The Society of Nuclear Medicine and Molecular Imaging (SNMMI) has published appropriate use criteria (AUC) for bone scintigraphy in patients with prostate or breast cancer. This is the first in a series of new AUC developed by SNMMI in its role as a qualified provider–led entity (PLE) under the Medicare Appropriate Use Criteria program for advanced diagnostic imaging.

The new AUC are intended to assist referring physicians and ordering professionals in fulfilling the requirements of the 2014 Protecting Access to Medicare Act (PAMA). Beginning January 1, 2018, PAMA will require referring physicians to consult AUC developed by a PLE to ensure cost–effective and appropriate utilization of advanced diagnostic imaging services.

Bone scintigraphy is one of the highest–volume procedures in nuclear medicine imaging facilities. In 2014, approximately 407,000 bone scintigraphy studies were performed on Medicare patients for all indications. It is hoped that this evidence–based expert guidance will help make the use of bone scintigraphy more consistent and improve healthcare outcomes for the intended patient population while minimizing unnecessary imaging costs.

This AUC was developed by a workgroup composed of representatives from SNMMI, the European Association of Nuclear Medicine (EANM), and the American Society of Clinical Oncology (ASCO). Their expertise was supplemented by a systematic review of existing evidence conducted by the Oregon Health Science University's (OHSU) Evidence–based Practice Center.

In addition to bone scintigraphy AUC, the SNMMI Guidance Oversight Committee is developing AUC for ventilation/perfusion imaging in pulmonary embolism, hepatobiliary scintigraphy in abdominal pain, F–18–FDG PET restaging of malignant disease, gastrointestinal transit, infection imaging, PET myocardial perfusion imaging, prostate cancer imaging, somatostatin imaging, and thyroid imaging and therapy.