Quebec doubling PET capacity

If Quebecers didn't know what positron emission tomography (PET) was before Les Invasions Barbares became an Oscar-winning hit, they do now. In the film — which mocks the overcrowded, underfunded state of Quebec's hospitals — a man with cancer is sent to New York for a PET scan.

Figure. Quebec now has 3 PET scanners and is slated to get about 17 more. Photo by: Courtesy of Brookhaven National Laboratory

When the film was released in 2003, the only PET scanner available in Quebec for clinical purposes was at the Centre hospitalier universitaire de Sherbrooke — widely regarded as the leading institution for nuclear medicine research in Canada. That is where Saku Koivu, team captain of the Montréal Canadiens, went in early 2002 to determine if the aggressive round of chemotherapy waged against his abdominal cancer had worked. So impressed was Koivu with the technology that pronounced him cured, that he set up a foundation to finance a $2.5-million integrated PET/CT scanner for the McGill University Health Centre.

Initially allocated a budget from the provincial health ministry for 1500 patients per year, nuclear medicine specialists at the MUHC complained last year that their sophisticated machine sat idle while cancer patients waited for scans.

“To be fair, the government determined its initial budget based on older technologies,” says the MUHC's chief of medical imaging, Dr. Robert Lisbona. He expects that operating budget to double this year, to provide PET scans to 3000 patients.

With 3 PET scanners doing clinical work (the third is at Centre hospitalier de l'Université de Montréal's Hôtel-Dieu) “Quebec is probably the best province in Canada right now,” says Dr. François Bénard, the head of Sherbrooke's nuclear imaging centre. “But only because the situation is so dismal across the country. In the US and Europe, PET scanners are widely available.”

Across Quebec, 21 000 patients could benefit from PET scans each year, Bénard estimates. Although the scanners are expensive to run — radioactive tracers (FDG) alone can cost $600 per injection — Bénard concurs with other nuclear medicine specialists that the potential cost savings are enormous.

The arguments appear to have convinced Quebec's health minister. Philippe Couillard is poised to announce an investment in PET technology in all regions of the province.

For Bénard, the announcement can't come too soon. “We've had people coming from the Gaspésie — a 14-hour drive to Sherbrooke,” he says.

The government has been consulting with the Quebec Association of Nuclear Medicine Specialists to make sure there are sufficient specialists to deploy across Quebec, along with the new equipment.

The challenge will not be finding the specialists, but hiring enough nuclear medicine technologists to run the machines, says Association president Dr. François Lamoureux. At Montréal's Ahuntsic College — the only school in Quebec to offer the nuclear medicine technology program — coordinator Chantal Asselin says every one of this year's 25 graduates already has a job waiting.“We won't meet the demand,” she says.

“It takes 3 years to train a technologist,” Bénard points out. “The time to act is now, to avoid a worse shortage.”