CASE STUDY: Expanding PET/CT Programs in Cardiology and Urology - ROI and Strategic Deployment
The Growing Opportunity in Cardiac and Urologic PET/CT
Positron Emission Tomography combined with CT (PET/CT) has long been a cornerstone of oncology imaging, but new applications in cardiology and urology are driving significant growth in hospital PET/CT programs.
In cardiology, PET myocardial perfusion imaging (MPI) is increasingly favored over traditional SPECT for its superior resolution and ability to quantify blood flow. Medicare data show cardiac PET usage rising even as older modalities decline. Meanwhile in urology, PET/CT has been revolutionized by prostate-specific tracers (e.g. PSMA). In recent years, prostate PET scan volume has surged, reflecting the rapid adoption of PSMA PET for prostate cancer staging and recurrence, following new FDA approvals and coverage.
From a strategic standpoint, these trends indicate untapped financial and clinical opportunity. Hospitals that expand PET/CT into cardiac stress testing and prostate cancer imaging can attract new patient cohorts and referrals. Adding cardiac PET can capture cardiology referrals that might otherwise go to outpatient centers, and PSMA PET/CT allows retention of prostate cancer patients who previously had to travel for advanced imaging. Real-world programs show this growth, as some systems have seen high demand and backlogs, prompting PET/CT expansion.
Reimbursement Trends and ROI Potential in Specialized PET/CT
Cardiology and urology PET/CT are gaining traction due to improved reimbursement and expanded coverage. CMS introduced new CPT codes for cardiac PET, boosting payment for certain procedures and acknowledging their clinical and economic value. Similarly, PSMA PET/CT now has dedicated reimbursement under Medicare, and newer tracers may qualify for separate payment beyond the bundled technical fee.
Standard FDG oncology PET scans might reimburse ~$1,400. In contrast, cardiac PET studies often exceed $2,000, and PSMA PET can range from $1,800 to $2,200+, especially with pass-through reimbursement for radiopharmaceuticals. This shift increases net profitability and incentivizes hospitals to expand PET/CT offerings.
By supplementing a PET/CT schedule with just a few high-reimbursement cardiac or urology cases each week, hospitals can lift average scan reimbursement and overall ROI. Diversifying case mix beyond oncology is becoming a financial and clinical imperative.
PET/CT Program ROI: 60 Scans/Month Breakdown (Capital Purchase vs. Rental)
To illustrate the financial outlook, consider a PET/CT service performing ~60 scans per month (approximately 720 per year) at an average reimbursement of $1,400 per scan. This volume could come from a mix of oncology, cardiology, and urology studies. Below is a comparative ROI breakdown for two deployment models: purchasing a PET/CT scanner (capital ownership) versus renting a mobile PET/CT unit. For simplicity, we’ll assume the hospital already has or can share staff and that operational costs aside from equipment are similar in both cases. The focus here is on equipment cost differences and net revenue.
Assuming:
60 scans/month (~720/year)
$1,400 average reimbursement/scan
Annual gross revenue: ~$1,008,000
Capital Purchase Model:
Upfront capital: ~$2.5M
Annual depreciation/service: ~$600,000
Net Year 1 Revenue: ~$408,000
Long-term profit improves dramatically after 3–5 years once financing ends.
Rental Model:
Annual rent: ~$480,000
Net Year 1 Revenue: ~$528,000
Immediate ROI without capital outlay, but no equity.
