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PET Imaging2019

Benchmark Report

PET IMAGING

2019

© 2019 IMV, part of the Science and Medicine Group

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2019 PET Imaging Benchmark Report Table of Contents

IMV 2019 PET Imaging Benchmark Report © 2019 IMV, part of the Science and Medicine Group

Number of Clinical PET Scans, Sites, & Units 1 Distribution of PET Imaging Sites and PET Scans, by Site Type, 2018 ................................................................................ 1

Distribution of PET Imaging Sites and PET Scans, All Sites, by Current PET Capability, 2018 ........................................... 1

Distribution of Fixed PET Imaging Systems in Hospital vs. Non-Hospital Sites, as of 2018 PET Census Survey .................. 2

Mix of Sites with Mobile vs. Fixed PET Imaging Systems, by Site Type, as of 2018 PET Census Survey ............................. 2

Mobile vs. Fixed PET Imaging: Sites and Units, as of 2018 PET Census Survey .................................................................. 2

Total Estimated Clinical PET Scans, by Site Type, 2005-2018 ............................................................................................. 3

Whether Fixed PET Imaging Site Performs Research Scans, by Site Type, as of 2018 PET Census Survey........................... 3

Whether Department Currently Performs Specialized PET Scans, as of 2018 Census Survey ............................................... 3

PET Clinical Patient Scan Mix 4 Clinical Applications Mix for PET Imaging Scans, 2018 ..................................................................................................... 4

Mix of Pediatric vs. Adult PET Scans, 2018 ......................................................................................................................... 4

PET Inpatient vs. Outpatient Mix, 2018 ............................................................................................................................... 4

Distribution of PET Imaging Oncology Scans, by Lung Cancer Study Type, 2018 ................................................................ 5

Relative Distribution of Clinical PET Oncology Scans and Percent of Sites Performing, 2018 .............................................. 5

Characteristics of the Fixed PET Imaging Installed Base 6 Distribution of Fixed PET Imaging Installed Base, by Year of Installation, by Site Type, as of 2018 PET Census Survey ..... 6

Mix of Fixed PET Imaging Installed Base, by PET Scanner Type, as of 2018 PET Census Survey ....................................... 6

Percent Distribution of PET/CT Installed Base, by Number of CT Slices, as of 2018 PET Census Survey ............................. 6

Variation of PET Scans per Site, by Current PET Capability and Site Type 7 Average Annual Clinical PET Scans per Site, by Current PET Capability and Site Type, 2018 ............................................ 7

2018 Clinical PET Scans vs. Number of Hospital Beds ........................................................................................................ 7

Average PET Scans per Fixed PET Imaging System 8 Distribution of Sites, by Number of Fixed PET Imaging Systems Installed, by Site Type, as of 2018 PET Census Survey ..... 8

Average PET Scans Performed per Fixed PET Imaging System, by Site Type, 2018............................................................. 8

Staffing Configurations at PET Imaging Sites 9 Percent of Fixed PET Imaging Sites with Staff Types, by Site Type, as of 2018 PET Census Survey .................................... 9

Mean # of Employees per Fixed PET Imaging Site Having That Staff Type, by Site Type , as of 2018 PET Census Survey .. 9

# of Technologists Typically Involved with Patient Scanning at Fixed PET Imaging Sites, as of 2018 PET Census Survey 10

Whether PET Schedulers Work Within the PET Department or in Central Scheduling, as of 2018 PET Census Survey ..... 10

PET/CT Sites Performing Diagnostic CT-Only Scans 10 Percent of Fixed PET/CT Sites Performing Diagnostic CT-only Scans with No Associated PET Scans, 2018 PET Census . 10

PET Radiopharmaceutical Utilization and Budgets 11 Radiopharmaceutical Sources for PET Imaging Sites, by Site Type, 2018 .......................................................................... 11

Distribution of Clinical PET Scans, by Radiopharmaceutical Used, 2018 ........................................................................... 11

Distribution of 2018 PET Radiopharmaceutical Budgets, for Fixed PET Imaging Sites Using Outside Suppliers ................ 11

Hours of Operation 12 Hours per Week (Monday-Friday) PET Department Open for Scheduled PET Scans, by Site Type, 2018 PET Census ....... 12

Hours per Week (Monday-Friday) PET Department Open for Scheduled PET Scans, by Current PET Capability ............... 12

Hours per Weekend PET Department Open for Scheduled PET Scans, by Current Fixed vs. Mobile PET Capability .......... 12

Waiting Time for Scheduled Outpatient PET Scans 13 Waiting Time for Non-Emergency Outpatient PET Scan, by Current Fixed vs. Mobile PET Capability, as of 2018 PET

Census Survey............................................................................................................................................................... 13

Waiting Time for Non-Emergency Outpatient PET Scan, by Site Type, as of 2018 PET Census Survey ............................. 13

2018 PET Scans per Thousand Population, by State 14

Data Collection and Methodology 15

About IMV & IMV’s 2017-2018 PET Imaging ServiceTrakTM

Awards 16

IMV 2019 PET Imaging Benchmark Report 1 © 2019 IMV, part of the Science and Medicine Group

Operational Parameters of Facilities Performing

PET Imaging, Based on 2018 IMV Census

of Hospital and Non-Hospital Sites

The following is a summary of aggregate results of IMV Medical Information Division’s

2018 census of sites performing PET imaging in the United States. The universe of PET

sites for this data collection is defined as any location where PET scans are performed

using a fixed PET/CT, PET/MR, or PET-only scanner, or using a PET/CT or PET-only

scanner provided by a mobile service. Telephone interviews for this study were

conducted from January through December 2018. A total of 802 respondents

participated in this survey and the results are projected to the identified universe of sites

performing PET imaging procedures using fixed units or mobile PET services. The

findings reported here cover PET scan types and volumes, installed base characteristics,

staffing levels, radiopharmaceutical utilization and budgets, typical hours of operation,

and typical waiting time for scheduled outpatient appointments.

