PET Scans Ontario
Insured PET Services
 

Positron Emission Tomography, or PET scanning, is a publicly insured health service available since October 1, 2009 to patients under certain conditions.

Fifteen indications (diagnostic situations or conditions) are approved for funding as an insured service. An indication is insured when there is sufficient evidence both that the PET scan will benefit the patient and that it has advantages over other testing tools. These PET scans are paid for by the Ontario Health Insurance Program (OHIP).

View indications for insured PET scans

Insured indications

Cancer

HEAD AND NECK

  • for the evaluation of metastatic squamous cell carcinoma in neck nodes when the primary disease site is unknown after standard radiologic and clinical investigation; OR
  • for the staging of nasopharyngeal cancer.

LUNG

  • Solitary Pulmonary Nodule (SPN): a lung nodule for which a diagnosis could not be established by a needle biopsy due to unsuccessful attempted needle biopsy; the SPN is inaccessible to needle biopsy; or the existence of a contra-indication to the use of needle biopsy; OR
  • Non-small cell lung cancer: 
    • where curative surgical resection is being considered based on negative standard imaging tests; OR
    • clinical stage III non-small cell lung cancer where potentially curative combined modality therapy with radical radiotherapy and chemotherapy is being considered; OR
  • Small cell lung cancer: limited disease small cell lung cancer where combined modality therapy with chemotherapy and radiotherapy is being considered.

LYMPHOMA

  • for the evaluation of residual mass(es) following chemotherapy in a patient with Hodgkin's or non-Hodgkin's lymphoma when further potentially curative therapy (such as radiation or stem cell transplantation) is being considered; OR
  • for the assessment of response in early stage Hodgkin's lymphoma following two (2) or three (3) cycles of chemotherapy when chemotherapy is being considered as the definitive single modality therapy.

DIGESTIVE

  • Colorectal cancer: 
    • where recurrent disease is suspected on the basis of an elevated and/or rising carcinoembryronic antigen (CEA) level(s) during follow-up after surgical resection but standard imaging tests are negative or equivocal; OR
    • prior to surgery for liver metastases from colorectal cancer when the procedure is high risk (e.g., multiple staged liver resection or vascular reconstruction), or where the patient is at high risk for surgery (e.g., American Society of Anesthesiology (ASA) score ≥ 4); OR
  • Esophageal cancer: for baseline staging assessment of those patients diagnosed with esophageal cancer being considered for curative therapy and/or repeat PET/CT scan on completion of pre-operative/ neoadjuvant therapy, prior to surgery.

REPRODUCTIVE

  • Germ cell tumours:
    • where recurrent disease is suspected on the basis of elevated tumour marker(s) - (beta human chorionic gonadotrophin (HCG) and/or alpha fetoprotein) and standard imaging tests are negative; OR
    • where persistent disease is suspected on the basis of the presence of a residual mass after primary treatment for seminoma when curative surgical resection is being considered.

THYROID

  • where recurrent or persistent disease is suspected on the basis of an elevated and/or rising thyroglobulin level(s) but standard imaging studies, including I-131 scan and/or neck ultrasound, are negative or equivocal.

Cardiac

  • Myocardial viability assessment in a patient suitable for a cardiac revascularization procedure or cardiac transplantation with moderate to severe ischemic left ventricular dysfunction (left ventricular ejection fraction of 40% or less) despite maximal therapy; and prior myocardial viability or stress imaging assessment with another modality (i.e. SPECT using thallium, MIBI or dobutamine stress echocardiography) has been equivocal for viability or demonstrated insufficient viable myocardium or a patient with severe ischemic left ventricular dysfunction and known multi-vessel coronary disease (determined by coronary angiography) urgently requires an assessment of myocardial viability.
Please note: the list of the insured indications funded through OHIP is the responsibility of the Ministry of Health and Long-Term Care. For the most up to-date information, please visit the Ministry’s website at: http://health.gov.on.ca/en/public/publications/ohip/pet.aspx


Patients who do not meet the criteria for insured PET scans may be eligible for a funded PET scan through the PET Scans Ontario program or a local clinical trial.

How to request an insured PET scan

If you are a patient, you should speak with your physician to determine whether a PET scan is an appropriate diagnostic or treatment assessment tool for you, and whether you are eligible for an insured PET scan. All referrals for insured PET scans must be made by a physician.

If you are a physician, you must provide specific information to the PET centre to request a scan. 

To request a PET scan you must register and log in.

Register now / Log in

  1. First review the list of insured indications to confirm that your patient is eligible for an insured PET scan.
  2. Log in to the online referral tool to access PET-centre-specific forms and submit your completed request.

Want more information? Go to http://health.gov.on.ca/en/public/publications/ohip/pet.aspx

Contact

ServiceOntario Infoline 1-866-532-3161 (Toll-free in Ontario only)