5-Year Outlook:
Over a five-year horizon, owning eventually yields greater cumulative profit if volume and reimbursements are sustained. Using the above figures, 5-year equipment costs total ~$3M for purchase (including maintenance) vs. ~$2.4M for renting. However, after financing ends, ownership costs drop sharply, whereas rental fees continue. By Year 5, the owned scanner would generate ~$900k/year net (since only maintenance costs remain) while rental continues at ~$480k cost per year. Thus, the crossover point where owning becomes more cost-effective than renting is roughly 4–5 years at this volume, or sooner if volumes grow. Table: PET/CT ROI Comparison (60 scans/month)
Note: The above table focuses on equipment economics. In practice, both scenarios would also include costs for technologists, physicians, radiopharmaceuticals, etc., which should be accounted for separately. The key insight is that at ~60 scans/month, a PET/CT program can gross about $1 million/year. Renting yields a healthy immediate profit with flexibility, whereas buying yields a valuable asset and higher long-term profit if the hospital can absorb the upfront cost. Profitability could further improve if more high-reimbursement scans are in the mix – for example, replacing some $1,400 studies with $2,000 cardiac PETs or separately reimbursed therapeutics. In a blended scenario including cardiac and PSMA scans, the average reimbursement might exceed $1,400, boosting all net figures above. This means our estimates are conservative; a well-run program with specialty PET/CT services could see even greater margins than shown above.
Rent vs. Buy: When to Share, When to Own
Given the financial outlines, how should a hospital decide between renting a mobile unit or purchasinga PET/CT system? The choice comes down to volume, capital access, strategic timeline, and operationalcontrol. Below are key considerations and strategies:
Volume and Utilization: Volume is the linchpin of ROI. If your hospital is unsure it can sustain high PET/CT volumes initially, a mobile or shared rental makes sense for low-volume situations . Renting is typically more expensive per scan than owning in the long run, but it shines when volumes are modest or unpredictable. It prevents buying an expensive scanner that sits idle. As throughput grows (e.g. >~100 scans/month), owning becomes more cost-effective since you can spread the fixed cost over more cases. One industry example noted that with sufficient volume (160 scans/month), the cost per PET/CT scan can drop below $600 using an optimized leasing model – yielding excellent profit under typical reimbursements.
Capital Budget and Cash Flow: Hospitals operate under strict capital budget limits. Capital budgeting for imaging equipment remains tight, with recent surveys showing only ~11% of sites planning a PET/CT capital purchase in 2023. Renting or leasing allows a hospital to acquire PET/CT service as an operating expense instead of a large capital outlay, preserving capital for other needs. This is especially appealing if the hospital’s capital budget is limited or allocated elsewhere. Additionally, refurbished systems offer a middle ground – buy at 30–70% off new equipment cost. In fact, ~80% of healthcare organizations now use some pre-owned medical devices to manage costs. A refurbished PET/CT purchase can dramatically lower the break-even volume while still giving you an owned asset. Hospitals with constrained budgets should consider this route (for example, a quality refurbished PET/CT might cost ~$1.2M instead of $2.5M, cutting depreciation in half).
Technology and Upgrades: PET/CT technology is advancing (digital detectors, higher sensitivity, etc.). If having the latest tech is important or you anticipate upgrading frequently, a lease/rental can make swapping easier. Leasing agreements can be structured to upgrade the unit after a few years. In contrast, owning means you’re committed to a machine for 7–10+ years to fully depreciate it. If you invest in a new scanner, ensure it’s upgradable or sufficiently advanced (90%+ of planned PET purchases now are digital detector models). If not, mobile vendors often maintain state-of-the-art fleet units, so renting can give access to cutting-edge scanners without the upgrade burden.
Staffing and Operations: When you own a scanner, you must staff it (technologists, possibly a radiopharmacist or nurse depending on tracers, etc.) and manage scheduling internally. With a mobile service, often the provider can supply technologists or at least help with training and protocols. For hospitals without existing nuclear medicine staff, this can be a lifesaver. Mobile providers may also handle maintenance, calibration, and downtime management – reducing administrative load. On the other hand, an in-house program offers tighter integration: your staff can tailor protocols, and you have full control of the scanner’s schedule (including on-demand scans or after-hours if needed). Consider your team’s readiness: do you have or can you hire PET/CT technologists and a physician who can interpret scans? If not immediately, starting with a managed mobile service can bridge the gap while you build volume and expertise.