Number of Clinical PET Scans, Sites, & Units

Based on the data reported by the participants,

IMV estimates that 2,086,000 clinical PET

scans were performed in 2018 in 2,370

hospital and non-hospital facilities. By site

type, independent PET sites comprise 30% of

the PET scans and 30% of the locations,

whereas PET centers owned by hospital

organizations comprise 19% of the PET scans

and 15% of the locations. Hospitals with

400+ beds constitute 23% of the PET scans

and 10% of the sites, while the smaller <200

bed hospitals and 200-399 bed hospitals

together constitute 28% of the PET scans and

comprise 45% of the sites.

The PET imaging sites have been grouped into

three PET capability categories:

1,370 “fixed PET/CT and/or PET/MR” sites

which have at least one fixed PET/CT or

PET/MR installed;

50 “fixed PET-only” sites which have at least

one fixed PET-only scanner installed, and do

not have a fixed PET/CT or PET/MR scanner;

950 “mobile PET/CT & PET users” which use

mobile van PET services, and do not have

their own fixed PET imaging systems.

By these categories, fixed PET/CT and/or

PET/MR sites comprise 58% of the sites and

80% of the PET scans, while fixed PET-only

sites comprise 2% of the sites and 2% of the

scans, and sites using mobile services account

for 40% of the sites and 18% of the scans.

700 637.3

355390.7

635248.6

430

336.3

250473.1

0%

20%

40%

60%

80%

100%

PET Imaging Sites(N = 2,370 Sites)

PET Scans(N = 2,086.0K)

Distribution of PET Imaging Sites and PET Scans, by Site Type, 2018

400+ Beds

200-399 Beds

<200 Beds

PET Centers Ownedby Hospital Orgs.

IndependentPET Sites

27%

10%

16%

18%

30%

23%

12%

30%

15%19%

1,370

1,674.5

50

47.1 950

364.4

0%

20%

40%

60%

80%

100%

PET Imaging Sites(N = 2,370 Sites)

PET Scans(N = 2,086.0 K)

Distribution of PET Imaging Sites and PET Scans, All Sites, by Current PET Capability, 2018

Mobile PET/CTor PET User

Have FixedPET-only

Have FixedPET/CT and/orPET/MR

18%

80%

40%

58%

2%

2%


As of this 2018 census survey,

the total installed base of fixed

PET imaging systems is

estimated to be 1,545 units

installed in 1,420 sites,

including 1,480 fixed PET/CT

scanners, 15 fixed PET/MR

scanners, and 50 fixed PET-only

scanners. (Note this estimate

does not include any scanners in

mobile vans providing PET or

PET/CT services to end users on

mobile routes.)

Overall, 950 sites report they utilize

a mobile PET service, resulting in a

total of 2,370 sites conducting PET

scans. Just over half (51%) of the

identified mobile users are <200 bed

hospitals, while another 21% are

200-399 bed hospitals. Over two

fifths (41%) of the sites with fixed

PET imaging systems are

independent PET sites.

The 950 sites using mobile PET

services report that they use the

mobile service for an average of 5.2

days per month per site. Assuming

that the mobile vans are scheduled

with no downtime between sites, an

estimated 245 mobile vans serve

these 950 sites. The resulting

estimate for the total number of PET

imaging systems in use, including

fixed and mobile units, is 1,790

PET-only, PET/CT and PET/MR

scanners.

595

665

580

560

245

255

- 250 500 750 1,000 1,250 1,500 1,750

Sites with Fixed PETImaging Systems

Fixed PET-only Scanners

Fixed PET/MR Scanners

Fixed PET/CT Scanners

Distribution of Fixed PET Imaging Systemsin Hospital vs. Non-Hospital Sites,

as of 2018 PET Census Survey

Hospitals Independent PET Sites PET Centers Owned by Hospital Orgs.

1,480

1,420

50

15

15% 12% 17%

30%

12%

41%

27%

51%

11%

18%21%

16%

10%4%

15%

0%

20%

40%

60%

80%

100%

Total PET Imaging Sites,Mobile and Fixed

(N = 2,370)

Sites Using MobilePET-only or PET/CT

(N = 950)

Sites with Fixed PETImaging Systems

(N = 1,420)

Perc

en

t o

f S

ites

Mix of Sites with Mobile vs. Fixed PET Imaging Systems, by Site Type, as of 2018 PET Census Survey

400+ Beds

200-399 Beds

<200 Beds

Independent PET Sites


1,545

245

1,420

950

0 250 500 750 1,000 1,250 1,500 1,750 2,000

Fixed PETImaging

Use MobilePET/CT

or PET-only

Mobile vs. Fixed PET Imaging: Sites and Units, as of 2018 PET Census Survey

Sites

Units


Clinical PET Scan Trends

In 2018, an estimated 2,086,000 clinical PET scans (excluding research studies) were performed

in 2,370 hospital and non-hospital sites with fixed units or using mobile services. Compared to

1,945,000 PET scans performed in 2017, this represents a 7% increase, and is the highest level of

PET scan volume to date. From 2011 to 2013, total PET scans decreased 14% from 1,853,700 to

1,594,100, but have increased 31% in the five years since 2013. The average annual increase

from 1,594,100 in 2013 to the current 2,086,000 is ~6% per year.

