I'm Dr. Terry Ruddy, head of cardiology at the University of Ottawa Heart Institute and director of nuclear cardiology at that site. I'm also head of nuclear medicine at the Ottawa Hospital, so I look at business from both ends.
In the cardiac world we're doing well. It's more or less business as usual, but not exactly. When we switch to thallium from the technetium compound, we're actually using a compound that has a less favourable symmetry and less favourable imaging characteristics. It's adequate, but sort of borderline adequate. It's a band-aid solution that works okay, but something you wouldn't really want as a long-term solution.
So we need either our technetium compounds restored in a way that we can count on them, or we need to go into PET imaging to a greater degree. Technetium-labelled compounds for cardiac imaging are adequate or borderline adequate compared to PET. PET diagnostic accuracy is much greater in cardiac disease than SPECT technetium compounds. You can look at this as an opportunity to move more toward PET. That means more PET cameras across Canada and more development of cyclotrons so we can use a superior alternative to technetium, get away from the concern about technetium, and actually have better diagnostic imaging.
In nuclear medicine, bone scans are an essential test in about 50% or so of patients. The other 50% can be moved to other tests that may be similar or may not be exactly similar--sort of like apples and oranges. There is a significant population for whom there's really no alternative to a bone scan. Bone scans can be done with either technetium or a PET tracer, the way Dr. McEwan has developed the sodium fluoride.
To offset future shortages, having more PET cameras across the country would be very desirable. It would also be very desirable for the bone scans that are at risk with our technetium shortage.