Scheduling and Patient Access: Mobile shared models (e.g. a trailer that comes 1–2 days per week) are efficient for low volume, but they constrain scheduling. If your PET/CT is only on-site Wednesdays, then any patient who needs a scan sooner might be referred out. This could delay care or send revenue elsewhere. As demand grows, many hospitals increase the days of mobile service or transition to a full-time unit. One approach is to incrementally expand mobile days: for example, go from one day a week to two or three as volume rises, until it justifies an on-campus scanner. Hospitals must balance patient convenience and referral capture with the cost of moving to a dedicated unit. Keep an eye on backlog and wait times – a growing waitlist is a clear signal that it may be time to invest in a full-time solution to meet community needs (Sentara’s experience of backlogs with a single mobile unit is a case in point).
Data Control and Integration: In today’s connected healthcare environment, data integration is vital. Owning your PET/CT can make it easier to integrate with your PACS, EMR, scheduling systems, and to implement customized workflows. Mobile units, however, can integrate as well – typically the mobile staff will transmit images to your PACS and reports go through your radiologists. Still, some hospitals worry about relying on third-party services for critical diagnostics. Issues like cybersecurity and patient data privacy are considerations; top mobile providers and OEMs address these with secure data handling (for instance, Siemens emphasizes built-in cybersecurity even in mobile PET/CT units). If your hospital leadership is concerned about having full control over imaging data and equipment uptime, you’ll need strong service-level agreements with a rental provider, or you may lean towards ownership once volume and finances allow.
Strategic Timeline and Flexibility: Renting or leasing is often used as a strategy to “test the waters” or to ramp up a program quickly. It provides maximum flexibility: if the program underperforms, you can scale down or cancel after the lease term; if it booms, you can transition to purchase. Mobile imaging also serves as an excellent interim solution – for example, if you’re building a cancer center that will have its own PET/CT in two years, a rental can cover you in the meantime so no service gap occurs. Similarly, smaller regional hospitals have successfully shared mobile PET/CT units to collectively benefit from advanced imaging without each buying a scanner. In Illinois, a network of small hospitals coordinated a shared mobile route, expanding diagnostics and retaining patients locally without individual capital investments. This collaborative model can strengthen community hospitals and prevent patient migration to larger centers.
In summary, renting/shared models work best for low initial volumes, short-term needs, or when capital is constrained, while owning your PET/CT is ideal once you have consistent high volume and the capital or financing to support it. Many hospitals follow a progression: start with a part-time mobile service, prove demand and revenue, then make the case for a permanent scanner purchase in a few years. During that transition, be mindful of the soft factors too – community perception (having an in-house PET/CT can elevate your cancer or cardiology program’s profile), physician support (ensure your cardiologists or urologists know about and utilize the PET service), and contractual details (e.g. mobile provider terms, or warranties on refurbished units).
Flexible PET/CT Solutions with USA Mobile Medical
Successfully launching or expanding a PET/CT program requires not just one decision, but a continuum of planning. This is where a partner like USA Mobile Medical can add value. USA Mobile Medical is unique in that it offers multiple pathways to PET/CT implementation – from interim rentals to refurbished systems to brand-new scanners – rather than a one-size-fits-all approach. This flexibility lets hospitals craft a solution that fits their current needs and future plans:
Mobile PET/CT Rentals: USA Mobile Medical provides state-of-the-art mobile PET/CT units that can be delivered to your site with minimal infrastructure required. This option is ideal if you want to offer PET/CT immediately without waiting for construction or capital budget cycles. It can be scheduled for the days and hours you need, and as discussed, converts what would be a large capital expense into a pay-as-you-go service. Hospitals can start scanning patients and generating revenue right away, with USA Mobile Medical handling the coach, installation, and potentially technical staffing. It’s a fast-track to boosting service line revenue and keeping patients in-house for imaging.