563.8 637.7 711.6 740.0 804.0 868.1 909.1 830.4 751.7 760.5888.4 973.6 1012.0 1028.0

307.6375.3

443.0 458.6467.1

475.6493.0

469.6446.2 463.7

494.4

557.6 555.5 584.9

258.5

280.6

302.8322.2

361.3400.3

451.6

423.9

396.2 392.7

335.7

449.5 377.5473.1

1,129.9

1,293.6

1,457.4 1,520.8

1,632.4 1,744.0

1,853.7

1,723.9

1,594.1 1,616.9 1,718.5

1,980.6 1,945.0

2,086.0

0

250

500

750

1,000

1,250

1,500

1,750

2,000

2,250

2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018

Nu

mb

er

of

PE

T S

can

s (

Th

ou

san

ds)

Total Estimated Clinical PET Scans, by Site Type, 2005-2018

400+ Beds

<400 Beds

Non-Hospitals

Excludes Research PET Scans

Research Patient PET Scans

Overall, 34% of the fixed PET

imaging sites perform research

scans, while 66% perform clinical

scans only. By site type, the larger

400+ bed hospitals and independent

PET sites are more likely to perform

research scans, with 43-46% of the

sites performing, compared to 13-

26% of the <400 bed hospitals and

PET centers owned by hospital

organizations.

Specialized PET Scans

As of this 2018 census survey, 32%

of the PET imaging sites perform

bone studies with sodium fluoride

(NaF18), 28% provide simulation for

radiation therapy treatment planning,

19% use neuroimaging agents to

detect beta-amyloid plaque for

Alzheimer’s disease, 16% use Ga-68

Dotatate for neuroendocrine tumors,

5% perform PET myocardial

perfusion studies, and 3% perform

cardiovascular CT studies with

PET/CT scanners.

66%76%

57%

87%74%

54%

34%24%

43%

13%

26%

46%

0%

20%

40%

60%

80%

100%

All Fixed Sites(N = 1,305)

PET CentersOwned by

Hospital Orgs.(N = 235)

IndependentPET Sites(N = 530)

<200 Beds(N = 140)

200-399 Beds(N = 210)

400+ Beds(N = 190)

Perc

en

t o

f R

esp

on

din

g S

ites

Whether Fixed PET Imaging Site Performs Research Scans, by Site Type, as of 2018 Census Survey

PerformsResearch Scans

PerformsClinical ScansOnly

3%

5%

16%

19%

28%

32%

0%5%10%15%20%25%30%35%

Cardiovascular CT with a PET/CT

PET Myocardial Perfusion Studies

Imaging for neuroendocrine tumors with Ga68Dotatate

Neuroimaging agents to detect beta-amyloid plaquefor Alzheimer's disease

Simulation for radiation therapy treatment planning

Bone studies with Sodium Fluoride (NaF18)

% of Sites (N = 2,370)

Whether Department Currently PerformsSpecialized PET Scans, as of 2018 Census Survey


Oncology(N = 1,893.9 K)

91%

Cardiology(N = 117.7 K)

6%

Neurology(N = 71.7 K)

3%

Other(N = 2.7 K)

<1%

Clinical Applications Mixfor PET Imaging Scans, 2018

N = 2,086.0K Clinical PET Scans

PET Clinical Patient Scan Mix Clinical PET Scan Volume,

by Application Type

Of the 2,086,000 clinical PET scans

performed in 2018, 91% (1,893,900)

were for oncology studies, 6% (117,700)

were for cardiology studies, and 3%

(71,700) were for neurology studies. A

negligible <1% (2,700) scans were other

types of PET scans.

Pediatric vs. Adult Mix

Of the PET scans performed in 2018,

98% were performed on adults and 2%

were performed on pediatric patients.

Inpatient vs. Outpatient Mix

In 2018, 97% of all PET scans were

performed on an outpatient basis and

3% were for inpatients.

Adult98%

Pediatric2%

Mix of Pediatric vs. Adult PET Scans, 2018

N = 2,086.1K PET Scans

Inpatient3%

Outpatient97%

PET Inpatient vs. Outpatient Mix, 2018



Other22%

Prostate3%

Melanoma4%

Head & Neck5%

Breast14%

Colorectal8%

Hodgkins/ Lymphoma

15%

Solitary Pulmonary Nodules

14%

Non-Small Cell Lung Cancer

10%

Other Lung5%

Lung29%

Distribution of PET Imaging Oncology Scans, by Lung Cancer Study Type, 2018

N = 1,893.9K PET Imaging Oncology Scans

PET Imaging

Oncology Study Mix

Of the 1,893,900 clinical PET

oncology studies performed in 2018,

the top three study types are lung

(29%), Hodgkins/Lymphoma (15%),

and breast studies (14%). Colorectal

studies comprise 8% of the oncology

scans, followed by head & neck (5%),

melanoma (4%), and prostate scans

(3%). The lung PET scans are

comprised of solitary pulmonary

nodule studies (14%), non-small cell

lung cancer studies (10%), and “other

lung” scans (5%).

Of the 1,893,900 PET imaging

oncology scans performed in 2018,

two thirds (66%) are comprised of

the top four cancer indication types:

lung, Hodgkins/Lymphoma, breast,

and colorectal.

An estimated 2,335 sites perform PET

oncology scans. Of these, 92%

perform lung procedures. Hodgkins/

Lymphoma scans are performed by

73% of the sites, followed by breast

(71%), colorectal (65%), melanoma

(55%), and head & neck (54%).

PET Oncology

Indication Categories

Lung 556.9 30% 92%

- Solitary Pulmonary Nodules 273.0 14% 87%

- Non-small Cell Lung Cancer 192.3 10% 82%

- Other Lung 91.6 5% 59%

Breast 272.3 14% 71%

Hodgkins / Lymphoma 273.7 14% 73%

Colorectal 152.1 8% 65%

Head & Neck 100.3 5% 54%

Melanoma 71.3 4% 55%

Prostate 62.5 3% 40%

Esophageal 36.9 2% 42%

Cervical 30.1 2% 34%

Ovarian 27.7 1% 36%

Pancreatic 23.1 1% 39%

Liver 14.1 1% 29%

Brain 19.4 1% 24%

Sodium Fluoride18 Bone Scans 8.2 0% 8%

Thyroid 13.7 1% 29%

Neuroendocrine Tumors 22.8 1% 24%

Testicular 9.7 1% 25%

Unknown Primary 33.9 2% 33%

Other 165.3 9% 29%

Total 2018 PET

Oncology Scans (K)1,893.9 K 100% (N = 2,335 Sites)

