Aetna considers the CEA-scan experimental and investigational for all other indications because its effectiveness for indications other than the ones listed above has not been established.Aetna considers technetium-99m-sestamibi (Tc-MIBI) scintigraphy medically necessary for any of the following indications: Aetna considers technetium-99m-sestamibi scintigraphy experimental and investigational for all other indications such as the following because its role for these indications has not been established: Indium-pentetreotide, medically necessary for the diagnosis and staging of persons with primary and metastatic neuroendocrine tumors bearing somatostatin receptors.Aetna considers radiolabeled octreotide experimental and investigational for the treatment of incompletely resected meningioma because its effectiveness for this indication has not been established.Aetna considers lymphoscintigraphy and sentinel lymph node biopsy (SLNB) medically necessary for persons with malignant melanoma.Aetna considers scintimammography, including breast-specific gamma imaging (BSGI; also known as molecular breast imaging), experimental and investigational as an adjunct to mammography for imaging of breast tissue, for the detection of axillary metastases, staging the axillary lymph nodes in members with breast cancer, and to assess response to adjuvant chemotherapy in members with breast cancer, and for all other indications because its effectiveness has not been established.
Patients with primary colorectal carcinoma undergo an extensive pre-operative staging work-up.
Aetna considers lymphoscintigraphy and SLNB experimental and investigational for all other indications (e.g., as a screening test in persons with a BRCA mutation, with or without prophylactic mastectomy) because its effectiveness for indications other than the ones listed above has not been established.
Aetna considers I-131 labeled meta-iodobenzylguanidine (MIBG, also known as iobenguane I-131) imaging medically necessary for localizing or confirming any of the following conditions: Aetna considers I-123 labeled MIBG imaging experimental and investigational in the management of all conditions, such as any of the following, because its value for these indications has not been established: pheochromocytoma and all other indications because its effectiveness for these indications has not been established.
Unfortunately, the accuracy of non-surgical staging techniques (CT or MRI) has been shown to be poor.
Recurrent disease is seen in up to 40 % of patients with Dukes stage B or C colorectal carcinoma, generally within the first 18 months post-operatively.