“With one PET/CT scanner already in place at the BC Cancer Agency, we have seen how British Columbians have benefitted from better access to a proven diagnostic imaging tool,” said Wynne Powell, Chair, Board of Directors, Provincial Health Services Authority (PHSA). “The commitment shown by PHSA, the Ministry of Health Services, the BC Cancer Agency and the BC Cancer Foundation to invest in the purchase and ongoing operation of a second public PET/CT scanner helps enhance B.C.’s reputation for providing the highest level of cancer care in the country.“
PET/CT uses radioactive tracers injected into the body, in conjunction with functional imaging technology, to determine the site(s) of disease and how cancer is behaving in an individual’s body. For patients, this technology means a single test that is highly effective at showing the presence and progress of disease and the patient’s response to treatment.
“With both a growing and aging population in B.C., demand for PET scanning continues to increase. A second PET/CT scanner will help improve timely access for patients,” said Dr. David Levy, President at the BC Cancer Agency, an agency of the PHSA. “On behalf of the BC Cancer Agency, I would like to take this opportunity to thank the BC Cancer Foundation for its efforts in raising funds for the purchase of this new PET/CT scanner.”
“BC Cancer Foundation donors are instrumental in making this very important project possible,” said Douglas Nelson, President and CEO, BC Cancer Foundation. “They have invested in it from the very beginning, having provided $2.25 million to establish the Leading Edge Endowment Fund which supports the research chair in functional cancer imaging. They are truly our partners in discovery, helping to advance the knowledge and treatment of cancer in B.C.”
The release of the RFP is a significant stage in the procurement process. Once submissions to the RFP are received and evaluated, a preferred proponent will be selected and offered the opportunity to negotiate an agreement to install the PET/CT scanner, as well as provide training and maintenance services in the long term. The Request for Proposals will be posted on the Provincial Government BC Bid website at www.bcbid.gov.bc.ca
The first publicly-funded PET/CT scanner has been in operation since June 2005. The Centre of Excellence for Functional Cancer Imaging at the BC Cancer Agency currently performs 3,100 scans per year. A second scanner, expected to be up and running by late spring 2011, will effectively double this annual capacity.
PET/CT is available for patients who fall within a specific set of evidence-based clinical guidelines established by the BC Cancer Agency’s Provincial Tumour Groups. This will ensure that those who will benefit the most from this technology will have access to it. Currently, patients with specific cancer indications in lung, head and neck, colorectal, testicular, gynaecologic, and lymphomas receive priority. Patients who do not meet the required clinical indications but want to have a PET scan are still able to access existing private sector facilities.
The BC Cancer Agency, an agency of the Provincial Health Services Authority, is committed to reducing the incidence of cancer, reducing the mortality from cancer, and improving the quality of life of those living with cancer. It provides a comprehensive cancer control program for the people of British Columbia by working with community partners to deliver a range of oncology services, including prevention, early detection, diagnosis and treatment, research, education, supportive care, rehabilitation and palliative care. The BC Cancer Foundation raises funds to support research and enhancements to patient care at the BC Cancer Agency. Visit www.bccancer.bc.ca
BC Cancer Agency
Current Clinical Indications for PET/CT Scanning
PET/CT scanning for adults at the BC Cancer Agency is done under a Clinical Trial Agreement with Health Canada. The numbers and types of patients that can be scanned will be limited by operational capacity and approved indications. The currently approved indications were developed in consultation with provincial tumour groups and are within the framework of the evidence based BC Cancer Agency guidelines for FDG-PET. PET/CT referrals are currently being accepted at the BC Cancer Agency’s Vancouver Centre for the following indications in adult oncology patients:
1. Non-Small Cell Lung Cancer
a. Staging of patients with clinical stage I and IIA lesions
b. Staging of potentially resectable stage IIB and III disease