RELATIVE DISTRIBUTION OF CLINICAL PET ONCOLOGY

SCANS AND PERCENT OF SITES PERFORMING, 2018

Total 2018 PET

Scans (K)

% of PET

Scans

% of Sites

Performing


Characteristics of the Fixed PET Imaging Installed Base

PET Imaging Installed Base,

by Year of Installation As of this census survey, nearly half

(51%) of the fixed PET imaging system

installed base have been installed in

2011 and after. By hospital bed size, a

larger proportion of the fixed units in

smaller <200 bed hospitals are newer

(although they constitute a low

percentage of the fixed units), with

64% of the units in <200 bed hospitals

having been installed in 2011 or later,

compared to 47% of the units in 200-

399 bed hospitals, 54% of the units in

400+ bed hospitals, and 44-49% of the

units in the non-hospital locations.

PET Installed Base, by Fixed

PET/CT, PET/MR, vs. PET-Only

Configurations

As of this 2018 census survey, 96% of the

fixed PET imaging systems installed are

PET/CT scanners, 1% are PET/MR, and

3% are PET-only scanners.

PET/CT Installed Base,

by Number of CT Slices

As of this 2018 census survey, 19% of

the installed fixed PET/CT scanners are

reported to have fewer than 16 CT

slices, 43% have 16 slices, 13% have

20-40 slices, and 25% have 64-128

slices.

23% 24% 26%16% 18%

26%

14% 17% 15%

16%16%

9%

12%15% 10%

4%

19%11%

10%10%

6%

16%

12%

11%

14%12%

17%20%

7%

11%

15%13%

13% 24%14% 18%

12% 9% 13%4%

14% 14%

0%

20%

40%

60%

80%

100%

Total Units(N = 1,325)

Average age= 7.5 years

PET CentersOwned by

Hospital Orgs.(N = 225)




<200 Beds(N = 140)


200-399 Beds(N = 210)


400+ Beds(N = 230)


Perc

en

t o

f U

nit

s

wit

h Y

ear

Sp

ecif

ied

Average Age and Distribution of the Fixed PET Imaging System Installed Base, by Year of Installation, by Site Type, as of 2018 PET Census Survey

2017-2018

2015-2016

2013-2014

2011-2012

2009-2010

2007-2008

2006 and before

Fixed PET-only3%

Fixed PET/MR1%

Fixed PET/CT96%

Mix of Fixed PET Imaging Installed Base, by PET Scanner Type,


% of PET Imaging Systems (N = 1,545)

<16 Slices19%

16 Slices43%

20-40 Slices13%

64-128 Slices25%

Percent Distribution of PET/CT Installed Base, by Number of CT Slices, as of 2018 PET Census Survey

N = 1,385 Fixed PET/CT Scanners with # of Slices Specified


Variation of PET Scans per Site, by Current PET Capability and Site Type

In 2018, an average annual number of

880 clinical PET scans was performed

per site, including sites using fixed

PET imaging systems and mobile PET

services. Sites with fixed PET/CT

and/or PET/MR scanners averaged

1,225 scans per site, while the few

sites using fixed PET-only scanners

averaged 905 scans, and mobile

PET/CT or PET users averaged 385

PET scans per site.

By site type, the larger 400+ bed

hospitals performed an annual

average of 1,910 PET scans per site,

compared to 780 in 200-399 bed

hospitals, 390 in <200 bed hospitals,

915 in independent PET sites, and

1,090 in PET centers owned by

hospital organizations.

The following graph and regression formula may be used to determine the annual

clinical PET scans normally performed on fixed PET imaging systems or using mobile

PET/CT or PET services, for any given hospital size.

REGRESSION FORMULA Annual Total PET Scan Volume = (# of Staffed Beds x 3.0788) + 31.484

r2 = 0.1555

SAMPLE CALCULATIONS Hospital Annual Bed Size PET Scans 100 340 200 645 300 955 400 1,265 500 1,570 750 2,340 1,000 3,110

1,090

915

390

780

1,910

385

905

1,225

880

- 500 1,000 1,500 2,000 2,500

PET Centers Owned by Hospital Orgs.(N = 355)

Independent PET Sites(N = 700)

<200 Beds(N = 635)

200-399 Beds(N = 430)

400+ Beds(N = 250)

Mobile PET/CT or PET User(N = 950)

Have Fixed PET-only(N = 50)

Have Fixed PET/CT and/or PET/MR(N = 1,370)

All Sites(N = 2,370)

Site T

yp

eC

urr

ent

PE

T C

apa

bili

tyA

llS

ites

Average Annual PET Scans per Site

Average Annual Clinical PET Scans per Site, by Current PET Capability and Site Type, 2018

0

300

600

900

1,200

1,500

1,800

2,100

2,400

2,700

3,000

0 100 200 300 400 500 600 700 800 900 1,000

An

nu

al

PE

T S

can

Vo

lum

e

Number of Hospital Beds

2018 Clinical PET Scans vs. Number of Hospital Beds(352 Responding Hospitals)


1,325

955

760

970

1,625

1,115

- 250 500 750 1,000 1,250 1,500 1,750 2,000

PET Centers Owned by Hospital Orgs.(N = 260 units)

Independent PET Sites(N = 605 units)

<200 Beds(N = 175 units)

200-399 Beds(N = 240 units)

400+ Beds(N = 275 units)

Total Fixed PET Imaging Systems(N = 1,555 units)

Average # of PET Scans per Fixed PET Imaging System

Average PET Scans Performed per Fixed PET Imaging System, by Site Type, 2018

Average PET Scans per Fixed PET Imaging System

As of this census survey, 94% of

all fixed PET imaging sites have

one unit installed and 6% have two

or more units, resulting in an

average of 1.1 scanners per site.

