Technology Assessments

Electromagnetic Navigation Bronchoscopy – pro

ENB (Electromagnetic Navigation Bronchoscopy) or EMN bronchoscopy is a type of bronchoscopy that uses electromagnetic guidance to project catheters into and through bronchial passages. Using a virtual, three-dimensional (3D) bronchial map from a recent CT scan and disposable catheters, it makes it possible to navigate to a desired location within the lung  and to look at it or biopsy it, stage lymphatic nodes or to insert markers to guide future

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MUD for aplastic anemia – pro

Allogeneic bone marrow transplantation from human leukocyte antigen (HLA)-matched, related donors is generally accepted as the initial treatment of choice for young patients (< 20 years old). It results in the complete reconstitution of hematopoiesis, whereas autologous hematopoietic remissions after immunosupression (IST) are more susceptible to relapse. The literature indicates that survival rates after ABMT, in patients between the ages of

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PET for melanoma – pro

Medicare currently covers PET for initial staging of melanoma although it states, "CMS guidelines state that PET would rarely be used in the diagnosis of melanoma; CMS does not cover PET for evaluation of regional nodes when there is not suspicion for more extensive disease". NCCN does list PET as a staging option. The most recent review concluded: "PET scanning facilitates the appropriate management of high-risk melanoma patients being considered

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PET for biliary cancer – pro

PET scanning is a new modality and many questions as to appropriateness and clinical benefit remain. This is especially so in complex anatomic location like biliary and gallbladder carcinoma. It is not at all certain that using PET in gallbladder cancer results in clinically beneficial decisions and false positive and false negative rates have not been adequately studied.ESMo (2016) aSYS: " The utility of positron emission tomography (PET)-CT is

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Busulfan/Cytoxan and Busulfan/Fludarabine induction in BMT – pro

Two combinations are well established as preparative regimens for leukemia: cyclophosphamide (Cytoxan, Neosar) plus total-body irradiation (TBI) or busulfan (Myleran) plus cyclophosphamide. TBI has been given as a single dose in the past, but a high incidence of complications, especially interstitial pneumonitis, occurred. Fractionated TBI with lung shielding in combination with cyclophosphamide, 60 mg/kg/d intravenously (IV) for 2 days, has been

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Cyberknife for prostate ca – pro

The CyberKnife belongs to a new class of radiotherapy techniques called IGRT (image-guided radiotherapy). It is a type of radiosurgery, a name for a group of techniques that uses computer simulated delivery of radiation. The CyberKnife is theoretically unique in that it uses a compact linear accelerator (LINAC) mounted on an image-guided robotic arm to deliver multiple beams of high energy x-rays to a target. The ability of the CyberKnife to shape

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TEC assessment language – pro

1.Does the technology have final approval from the appropriate goverment regulatory body? 2.Does scientific evidence permit conclusions concerning the effect of technology on health care outcomes? 3.Does it improve net health care outcomes? 4.Is it as beneficial as well established alternatives? 5.Are there improvement gained that are attainable outside the investigtional setting? 6.Is the denial of experimental/ investigational supported in consideration

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FISH for myeloma – pro

A recent workshop was conducted to agree on guidelines for use of FISH in myeloma. These recommendations arose from a workshop organised for the European Myeloma Network, held at the Royal Marsden Hospital, London on March 11th 2005. 31 European laboratories were represented at the meeting. These recommendations are intended to apply only to newly diagnosed cases of myeloma or frank relapse cases. The use of FISH to monitor response to high dose

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Cowden testing – pro

Lay Summary: Abnormalities in the PTEN gene are a part of Cowden syndrome. It is rare, but associated with an increased risk of developing several types of cancer, including breast cancer. Under some circumstances it is appropriate to test for PTEN gene mutations. Cowden syndrome is a complex disorder with malignant and benign (hamartomatous) lesions affecting derivatives of all three germ cell layers. Major organs involved include the breast, thyroid,

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PET for HNC after treatment- pro

The detection of residual disease after therapy is a particularly difficult problem for patients who have head and neck cancer. Surgery, radiation therapy, and chemotherapy may result in anatomic changes that are difficult to differentiate from recurrent or residual tumor. CT and MRI frequently require serial studies to determine if tumor recurrence is present or absent. FDG-PET is not based on anatomic information, so the functional imaging of PET

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