Refurbished PET/CT Systems: For a more permanent solution at lower cost, refurbished equipment is a smart strategy. USA Mobile Medical sources and certifies high-quality refurbished PET/CT scanners (as well as other imaging modalities). This can save a hospital 30–50% or more on purchase price, directly improving ROI. Importantly, reputable refurbishers like USA Mobile Medical ensure the scanners meet OEM performance specs and often include updated software and warranties. This means a hospital can own a PET/CT with a much lower capital hurdle, allowing even mid-sized or smaller facilities to afford advanced imaging. Given that so many hospitals are adopting pre-owned devices to manage capital costs, having a partner experienced in refurbishment is key. USA Mobile Medical not only sells refurbished PET/CTs, but also provides guidance on site planning, installation, and training to make sure the upgrade is seamless.
New PET/CT Purchase and Turnkey Setup: If the analysis shows that purchasing a new PET/CT scanner is the right move (for example, a large health system launching a high-volume regional PET center), USA Mobile Medical can assist with that as well. The company offers purchase guidance, helping evaluate different OEM models (Siemens, GE, Canon, etc.), features like digital detectors or time-of-flight, and integration considerations. Their team’s expertise can be valuable in comparing total costs of ownership, service contracts, and even negotiating with manufacturers. Moreover, USA Mobile Medical can provide turnkey project management – coordinating delivery, shielding requirements for PET (if installing in-house), acceptance testing, and even interim rental coverage during construction. By having both mobile units and fixed system capabilities, they ensure there’s no downtime in your imaging program.
Hybrid and Transition Solutions: Perhaps one of the greatest strengths of working with a full-scope provider is the ability to map out a long-term plan. For instance, a hospital might begin with a mobile shared service, then move to a long-term lease or rent-to-own of a specific unit, and finally transition to outright ownership when ready. Throughout this process, USA Mobile Medical can adapt the solution – scaling the service up, swapping in a newer scanner, or shifting from mobile to a stationary installation. They also understand the softer issues mentioned earlier: data integration (ensuring the images flow into your PACS and EMR securely), regulatory compliance, and staff training. By partnering with a provider that can do rentals, refurbishments, and new system placements, a hospital is not locked into a single path. Instead, you can periodically reassess and choose the next step that makes sense financially and operationally.
Bottom Line: Cardiac and urologic PET/CT imaging represent a compelling growth frontier for hospital imaging programs. With favorable reimbursement changes and surging clinical demand, these services can significantly enhance both patient care and profitability. The key is to approach the expansion strategically – weighing the ROI of capital purchase versus rental, and understanding when to pivot from one model to another. By reframing capital budgeting discussions to include alternatives like rentals, operational leases, and refurbished equipment, hospital leaders can overcome the inertia of “we can’t afford it” and find creative ways to launch or grow PET/CT services. In many cases, the cost of not offering PET/CT (lost referrals, out-migrating patients, and foregone revenue) far exceeds the cost of a flexible program startup.
Innovative approaches, such as mobile sharing consortiums or staged upgrade plans, can further lower risk and investment.
USA Mobile Medical’s suite of offerings aligns perfectly with this modern mindset. Whether a hospital needs an immediate mobile PET/CT to start scanning next month, a budget-friendly refurbished scanner to install in a permanent suite, or unbiased expertise in selecting a new PET/CT, their team can deliver a solution tailored to the hospital’s situation. The message to hospital CFOs and CEOs is clear: enhancing your PET/CT capabilities doesn’t have to mean a multi-million-dollar check upfront. By leveraging cost- saving and revenue-enhancing alternatives – and partnering with experts in mobile and modular imaging – you can expand into cardiac and urologic PET/CT smartly and profitably. Embracing these alternatives not only saves capital, but can also accelerate the timeline for offering cutting-edge imaging, ultimately benefiting patient care and the hospital’s competitive position. With careful planning and the right partnerships, any hospital can turn the emerging cardiology and urology PET/CT opportunity into a reality – growing service lines, improving outcomes, and doing so with financial confidence.
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