Of the 400+ bed hospitals, 85% have

one unit installed and 15% have two

or more units installed, while 94-

97% of the <400 bed hospitals and

non-hospital sites have one unit

installed.

In 2018, the average annual

number of PET scans performed

per fixed PET imaging system is

estimated to be 1,115.

By site type, the larger 400+ bed

hospitals performed the highest

average number of clinical PET

scans per scanner, with 1,625

scans, compared to 970 at 200-

399 bed hospitals, 760 at <200

bed hospitals, 955 at independent

PET sites, and 1,325 at PET

centers owned by hospital

organizations.

96%

94%

97%

85%

94%

4%

6%

3%

15%

6%

0% 20% 40% 60% 80% 100%

Non-Hospitals(N = 825)

<200 Beds(N = 150)

200-399 Beds(N = 230)

400+ Beds(N = 215)


% of Sites with Fixed PET/CT, PET/MR, or PET-Only Scanners

Distribution of Sites, by Number of Fixed PET Imaging Systems Installed, by Site Type, as of 2018 PET Census Survey

1 Unit 2+ Units

Average Fixed Units per Site

1.3

1.0

1.2

1.0

1.1


6%

74%

92%

100%

9%

86%

96%

100%

9%

74%

96%

100%

5%

66%

94%

100%

11%

76%

92%

100%

8%

78%

95%

100%

0% 20% 40% 60% 80% 100%

Radiopharmacists

Secretaries/Clerks/Transcriptionists

Administrators

Technologists

Percent of Fixed PET Imaging Sites

Percent of Fixed PET Imaging Sites with Staff Types, by Site Type, as of 2018 PET Census Survey


400+ Beds(N = 250)

200-399 Beds(N = 430)

<200 Beds(N = 640)

Independent PET Sites(N = 700)

PET Centers Ownedby Hospital Orgs.(N = 360)

Staffing Configurations at PET Imaging Sites

Using the data reported by participants on

the number of employees in different

general staff categories, IMV has developed

a profile representing an average staffing complement for fixed PET imaging sites.

Technologists are reported to be on staff at

100% of the sites, while 8% report having

radiopharmacists. Over three quarters

(78%) of the sites report having

secretaries/clerks/transcriptionists on staff

and 95% report having administrators.

By site type, independent PET sites are

slightly more likely to have technologists

and secretaries/clerks/transcriptionists

than the hospitals or PET centers owned

by hospital organizations.

This graph compares the average number

of employees for these staff categories, by

site type. Each average includes only

those fixed PET imaging sites reporting

personnel in that category.

As of this census survey, the average

staffing per fixed site having that staff

type is 4.3 technologists, including both

full- and part-time employees, 3.3

secretaries/clerks/transcriptionists, 1.3

administrators, and 2.3 radiopharmacists.

By site type, the 400+ bed hospitals

are likely to have more technologists,

both full-time and part-time, than the

other site types. Both non-hospital

site types are likely to have more

secretaries/clerks/transcriptionists,

with an average of 3.8, compared to

2.3-2.7 in the hospitals.

1.2

3.8

1.3

4.1

2.7

3.8

1.3

2.8

2.8

2.7

1.2

4.6

1.5

2.5

1.6

5.2

2.1

2.3

1.4

7.3

2.3

3.3

1.3

4.3

0.0 1.0 2.0 3.0 4.0 5.0 6.0 7.0 8.0

Radiopharmacists

Secretaries/Clerks/Transcriptionists

Administrators

Full-time andPart-time

Technologists

Average Number of Employees per Site Having Staff Type

Mean Number of Employees per Fixed PET Imaging Site Having that Staff Type, by Site Type, as of 2018 PET Census Survey

All Sites

400+ Beds

200-399 Beds

<200 Beds

Independent PET Sites



The respondents in fixed PET imaging

sites were asked how many

technologists are typically involved

with performing or preparing patients

for scans on a typical day.

Overall, 48% of the sites use one

technologist, 39% use two

technologists, and 13% use three or

more technologists, resulting in an

average of 1.8 technologists per site.

The respondents in fixed PET imaging

sites were asked whether their PET

patients are scheduled by schedulers in

a central scheduling department and/or

within their PET department.

Overall, 38% of the respondents

indicated that they have schedulers in

their PET department, which is

comprised of 25% with schedulers in

their PET department and 13% with

schedulers in both central scheduling

and in their PET department.

PET/CT Sites Performing Diagnostic CT-Only Scans

Percent of Fixed PET/CT Sites

Performing Diagnostic CT-Only Scans

with No Associated PET Scans

As of this 2018 census survey, just

under half (44%) of the responding

sites with fixed PET/CT scanners

indicated that they perform

diagnostic CT-only scans with no

associated PET scans on their

PET/CT scanners and 56% do not

perform any diagnostic CT-only

scans on their PET/CT scanners.

1 technologist48%

2 techs39%

3 techs8%

4 techs2%

5+ techs3%

Number of Technologists Typically Involved with Performing or Preparing Patients for Scans on a Typical Day

at Fixed PET Imaging Sites, as of 2018 Census Survey

Average = 1.8 Technologists

per Site

Central scheduling department

62%

Within PET department

25%

Both central scheduling &

PET department

13%

Whether PET Schedulers Work Within the PET Department or in Central Scheduling,


N = 1,420 Fixed PET Imaging Sites

Perform Diagnostic CT Scans with No Associated PET

Scans 44%

Don’t Perform Diagnostic

CT-Only Scans56%

Percent of Fixed PET/CT Sites Performing Diagnostic CT-only Scans with No Associated PET Scans,


N = 1,230 PET/CT Sites Specifying Use


PET Radiopharmaceutical Utilization and Budgets

Sources of Radiopharmaceuticals

Overall, 98% of the PET imaging sites

(2,315 sites) use outside suppliers as their

sole source of radiopharmaceuticals, 1%

(30 sites) use a cyclotron on site, and 1%

(25 sites) indicate they use both.

