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Tusar brings PET Scan to Canada
By Correy Van't Haaff
Denis Tusar's journey to bring clinical PET scan to Canada started with a personal and tragic story. A very dear member of his family - his wife's niece - was diagnosed with non-Hodgkins lymphoma. It was the early 1990s, she was 19 and living in Estonia. Being behind the iron curtain meant there was a dearth of technology to save her. "It was a very painful period in our lives," said Tusar. "It made me so aware of technology and geography - we pay a price for where we live."
An architect by training and vocation, Tusar was later approached about the concept of PET scans and what they could do. He had never heard of this technology; it was only used for research in Canada.
"Here in Canada, we pay a price for not having access to technology which is used in the USA and Europe," he said.
He founded a private company, International PET Diagnostics Inc., in 1999 to bring clinical PET scans to Canada. He mortgaged the house and said he would have sold his first-born to raise the money to bring this technology home. The company has performed some 3,500 scans since 2000 with volume growing by 20 to 30 per cent each year.
PET, or positron emission tomography, is the world's gold standard for cancer detection, said Tusar. PET scan technology provides for the very accurate detection of both cancer and the spread of cancer in the body. The patient is injected intravenously with a small amount of sugar labelled with radiotracer. The sugar will distribute through the body and, because cancerous tissues feed abnormally on sugar, the affected cells and organs process more of the labeled sugar. The PET scanner then records the signals emitted from the tracer at disease sites. The computer reconstructs the patterns of detected signals into three-dimensional pictures of the body, and a qualified nuclear medicine physician analyzes the image.
The whole procedure takes about two hours with the patient spending less than one hour on the scanner. It is a safe, non-invasive procedure with no side effects.
One of the huge advantages of the PET scan over an MRI or CT scan is its ability to show the physician the biochemical activity of disease within the body. So why isn't it in everyday use?
"The problem in Canada," said Tusar, "is it's not paid for by the government. The only province to fund PET scans is Quebec. Their minister of health is a neurosurgeon; very bright, articulate, with a good grasp on practical matters. He announced a few weeks ago a very aggressive PET program for Quebec providing funding to purchase equipment and money to run equipment."
Closer to home, the B.C. Cancer Agency has recently acquired a PET scanner. That purchase should go a long way toward legitimizing the technology. The agency provides scans at no cost to the patient at the point of delivery. That cost is borne by the Provincial Health Services Authority.
"It's not free," said Tusar. "Someone has to pay for them." It's been an uphill battle, he said, as this mostly-new technology, especially in Canada, hasn't necessarily been endorsed by government. "It's expensive to have a scan; $2,850 for the whole body," he said. A full body scan starts mid-thigh and goes to the base of the nose. All scans are done by doctor referral and the company avoids "feel good" scans. Tusar tells of a clinical study of 75 cancer patients who had been through every test available including ultrasound, CT and MRI, with all patients diagnosed at the Cancer Agency and staged for treatment.
Upon receiving PET scans, four were shown not to have cancer, a fact later proven by biopsy. "That's why I get up in the morning - for things like that," said Tusar. PET scan technology is also vital in monitoring the efficiency of treatment. "If you are about to embark on an aggressive chemotherapy regime, we suggest PET before therapy to give a benchmark," said Tusar.
"After a few weeks or less, do another scan to determine whether the therapy is working. If not, you can adjust chemotherapy." In other words, after the second scan, if tumour activity hasn't lessened, the doctor has the ability to take another look at the chemistry of the cocktail.
"As a non-medical person, I have learned an awful lot along the way," said Tusar. "My job is to support the medical community the best I can. What I want to be able to do is provide the medical community with the proper tools to do their jobs."
Corey Van't Haaff is Just For Doctors' tech columnist, but also writes on business, medicine and the business of medicine. She can be reached at medicalnews@cohibacommunications.com. This article originally appeared in "Just for Canadian Doctors," February 2006.
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