Canadian Medical Imaging Inventory 2022–2023: PET-CT and PET-MRI

Key Messages

PET-CT Imaging

• PET-CT is an advanced imaging technique that combines PET with CT to measure metabolic or biochemical activity in the human body.
• Sixty PET-CT units in 9 provinces were identified by the Canadian Medical Imaging Inventory (CMII) in its 2022–2023 national survey. All units are located in urban centres.
• Canada has 1.5 PET-CT units per million people. The greatest density of units per million people is in Quebec, New Brunswick, and Newfoundland and Labrador.
• Approximately 156,320 publicly funded PET-CT examinations were performed in the 2022–2023 fiscal year. This represents a national average of 3.9 exams per 1,000 people, an increase of 18.2% since 2019–
• PET-CT was reported to have the largest demand in oncology (66.1%), followed by cardiology (13.2%) and neurology (10.1%). Applications for PET-CT continue to expand to new clinical indications and therapeutic areas.
• The upfront capital and ongoing operational costs of PET-CT units, as well as the costs of radiopharmaceutical products and equipment, may act as barriers to the rapid adoption of this technology.
• Canada is positioned in the bottom 25% of Organisation for Economic Co-operation and Development (OECD) countries in units per million population and the bottom 50% of OECD countries for average volume of publicly funded PET-CT exams per 1,000 population.
• The average age of PET-CT equipment in Canada is 7.2 years; 51.5% of PET-CT units are 5 years old or newer, 21.2% are 6 to 10 years old, and 27.3% are more than 10 years old.
• Radiotracers are essential in PET imaging. The most commonly used PET-CT radiotracers are for oncology: 91% of sites reported using fluorodeoxyglucose F18 and 31.8% of sites reported using gallium-68 DOTA-TATE.
• The production of most radiotracers requires the use of a cyclotron.¹ Overall, 21.7% of PET-CT sites reported local proximity to a cyclotron, reflecting a disparity in the access to and growing demand for radiotracer supply.

PET-MRI Imaging

• PET-MRI is a technique that combines PET with MRI to produce highly detailed imaging of soft tissues in the human body.
• PET-MRI is almost exclusively used for research purposes in Canada; therefore, data are limited for this modality.
• Six PET-MRI units were identified in Canada across 3 provinces, representing a national average of 0.2 units per million people.
• The average age of PET-MRI equipment in Canada is 6.7 years; 2 units are 6 to 10 years old, and 1 unit is 5 years old.