By site type, a slightly larger proportion

of the 400+ bed hospitals obtain their

radiopharmaceuticals from a cyclotron

on site than the other site types: 9% of

the 400+ bed hospitals use PET

radiopharmaceuticals from a cyclotron

on site (including 6% who use both and

3% who only use a cyclotron on site),

compared to 1% of the <400 bed

hospitals and 2% of the non-hospitals.

Radiopharmaceutical Agents

Used for PET Imaging

Of the 2,086.0K clinical PET scans

performed in 2018, 91%, (an

estimated 1,908.5K scans) used

F18DG and 5% (97,000 scans) used

Rb82, while all other agents

comprised 4%.

Radiopharmaceutical Budgets

For 2018, 99% of the fixed PET imaging

sites using outside suppliers indicated they

had a radiopharmaceutical budget (>$0),

which is comprised of 10% having budgets

under $25K, 10% with budgets in the

$25K-$49K range, 17% with budgets in

the $50K-$99K range, 24% in the $100K-

$149K range, 17% in the $150-$249K

range, 9% in the $250K-$349K range, and

12% with budgets of $350K or more.

1%

3%

1%

98%

99%

99%

91%

98%

1%

6%

1%

0% 20% 40% 60% 80% 100%

Non-Hospitals(N = 1,055)

<200 Beds(N = 635)

200-399 Beds(N = 430)

400+ Beds(N = 250)


Percent of Fixed and Mobile PET Imaging Sites

Radiopharmaceutical Sources for PET Imaging Sites, by Site Type, 2018

Cyclotron on Site Outside Supplier Both

F18DG(N = 1,908.5K)

91.5%

Rb82(N = 97.0K)

4.6%

Ga68 Dotatate(N = 28.8K)

1.4%

NaF18(N = 19.7K)

0.9%

Axumin(N = 13.8K)

0.7%

N13 Ammonia(N = 9.3K)

0.4%Amyvid

(N = 7.1K)0.3%

Other Agents(N = 1.8K)

0.1%

Distribution of Clinical PET Scans, by Radiopharmaceutical Used, 2018


Zero Dollars1%

$1 -$24K10%

$25K - $49K10%

$50K - $99K17%

$100K - $149K24%

$150K - $249K17%

$250K - $349K9%

$350K+12%

Distribution of 2018 PET Radiopharmaceutical Budgets, for Fixed PET Imaging Sites Using Outside Suppliers

N = 1,390 Fixed PET Imaging Sites Using Outside Suppliers


Hours of Operation Respondents were asked to indicate

the typical number of operating hours

their department is open for scheduled

PET scans during the typical week

(Monday-Friday) and weekend

(Saturday and Sunday).

Overall, PET sites (including those

using fixed PET imaging systems

and mobile PET services) are

typically open for 28 hours during

Monday-Friday for scheduled PET

scans and <1 hour on weekends.

The larger 400+ bed hospitals are

more likely to be open for more

hours during the week, with over

half of the sites (51%) being open

for more than 41+ hours.

The mean number of hours the

departments with fixed PET

imaging systems are open for

scheduled PET scans per week is 40

hours, while the mean number of

hours for facilities using mobile

PET services is 10 hours per week.

Only 9% of the sites currently

schedule their PET imaging

equipment on the weekend. Sites

that use mobile PET services are

slightly more likely to be open for

scheduled PET scans on weekends

(14%) than sites with fixed PET

imaging systems (6%).

9%

3%

14%

6%

32%

14%

39%

10%

21%

4%

46%

29%

43%

27%

0% 20% 40% 60% 80% 100%

Use Mobile PET/CTor PET

(N = 860)

Have Fixed PETImaging Systems

(N = 1,285)


% of Responding Sites

Hours per Week (Monday-Friday) PET Department Open for Scheduled PET Scans, by Current Fixed v. Mobile PET Capability,


Zero Hours 1 to 4 5 to 8 9 to 24 25 to 40 41+ Hours

Mean Hours per Site

28

10

40

86%

94%

91%

4%

2%

10%

5%

7%

0% 20% 40% 60% 80% 100%

Use Mobile PET/CT & PET(N = 870)


(N = 1,290)



Hours per Weekend PET Department Open for Scheduled PET Scans, by Current Fixed vs. Mobile PET Capability,


Zero Hours 1 to 4 Hours 5+ Hours

Mean Hours per Site

0.7

0.9

0.5

11%

3%

18%

6%

12%

3%

28%

14%

6%

14%

15%

21%

24%

31%

12%

21%

41%

36%

14%

29%

31%

29%

29%

39%

5%

23%

51%

27%

0% 20% 40% 60% 80% 100%

PET Centers Owned byHospital Orgs.

(N = 330)


<200 Beds(N = 565)

200-399 Beds(N = 395)

400+ Beds(N = 220)



Hours per Week (Monday-Friday) PET Department Open for Scheduled PET Scans, by Site Type,


Zero Hours 1 to 4 5 to 8 9 to 24 25 to 40 41+ Hours

Mean Hours per Site

28

40

27

13

36

33


Waiting Time for Scheduled Outpatient PET Scans

Overall, 7% of the PET imaging

sites reported waiting times for a

non-emergency outpatient scan of

less than one day, and 93% have

waiting times of one day or more.

The median number of days patients

wait for scheduled appointments is

4 days overall, with fixed PET

imaging sites having a shorter

waiting time of 3 days compared to

7 days at sites using mobile PET

services (e.g., when the mobile PET

service makes its next visit).

By site type, the <200 bed hospitals

have longer waiting times for a non-

emergency outpatient scan of 7 days

(median), compared to 2-4 days at

the other site types, primarily

because the smaller hospitals are

more likely to be using mobile PET

services.