a. To plan duration of chemotherapy for patients with limited stage (IA or IIA, non-bulky) Hodgkin Lymphoma
b. To plan duration and type of treatment for limited stage (IA or IIA, non-bulky) aggressive histology (diffuse large B cell, mantle cell, peripheral T cell) lymphoma
c. Post-chemotherapy for patients with advanced stage aggressive non-Hodgkin lymphoma (including primary mediastinal large B cell lymphoma) and Hodgkin lymphoma with residual CT abnormalities or initial bulky (bulky = 10cm or larger in any single diameter) disease to assess need for radiation therapy
3. Head and Neck Cancer (non-CNS, non-thyroid)
a. Diagnosis of primary site in patients presenting with squamous cell carcinoma metastatic to cervical lymph nodes with no obvious primary on conventional work-up
b. Staging in patients with nasopharyngeal carcinoma and N2 or N3 nodal disease
c. Staging in patients with level IV cervical lymph node metastases
d. Diagnosis of suspected recurrence in the absence of other definitive evidence in patients being considered for salvage therapy
e. Evaluation of cervical lymph nodes in patients for whom radical neck dissection is a part of the treatment plan for advanced primary disease
4. Colorectal Carcinoma
a. Determination of stage in patients with potentially resectable recurrence
5. Testicular Carcinoma
a. Post-treatment evaluation of residual masses
6. Gynecologic Cancer
a. Staging of recurrent disease in patients being considered for pelvic exenteration
Referrals for other clinical oncology indications will be considered on an individual basis as capacity permits.
PET/CT scanning for children at the BC Cancer Agency is done under a Clinical Trial Agreement with Health Canada. The numbers and types of patients that can be scanned will be limited by operational capacity and approved indications. The currently approved pediatric indications were developed in consultation with provincial tumour groups and are within the framework of the evidence based BC Cancer Agency guidelines for FDG-PET. PET/CT referrals are currently being accepted at BC Cancer Agency’s Vancouver Centre through BC Children’s Hospital for the following indications in pediatric oncology patients:
1. For initial staging of patients to determine extent of disease.
2. To determine response to chemotherapy or radiation therapy.
3. Post-chemotherapy for patients with advanced stage aggressive non-Hodgkin’s lymphoma and Hodgkin’s lymphoma with residual CT abnormalities or initial bulky disease.
4. To plan duration of chemotherapy for patients with Hodgkin’s and non-Hodgkin’s lymphoma.
5. To plan duration and type of treatment for limited stage aggressive histology lymphoma.
1. To evaluate the primary soft tissue mass prior to biopsy to identify high grade areas and guide biopsy.
2. For staging of locally advanced high grade soft tissue sarcomas.
3. For detection of suspected local recurrence of soft tissue sarcoma after definitive treatment.
4. For staging of Ewing’s sarcoma.
5. For initial staging and evaluation of potential recurrence in osteogenic sarcoma.
1. For evaluation of extent of viable tumour tissue in primary tumour.
2. For staging and disease evaluation of MIBG-negative tumours.
3. Post-treatment, to evaluate residual mass or primary site for recurrent or residual tumour, particularly if conventional studies are not helpful or equivocal.
4. Post-treatment or marrow transplantation, to evaluate for local recurrence or distant metastases.
1. To evaluate for recurrent tumour.
2. To differentiate between recurrent tumour and post-treatment necrosis.
3. For localization of areas of high grade disease to guide biopsy and treatment planning.
E. Thyroid Carcinoma
1. For detection and localization of suspected recurrence after definitive therapy, in patients with elevated or rising thyroglobulin levels and negative radioiodine scan (papillary and follicular carcinomas).
F. Other cancers given specific clinical indications, as approved by the investigator at the site, on an individual basis.
It is well recognized in clinical practice that there may be clinical scenarios that do not meet specific guidelines but where expert medical opinion indicates the procedure could have a major impact on patient management. PET scan referrals in these cases will be reviewed on an individual basis by physician representatives from the appropriate Provincial Tumour Group and the Functional Imaging department. If approved by consensus, the patient will be offered participation in the study.
BC Cancer Agency