Video from RSNA 2019: Get ready for changes to radiology billing in 2020

Dec 3, 2019
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Response Evaluation Criteria in Bone Metastases (RECIBM) and metabolic criteria were used to detect a complete response missed at anatomic assessment. A 76-year-old male patient presented with 1 month of hemoptysis and was diagnosed with small cell lung cancer and bone metastases. Baseline (July 2022) F-18 FDG-PET/CT images (A, maximum intensity projection image; B–E, axial images) demonstrate FDG-avid lesions in the left lamina of the first lumbar vertebra (L1) (straight yellow arrows; maximum standardized uptake value, 2.74; peak standardized uptake value normalized to lean body mass, 1.59) and left ilium (curved yellow arrows; maximum standardized uptake value, 3.68; peak standardized uptake value normalized to lean body mass, 2.28). After seven chemotherapy cycles (December 2022), follow-up PET/CT images (F, maximum intensity projection image; G–J, axial images) show complete metabolic resolution of bony lesions (L1: maximum standardized uptake value, 1.32, and peak standardized uptake value normalized to lean body mass, 0.85; left ilium: maximum standardized uptake value, 1.48, and peak standardized uptake value normalized to lean body mass, 0.82), without apparent osteolytic or osteoblastic changes at CT. Assessment was stable disease (SD) according to the University of Texas MD Anderson Cancer Center (MDA) criteria but complete response (CR) or complete metabolic response (CMR) according to RECIBM, PET Response Criteria in Solid Tumors (PERCIST), and European Organization for Research and Treatment of Cancer (EORTC) criteria. The patient was alive as of September 30, 2025.
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