The Use of Positron Emission Tomography The Use of Positron Emission - - PowerPoint PPT Presentation

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The Use of Positron Emission Tomography The Use of Positron Emission Tomography (PET) for Cancer Care Across Canada: (PET) for Cancer Care Across Canada: (PET) for Cancer Care Across Canada: (PET) for Cancer Care Across Canada: Time for a National

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The Use of Positron Emission Tomography The Use of Positron Emission Tomography (PET) for Cancer Care Across Canada: (PET) for Cancer Care Across Canada: (PET) for Cancer Care Across Canada: (PET) for Cancer Care Across Canada: Time for a National Strategy Time for a National Strategy

Report Release Briefing p g February 27, 2012

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The Use of Positron Emission Tomography The Use of Positron Emission Tomography (PET) for Cancer Care Across Canada: (PET) for Cancer Care Across Canada: (PET) for Cancer Care Across Canada: (PET) for Cancer Care Across Canada: Time for a National Strategy Time for a National Strategy

Susan D. Martinuk Report Release Briefing February 27, 2012

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CANCER in CANADA

Aff t 82% f C di

CANCER in CANADA

Affects 82% of Canadians

  • One of every four will die from cancer
  • 40% of women and

40% of women and

  • 45% of men will develop cancer
  • Every HOUR, 8 Canadians die from cancer

E HOUR 20 di d ith

  • Every HOUR, 20 are diagnosed with cancer

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2011 Canadian Cancer Statistics

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SLIDE 4

Ssss

Saku Koivu returns to hockey following cancer treatments

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Saku Koivu returns to hockey following cancer treatments PET imaging played a crucial role in his speedy recovery

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Saku Koivu cuts ribbon on PET scanner for M t l G l H it l

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Montreal General Hospital

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PET (Positron Emission Tomography) PET (Positron Emission Tomography)

  • nuclear medicine imaging technology
  • used for diagnosis, not treatment

i li h b d h ll l l l

  • visualizes the body at the cellular level
  • detects changes in the biological function
  • f cells before they undergo anatomical

changes to create a mass or tumour

  • detects cancer cells at an early stage
  • early detection prompts more timely treatment and improves probability

early detection prompts more timely treatment and improves probability

  • f successful outcome

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Roles of PET in Oncology

» Initial Diagnosis » Staging/Detecting Recurrence » Monitoring Response to Therapy i » Patient Management

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CLINICAL EFFECTIVENESSS OF PET

Th L St di i th U it d St t (NOPR)

CLINICAL EFFECTIVENESSS OF PET

Three Large Studies in the United States (NOPR)

PET changed patient management strategy in:

‐ 36.5% ‐ 38% 38% ‐ 49% of cases

Ch h b i il ll Changes shown to be similar across all cancer types.

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CLINICAL EFFECTIVENESSS OF PET CLINICAL EFFECTIVENESSS OF PET

A 2010 study from Vancouver General Hospital showed that PET changed intended treatment plans in 50% of cases.

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CLINICAL EFFECTIVENESSS OF PET CLINICAL EFFECTIVENESSS OF PET

After a PET scan, NOPR studies also showed:

  • Plans for surgical biopsy were eliminated in 70% of cases
  • Further diagnostic procedures were cancelled in

‐ 77%

‐ 90% of cases 90% of cases

Suggests PET should be a first‐line diagnostic tool, not a last resort

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Purpose of Study Purpose of Study

» determine the current state of PET in Canada i th t b i t di PET » examine the current barriers to expanding PET or increasing the utilization of PET » consider the strategies required for Canada to move g q ahead into 21st century cancer imaging

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The Use of Positron Emission Tomography (PET) for Cancer Care Across Canada: Care Across Canada: Time for a National Strategy

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FINDINGS

Canada is far behind the United States and Europe

FINDINGS

Canada is far behind the United States and Europe in adopting PET technology: » Canada has 29 clinical PET scanners » Europe will have 742 PET scanners by 2013 » The United States currently has about 2,000 PET scanners WHO – recommends a ratio of 2.0 PET scanners per million Canada’s current ratio = 0 86 Canada s current ratio = 0.86

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PET Scanners in Canada

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SLIDE 15

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QUEBEC

12 i 12 l i

QUEBEC

» 12 scanners in 12 locations » Lowest cost » Over 50% of all scans in Canada » Y2000 QC Government decision to make cancer care a priority » 2001 report recommended adoption of PET » Government deployed 12 scanners over the next 8 years » Will continue to add PET to all nuclear‐medicine departments

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Ontario

» 9 publicly‐funded, clinical scanners

Ontario

» Lowest number of PET scans » Lowest utilization of clinical scanners » Year 2001 report recommended no insured funding for PET » Clinical trials surrounded by controversy » 2 Ombudsmen investigations » In July 2009 Government announced that it would make PET » In July 2009, Government announced that it would make PET available to cancer patients – Ombudsman report unpublished » BUT in 2010, Ontario carried out fewer scans than 2009 » Ontario influences other provinces to take the cheap route » Ontario influences other provinces to take the cheap route

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Factors to OVERCOME in Growing g PET in Canada

  • 1. Costs
  • High operational ($2M/year) and capital costs ($3‐4M)
  • High costs of FDG – radioactive component of PET

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Cyclotrons Producing FDG for PET

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Factors CONSTRAINING PET Growth in Canada

1.Costs

  • 2. Infrastructure and Policy Framework

y

  • Canada’s unique geography and population density
  • Health Canada’s regulation of FDG

N ti l li i i di ti f f PET

  • No national policies or indications for use of PET
  • Concerns about overuse of PET without proper indications

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Factors CONSTRAINING PET Growth in Canada

  • 1. Costs
  • 2. Infrastructure and Policy Framework
  • 3. Education and Training
  • 3. Education and Training

» Physicians » Cancer patients and general public g » Conflicting visions about spending scarce healthcare dollars » Shortage of trained & educated personnel

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Canada’s Road to Success

  • Canada has a history of leadership in nuclear medicine

Canada’s Road to Success

  • Canada has a history of leadership in nuclear medicine
  • Canada has the resources and the track record to deploy

& standardize PET imaging at a national level & standardize PET imaging at a national level

  • Team Canada ― coordination among the provinces ― is

the winning strategy the winning strategy

  • Education is KEY

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Canada at the Crossroads Canada at the Crossroads

  • Canada lags far behind the rest of the world

in cancer imaging

  • Canada has a duty to improve cancer care

and investigate technologies that can be more clinically‐ and cost‐ effective

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Canada’s CHOICE

Move forward and adopt new technology OR Maintain the status quo Maintain the status quo

The choice is OURS The choice is OURS

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Susan D. Martinuk ‐‐ susanmartinuk@shaw.ca Susan D. Martinuk susanmartinuk@shaw.ca Tim Meyer ‐‐ tmeyer@triumf.ca

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