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Molecular Imaging and Therapy

Positron emission tomography (PET) is a technique that produces a three-dimensional image of functional processes in the body.
General PET Scan Information

The provincial Molecular Imaging and Therapy program is being developed to:

  • Improve cancer diagnosis and treatment planning for patients and health care professionals
  • Build research programs for the discovery, development and application of new radiotracers
  • Apply new advances in imaging to improve prevention, early diagnosis and management of cancers
  • Collaborate in a growing national and international network of molecular imaging and therapy programs
BC Cancer operates two publicly funded PET/CT scanners in Vancouver, one in Victoria, and one in Kelowna.

PET Functional Imaging at BC Cancer

For more information about PET/CT at BC Cancer please continue reading below or review the Patient Information handout.

PET & CT

Positron emission tomography (PET) imaging is a procedure that, when combined with computed tomography (CT), help physicians to more accurately diagnose and manage disease, especially cancer.

PET detects changes in cellular metabolism (how active a cell is), often indicating the presence of disease. CT detects changes in the physical size or shape of a lesion and shows exactly where in the body the lesion is located. By combining these two imaging technologies into a single scanner, we are now able to more accurately detect cancer and pinpoint its location in the body.

Together, PET and CT can be very helpful, for example, in the preoperative staging of some cancer types and in localizing suspected cancer recurrence when standard tests are inconclusive. This type of information can help physicians improve treatment planning for individual patients.

What a normal PET scan looks like
What a normal CT scan looks like
What a fused PET/CT scan looks like
Normal PET Scan
Normal CT Scan
Fused PET/CT Scan

How PET/CT works

Active cells such as malignant cancer cells will use sugar as an energy source. Inactive cells such as benign cells and scar tissue (both noncancerous) will not use sugar as an energy source.

In PET, a special type of sugar is combined with a safe radioactive component to produce the radioactive tracer called FDG (Fluorodeoxyglucose). Once injected into a vein, the tracer, which emits signals detected by the scanner, will be absorbed by malignant cells but will not be absorbed by benign cells and scar tissue. This will indicate whether or not a lesion could be cancerous.

Combined with the localizing abilities of CT, this information can be used, for example, to show a surgeon the exact location of a malignant lesion that needs to be removed.

Your appointment

Upon arrival to the Molecular Imaging and Therapy department, you will be asked to complete a brief questionnaire. A technologist will take you to an examination room to explain the procedure and answer any questions you may have. You will then receive the tracer injection and be asked to relax in the private exam room for approximately 60 minutes to allow the tracer to circulate throughout your body. When this "uptake" period is complete, we will take you to the scan room to begin imaging.

Scanning procedure

You will lie on the imaging table which will slowly move you through the scanner while collecting data. For most procedures, you will be able to listen to music during the scan. The scan itself will last approximately 20 - 40 minutes depending on the type of scan ordered by your physician.

Once the scan has been completed and reviewed for technical quality, the appointment concludes and you will be free to leave. The entire procedure, from the time you arrive at BC Cancer until the time you leave, will last approximately 2 hours. A report will be sent to your physician once the scan has been read by a PET physician at BC Cancer.

Risks

A PET/CT scan is considered a diagnostic procedure similar to those done in Radiology and Nuclear Medicine. With over 2 million PET scans having been performed worldwide to date, there have been no reports of any adverse reaction to the tracer. Although there is a small amount of radiation exposure involved in your PET/CT scan, the exposure level is small and within the acceptable limits mandated by Health Canada for these types of procedures. 

Also, tracers used in PET/CT have very short half-lives meaning they don't remain in your body very long. Twenty-four hours after your PET/CT scan, we would not be able to take any more images because the tracer will have completely left your body.

Patient Pre-Scan Instructions
To prepare for your PET/CT scan, please follow these instructions:

If you have any questions or there is any chance you will not be able to make your appointment, please call PET Reception as soon as possible:

  • Kelowna: 250-861-6456
  • Vancouver: 604-707-5951
  • Victoria: 250-519-5754
If you were referred for Cardiac Sarcoidosis Imaging, please refer to this Patient Information handout.

Mandatory preparation instructions
  • Do not eat or drink (except plain water) for at least 6 hours prior to your appointment
  • To keep hydrated, drink 3-4 glasses of plain water within 2 hours of arriving for your appointment (no coffee, tea, juice, pop, etc.)
  • If there is any chance you may be pregnant or breastfeeding, please contact us for further instructions
  • Avoid any strenuous physical activity for 24 hours prior to your appointment
  • Do not chew gum the day of your appointment
  • Take your regular medication(s) as normal if you can take them without food
  • If you are travelling over the border after your PET/CT scan please let us know prior to your appointment so we can prepare a travel letter for you, as trace amounts of radiation will be detectable from you up to 24 hours after your scan
  • Please limit your contact with small children or pregnant individuals for at least 6 hours after your scan 
  • If you are diabetic, see below for additional instructions

Diabetic patient instructions
In addition to the mandatory preparation instructions above, please follow these instructions if you are diabetic:

Your blood sugar level must be below 11.1 mmol/L at the time of your appointment (optimally below 8.3 mmol/L). 

