patient services at the Kreitchman PET Center, we will be both successful and profitable," he says.

The Kreitchman PET Center provides physicians with current literature and information on the merits of PET scans for diagnosis of disease.