PET for Heart Disease

Cardiac PET has long been an established test with significant advantages over other Nuclear Imaging tests that assess for coronary artery disease. Active Programs exist in Alberta, Ontario and Quebec.

Key Advantages for Patients

  • Shorter test
  • Lower Radiation Exposure
  • Better at detecting abnormalities
  • Smaller chance of mistakes in reading the images
  • Fewer unneccessary surgical and procedural interventions because of fewer mistakes

Key Advantages to the Healthcare System

  • Less labour intensive, requiring fewer technologist hours
  • Fewer false positives means lower downstream costs than existing tests
  • If done in high enough volumes, it can be cheaper to do than existing tests

The Plan for Cardiac PET in British Columbia

In 2027, St. Paul’s will see the deployment of the first non-oncologic PET camera in the province. Similar plans are in development at Royal Columbian Hospital in Burnaby and at the Royal Jubilee Hospital in Victoria.

PHSA Tiers of Service Document on Nuclear Imaging

In Winter of 2024, the Provincial Health Services Authority (PHSA) conducted a consultation with medical experts in all specialties on developing a list of what was felt to be appropriate services to provide at different hospitals to be consistent with other developed countries.

TierService Description and ScopeService RequirementsWorkforce Requirements
3May provide diagnostic and therapeutic
outpatient nuclear medicine service.
For sites providing nuclear medicine, dedicated patient spaces
and access to a regionally coordinated radiopharmaceutical
supply.
For sites providing nuclear medicine:
Nuclear medicine technologist on site.
Access to nuclear medicine physician (may be
virtual).
4Provides diagnostic and therapeutic outpatient
nuclear medicine services.
One or more gamma cameras offering single photon emission computed tomography (SPECT) combined with computed
tomography (SPECT-CT).
Access to radiopharmaceuticals.
Access to non-oncologic and oncologic positron emission tomography combined with computed tomography (PET-CT) preferred (on site or at networked site).
May have access to cardiac PET-CT.
Access to nuclear medicine physician (may be virtual).
Nuclear medicine technologists on site.
5Provides inpatient and outpatient diagnostic
and therapeutic nuclear medicine services
Access to a readily available isotope supply for both diagnostic
and therapeutic procedures, either manufactured on site
(preferred) or through timely delivery.
PET-CT on site or through a formal networked arrangement with
another site.
As for Tier 4. In addition, nuclear medicine physician on
site as required
6Provides support for one or more subspecialty
provincial service(s) (e.g. cardiac transplant,
pediatric neurosurgical, transplant, congenital
cardiac, burns).
Provides novel therapeutic and diagnostic
radiotracers.
Provides learning activities for physicians and staff from lower tiered medical imaging services to practice critical skills where
limited opportunity exists in “real life” (e.g. simulation, on site
clinical experiences).
Conducts and supports others to conduct interprofessional
research, including clinical trials, and innovation.
In addition, nuclear medicine physicist,
preferably on site.
Radiopharmaceutical scientist (may be virtual)

What is the agreed upon goal for Cardiac PET access in British Columbia?

The PHSA tiers of service document sets out targets for what the medical community believes is an appropriate standard for access to medical procedures in the province.

The agreed upon goal is to have Cardiac PET access at Tier 5 comprehensive regional centers and some Tier 4 sites (comprehensive community hospitals).

Has the Ministry of Health made a plan yet to get there?

Currently, there is no agreed timeline for reaching these goals.

There is funding for a program at St. Paul’s Hospital, likely to start in 2027.

There are plans for Cardiac PET programs at Royal Jubilee Hospital and at Royal Columbian Hospital.

Funding for these two programs has not been approved yet.

There is no coordinated provincial strategy to address this unmet need.

What can I do to improve access to this test?

Let politicians and decisionmakers know this is important to you.


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