  • Insulin - Do NOT take insulin within 4 hours prior to PET appointment or the appointment will be rescheduled.
    • If applicable, take ½ of your long-acting insulin the night before. Hold all insulin the morning of the appointment, or at least 4 hours prior to your appointment.
    • Each of the 3 days prior to your appointment, check your blood sugar level in the morning before eating to see if you are below 11.1 mmol/L in a fasting state. 
    • Please contact us if your blood sugar is above 11.1 mmol/L on any of the 3 days
    • Consult with your physician to determine the safest way possible to manage your blood sugar level before your scan if you have concerns
  • Metformin – Do NOT take Metformin for 48 hours before PET appointment. For all other diabetic pills (oral hypoglycemic), take as normal.

Frequently Asked Questions
For answers to frequently asked questions about positron emission tomography (PET), click "+" on the questions below.

No. The entire procedure is virtually painless except for a small IV needle placed into a vein in your arm to check your blood sugar level and to inject the tracer.

There are no known side effects from the tracer or scan itself.

A qualified nuclear medicine physician with PET/CT experience.

No. Due to the large amount of data collected during your scan, data processing takes time and must be completed before our physicians can view the images. Once the images are processed and evaluated, the results will be sent to the physician who requested the scan.

Most medications won't affect scan results and are okay to take. However, medications with sugar (i.e. cough/cold syrups/throat lozenges) can affect the scan results because of their high sugar content. If you have any questions about the medications you are taking, please call PET Reception:


  • Kelowna: 250-861-6456
  • Vancouver: 604-707-5951
  • Victoria: 250-519-5754

Yes, but we will need to go over some pre-scan instructions before you arrive. Please refer to the patient instruction page for further instructions or call PET Reception:


  • Kelowna: 250-861-6456
  • Vancouver: 604-707-5951
  • Victoria: 250-519-5754

Due to the small amount of radiation exposure you receive during the scan, we do not encourage other people to sit with you during the procedure. A general guideline is that only when medically necessary should you receive radiation exposure no matter how small that exposure may be.

Upon arrival, a technologist and/or a doctor will explain the procedure in detail and answer any question you may have. An IV will then be placed in a vein for injection of the tracer followed by a 60 minute "uptake period" allowing the tracer to distribute throughout your body. We will then perform your PET/CT scan which will last for about 20-40 minutes depending on the scanning protocol required. All in all, you end up spending about 2 hours with us.

The PET/CT scan is considered a very safe procedure. The amount of radiation exposure from the entire procedure is considered safe and medically necessary by your physician. Also, the tracer leaves your body very quickly. Within 24 hours after scan conclusion, the tracer will be virtually undetectable by our sensitive scanners.

No. It is very important that you don't eat or drink anything (except plain water) for at least 6 hours before your PET/CT scan. Sugars that your body absorbs from food can greatly alter the scan quality and results. Fasting ensures that your blood sugar level is not too high prior to starting the procedure. Water is recommended prior to your arrival for the scan. Please refer to the patient preparation handout for further information and instructions.

 

BC Cancer currently operates PET/CT scanners at its locations in Kelowna, Vancouver and Victoria. The addresses for each are:


Kelowna - PET

399 Royal Avenue

Kelowna, BC V1Y 5L3

PET Reception: 250-861-6456


Vancouver - PET

600 West 10th Avenue

Vancouver, BC, V5Z 4E6

PET Reception: 604-707-5951


Victoria - PET

2410 Lee Avenue

Victoria, BC V8R 6V5

PET Reception: 250-519-5754


Click here for parking instructions.

Yes. The CT portion of the scan is commonly done without contrast. The tracer that is injected for the PET portion is not a contrast type agent and will not cause an allergic reaction.

Loose comfortable clothing without metal is recommended. Any metal items in clothing or worn as jewellery (i.e. metal buttons, zippers, piercings, hairpins, etc) will affect the scan quality and will need to be removed for the scan. If necessary, you will be asked to change into a patient gown to ensure scan quality.

A radiotracer/radiopharmaceutical is a radioactive compound that can trace a certain body function without any side effects. Depending on how they are made, there are many different radiotracers that can show entirely different body functions. In PET, we most commonly use a radioactive form of sugar which can show different areas of metabolic activity in the body indicating the presence or absence of disease.

 

If you are covered by the provincial health plan and your indication meets BC Cancer's specific approved indications for PET/CT scanning, you will not be charged a fee for your procedure if done at our facility.

 

If your physician feels that a PET/CT scan is medically necessary and meets BC Cancer's criteria for currently approved indications, he/she will contact our centre to book an appointment. Once we have been able to book the appointment, we will then contact you to confirm the date and time as well as go over any instructions you will need to follow prior to arriving.

No. If you have never been to BC Cancer but have been approved to have a PET/CT scan done at our facility, we will first generate a BC Cancer patient identification number and then book your procedure as soon as possible.

 

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