Sudburians can expect the first shovel to go in the ground in two or three weeks, officially kicking off construction of the $5.1-million, 4,500-square-foot PET/CT suite at Health Sciences North’s Ramsey Lake Health Centre.
HSN has signed a contract with Sudbury-based Build North Construction Inc. and its workers have already begun scoping out the site, locating power and other service lines and getting ready to build.
The bunker that will house the positron emission tomography/computed tomography scanner will be built on stilts connecting to the existing nuclear medicine department on the second floor of the South Tower at the hospital.
The hospital has put a down payment on the GE Discovery MI PET/CT scanner, the price of which came in under the $3.5 million allocated for it, said Mark Hartman, vice-president of cancer services and clinical support at HSN.
It was necessary to purchase the scanner first to make sure the bunker would accommodate it and to “future proof” the addition as much as possible if the machine has to be replaced down the road.
When construction begins in earnest at the hospital, HSN will notify General Electric to ensure the scanner is ready to be moved in when the bunker is complete. Construction of the bunker is expected to take nine months so it will be well into 2019 before the first PET scan is conducted in the Northeast.
Hartman said there is only one other scanner in Ontario like the one HSN has purchased. The GE Discovery MI model is more “sensitive” than other models and requires an isotope of lower radioactivity to conduct a scan. That is an advantage because isotopes for PET scans will have to be transported here from a larger urban centre.
Positron emission tomography uses small amounts of radioactive material, a special camera and a computer to evaluate organ and tissue functions. It identifies changes at the cellular level, and can detect the early onset of disease before other imaging tests.
Hartman gave full credit to the family and friends of the late Sam Bruno for raising the $3.5 million needed to purchase a PET/CT scanner. Bruno, an award-winning salesman, died in July 2010 at age 55 after a two-year battle with colorectal cancer. Bruno lobbied tirelessly before his death to have a PET scanner located in the North. The Sam Bruno PET Committee was then indefatigable in its efforts to convince the Liberal government the Northeast needed a PET scanner and to raise the money to purchase it.
The question of Windsor
The announcement two months ago that the provincial government was paying for a positron emission tomography/computed tomography scanner for Windsor Regional Hospital was a bitter pill for some residents of the Northeast to swallow. It will be the first PET scanner in Ontario paid for with public dollars. There are more than a dozen such scanners in the province.
Michael Sherar, president and chief executive officer of Cancer Care Ontario, said the allocation of funding to Windsor by the ministry, through his agency, launched a new way of funding PET scanning in the province.
An essential component of the Windsor scanner announcement was the province’s commitment to provide operational funding for both PET scans paid for by OHIP and “uninsured services” paid for by CCO, said Sherar. Those uninsured services include what Sherar calls “emerging indications”, those for which not enough evidence has been gathered to fund them by OHIP.
There is a third way Ontarians can get a PET scan, Sherar explained. Physicians can apply to CCO for a patient to have a PET scan on compassionate grounds in areas where evidence is “less strong or complete,” he said. Those applications are reviewed case by case for patients for whom PET scanning indications don’t meet the threshold for either a registry trial run by CCO or the insured indications paid for by OHIP. It is called the PET Access Program.
Positron emission tomography is largely used to diagnose cancers and stage treatment for them, but is increasingly being used in cardiac and neurological disease diagnosis and treatment.
The ministry announcement two months ago confirmed it was going to combine both insured operational funding and the uninsured or emerging indications through Cancer Care Ontario, said Sherar.
While funding a PET/CT scanner for Windsor was a first, Sherar said there was already a scanner operating in the area that needed to be replaced. It was run by a private clinic.
Cancer Care Ontario has been tasked with conducting a capital strategy for what Sherar calls the “fleet” of PET scanners in Ontario.
Taxpayers to fund new scanners
The good news about the new way of funding is that, should CCO’s capital strategy be accepted by the ministry, PET scanners now in use that are coming to their end, and new ones required to treat growing populations, will be paid for by the Health ministry.
That means, as the situation now stands, that residents of the Northeast should not have to pay for a new PET scanner when the first one needs replacing.
“We’re hopeful that this is a positive attitude toward having a more sustainable approach to the fleet of PET scanners in the province,” said Sherar in a telephone interview from Toronto. He expects CCO will submit its strategy to the ministry during this fiscal year ending March 31, 2019.
“The consolidation of all of the operational funding through CCO will support a strong sustainable program for all patients who can benefit from access to PET scans,” said Sherar. “Mostly it’s cancer, but there’s a lot more.”
One of Cancer Care Ontario’s responsibilities is to work with physicians, among them cardiologists and oncologists, making referrals for PET scans. It will make sure they are aware of the current indications, the current level of evidence, the indications covered by the insured program, indications for which there are registry trials and those through the PET Access Program.
In Ontario, the various uses are generally well-known to physicians making those referrals, said Sherar.
PET scanning is also widely used in research. “We want to make sure that, as new innovations are developed and tested and evaluated, that we also have a program in the health system that can respond to that,” he said.
While Sherar is pleased CCO is developing a PET capital strategy, he said he understands why people in the Northeast may be upset they had to work so hard to raise money for a scanner.
Although the Health ministry did not provide dollars for the sophisticated piece of diagnostic equipment, it did provide “substantial support” for the construction to accommodate the scanner, said Sherar. The ministry allocated $4.6-million to build the PET/CT bunker. The community will be required to raise about $460,000 or one-tenth the cost of construction.
Sherar said he is pleased all the components of providing PET scanning have been pulled together under one program.
There are still areas of diagnostic medicine where money must be raised locally to purchase equipment such as magnetic resonance imaging scanners and CT scanners.
Hartman said HSN will need a second MRI at some point. The current scanner is operating virtually 24 hours a day, seven days a week, year-round. Work has begun on costing out a second MRI and will be presented to the North East Local Health Integration Network although Hartman said there may be other items that are higher on a priority lists of needs.
Cancer Care Ontario is the principal advisor to the Health minister on cancer and on the cancer system, including areas of diagnostic scanning such as positron emission tomography.
Carol Mulligan is an award-winning reporter and one of Greater Sudbury’s most experienced journalists.