1%

11%

7%

10%

43%

30%

20%

21%

21%

53%

18%

31%

16%

7%

11%

0% 20% 40% 60% 80% 100%

Use Mobile PET/CT& PET

(N = 735)


(N = 1,160)



Waiting Time for Non-Emergency Outpatient PET Scan, by Current Fixed vs. Mobile PET Capability,


<24 Hours 1 - 2 Days 3 - 4 Days 5 - 7 Days >1 Week

Median Days per Site >0

4

3

7

5%

13%

3%

4%

10%

7%

32%

44%

10%

30%

36%

30%

30%

19%

17%

21%

21%

21%

28%

20%

51%

31%

21%

31%

5%

4%

19%

14%

12%

11%

0% 20% 40% 60% 80% 100%

PET Centers Owned by Hospital Orgs.

(N = 285)

Independent PETSites

(N = 555)

<200 Beds(N = 485)

200-399 Beds(N = 360)

400+ Beds(N = 210)



Waiting Time for Non-Emergency Outpatient PET Scan, by Site Type, as of 2018 PET Census Survey

<24 Hours 1 - 2 Days 3 - 4 Days 5 - 7 Days >1 Week

Median Days per Site >0

4

7

2

4

3

3


2018 PET Scans per Thousand Population, by State

State

AK 0 4 4 0 0 - 4,455 5.9

AL 14 24 38 5 12 17 43,465 8.4

AR 11 12 23 3 7 10 31,018 9.6

AZ 18 40 58 5 13 18 58,520 7.9

CA 78 129 207 19 39 58 216,298 5.2

CO 18 16 34 4 1 5 29,636 5.2

CT 17 11 28 5 4 9 28,449 7.8

DC 7 1 8 4 0 4 6,704 12.2

DE 3 3 6 0 1 1 5,515 5.8

FL 52 144 196 20 47 67 201,925 9.5

GA 43 16 59 16 9 25 59,974 5.8

HI 1 1 2 0 0 - 3,192 2.3

IA 42 6 48 16 4 20 25,669 8.1

ID 5 3 8 0 1 1 5,851 3.4

IL 69 36 105 27 11 38 86,468 6.3

IN 44 28 72 17 11 28 54,190 7.7

KS 21 9 30 5 4 9 18,790 6.1

KY 21 21 42 6 8 14 30,664 6.6

LA 11 21 32 3 4 7 32,928 6.6

MA 27 20 47 7 4 11 35,226 5.1

MD 16 33 49 5 11 16 47,598 7.5

ME 8 3 11 3 2 5 6,868 4.9

MI 51 14 65 15 3 18 38,308 3.5

MN 33 17 50 14 6 20 32,037 5.4

MO 53 13 66 19 3 22 48,680 7.5

MS 15 8 23 7 4 11 22,957 7.0

MT 8 2 10 1 0 1 6,640 6.1

NC 42 11 53 14 3 17 49,389 4.9

ND 7 1 8 1 0 1 6,658 9.6

NE 23 7 30 9 2 11 17,356 8.8

NH 14 3 17 7 1 8 6,149 4.2

NJ 33 34 67 16 9 25 65,521 6.9

NM 8 7 15 3 3 6 11,254 4.8

NV 3 15 18 0 3 3 21,565 7.0

NY 46 69 115 11 27 38 128,255 6.3

OH 87 33 120 34 7 41 84,113 6.8

OK 18 12 30 8 7 15 30,546 7.6

OR 12 9 21 4 2 6 22,120 5.1

PA 77 37 114 32 12 44 82,880 6.3

RI 7 0 7 2 0 2 3,935 3.5

SC 17 10 27 8 3 11 26,382 5.3

SD 7 2 9 1 0 1 5,716 6.6

TN 26 13 39 10 6 16 37,981 5.4

TX 54 98 152 16 32 48 162,743 6.0

UT 9 1 10 3 0 3 12,663 4.0

VA 36 15 51 16 3 19 33,936 3.9

VT 5 0 5 2 0 2 3,331 4.7

WA 17 26 43 6 9 15 31,371 4.2

WI 63 14 77 16 5 21 42,794 6.9

WV 17 2 19 10 1 11 14,861 7.9

WY 2 2 4 1 2 3 2,515 4.5

Total 1,316 1,056 2,372 456 346 802 2,086,061 6.2 3

2 - This statistic is based on resident population; states with facilities treating large numbers of out-of-state patients may have a higher than average rate.

3 - This number reflects the national average.

Sites Using Fixed PET/CT, PET/MR & PET Scanners or Mobile PET Services

Hospitals

Non-

Hospitals Total

1 - Includes estimates for all identified sites performing PET patient studies using fixed PET/CT or PET scanners, and mobile PET/CT or PET services.

Hospitals

Non-

Hospitals Total

PET Scans

per 1000

Population2

Identified Sites Responding Sites 2018 PET

Scan

Estimates1


Data Collection and Methodology

Data Collection

This 2018 PET Imaging Benchmark

Report summarizes the 2018 results

of IMV Medical Information

Division’s 2018 census of U.S.

hospitals and non-hospitals that

perform PET scans. The universe of

PET sites for this report is defined as

any location performing PET scans

using a fixed PET-only, PET/CT,

PET/MR, or a PET-only or PET/CT

scanner provided by a mobile van

service. Telephone interviews for

this study were conducted from

January through December 2018. A

total of 802 respondents participated

in this data collection (including 456

hospitals and 346 non-hospital

locations). The responses from this

sample (n) were projected to a

universe (N) of 2,372 PET locations

(1,316 hospitals and 1,056 non-

hospital locations), which was IMV’s

identified universe of sites

performing PET scans using fixed

units or mobile PET services as of

the time of the writing of this report.

The non-hospital sample is further

subdivided into PET centers that are

owned or co-owned by hospitals or

healthcare systems and those that are

“independent PET sites” (e.g. PET

centers owned by physician practices

or by companies which own multiple

PET centers).

Methodology

Once the data are collected and

tabulated, IMV analyzes the data and

calculates numerous descriptive

statistics. For simple categorical

response questions, the sample size of

802 results in an overall statistical

error of +/-2.9% at a 90% confidence

level. Moreover, for the finite universe

of 2,372 PET facilities, the overall

statistical error is +/-2.4% at a 90%

confidence level.

While the results reported by a survey

sample such as this can be very useful

in assessing the status and operations

of the field, it is important to

recognize the data’s characteristics

and therefore its limitations. The

following briefly describes the

statistics and methods used to prepare

and present the data in this

benchmark report.

Summary statistics in this report do

involve some rounding to simplify the

presentation of results, consistent with

what is believed to be the order of

magnitude of the accuracy of the

estimates. For example, while this

Methodology section specifies that the

total universe of sites performing PET

scans is 2,372 sites, the analysis

describes the universe to be 2,370

sites. It should be noted that the most

representative estimates are of

averages and percentage distributions,

i.e. relative values, as opposed to

absolute values.

For some of the results, such as the

regression analyses on PET scans and

hospital bed size, the results are taken

directly from the sample of sites that

responded to the specific questions.

For other results, such as the estimates

for total PET scan volume, study mix,

and radiopharmaceutical budgets, the

sample of those responding was

projected to the universe of sites, to

provide a total nationwide estimate.

Some of the graphs refer to the mean

or average value. This is calculated

by taking the sum of all reported

values, and dividing by the total

number of values reported.

The data presented in the scatter

diagram has been subjected to

regression and correlation analyses.

This gives a visual representation of

the variance in reported values.

Linear regression analysis provides

an estimate of the linear relationship

between the variables, which is

described by the equation given and

is visually represented by the line

plotted through the observations.

The correlation coefficient (r2)

indicates the extent to which the

relationship really exists and provides a

measure of the relative strength of the

relationship. An r2 value of 1.0 means

that the distribution of the data adheres

perfectly to the relationship described

by the regression equation. In a sense,

the r2 value provides a measure of the

confidence with which one could apply

the equation for the relationship

between the variables derived through

the regression analysis to another

observation in order to calculate an

expected result.

Many of the variables included in the

regressions show a very wide range of

values. So great a dispersion leads to a

smaller r2 value. Because some of these

correlations are so small, it is apparent

that these relationships are not strong,

and managers and professionals in the

field must look to other factors and

variables to explain variances.

In reviewing the survey results, keep in

mind that variance from the “average” is

not necessarily negative or positive - the

key is whether it is expected, given

known and accepted factors influencing/

affecting the specific facility's

operations. Evaluation of this

information should be combined with

the department manager’s knowledge of

the specific circumstances concerning a

department’s staffing patterns, patient

mix, types of procedures performed,

physician services demand, equipment

capabilities, and facility workflow to

evaluate the underlying reasons why a

facility’s profile may vary from the

relationships shown in this summary.


About IMV

IMV Medical Information Division, part of the Science and Medicine Group, specializes

in researching the medical imaging and other advanced healthcare technology markets.

Since 1977, IMV has been a leading provider of market information to the healthcare

industry, providing off-the-shelf reports and custom studies that address the evolving

radiology, cardiology, radiation therapy and clinical laboratory markets. IMV’s

ServiceTrakTM

annual series of reports benchmark and monitor customer satisfaction with

equipment manufacturers, system performance by product type, and service providers.

IMV has over thirty years of experience in serving the diagnostic imaging industry

including researching user needs and requirements, developing databases of technology

applications in clinical sites, and consulting with vendors. Through the methods and

principles of market research, IMV provides a structured channel between the clinical

users and the developers of technology for diagnostic and therapy services.

IMV’s market research services enables companies to understand their markets and

competitors through the eyes of the most important source of all...the people who buy and

use their products and services.

Our actionable insights provide clients valuable assistance in assessing the size and

attractiveness of markets, evaluating customer needs, optimizing product configurations

and service offerings, measuring customer satisfaction and brand loyalty, and evaluating

brand strength and positioning for the clients’ market development and sales initiatives.

We help the health care industry grow, adapt, and change in a rapidly evolving market.

For more information about IMV reports and service offerings, please visit our website at

www.imvinfo.com, call 703.778.3080, or email [email protected]. For more

information on the Science and Medicine Group, please visit our website at

www.scienceandmedicinegroup.com.

IMV 671 North Glebe Road Suite 1610 Arlington, VA 22203 703.778.3080 703.778.3081 (fax) www.imvinfo.com

http://www.imvinfo.com/

mailto:[email protected]

http://www.scienceandmedicinegroup.com/


About IMV 2017-2018 PET Imaging ServiceTrakTM

Awards

ServiceTrak™ Imaging reports are based on

extensive interviews with imaging professionals

in hospital departments and imaging centers in

the United States. Imaging professionals are

asked to rate their level of satisfaction with the

equipment manufacturers, system performance,

and the service received for their imaging

equipment. Satisfaction ratings are collected on

a 10-point scale, where 10 = "excellent" and 1

= "very poor.” IMV’s report analysis is based

on the percentage of highly satisfied (%HS)

responses that are represented by satisfaction

ratings of a 9 or 10 on this scale.

The 2017-2018 ServiceTrak™ PET Imaging

Awards were presented at SNMMI 2018 to the

manufacturer with the highest %HS in each of

three categories, representing the industry best

in customer satisfaction, system performance,

and service. The “Best Customer Satisfaction

Award” is given to the manufacturer who has

the highest %HS responses when asked to rate

the likelihood they will purchase again from

their current manufacturer. The “Best Service

Award” is given to the manufacturer whose

customers give the highest %HS responses

when asked to rate overall OEM service

performance. The 2018 ServiceTrak™

Diagnostic Imaging Awards are based on

interviews conducted in 2017 and 2018.

0 10 20 30 40 50 60 70 80 90



Radiation Oncology 2006Based on responses from 669

hospital and non-hospital sites out of an identified universe of 2,111hospital and non-hospital sites

$500

Documents

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