Thank you. That's an excellent question.
There are philosophers of technology and science who will say that any true substitution for basic logistics takes generations, because those of us who grew up with one technology have to retire out of the workforce. I mean, retiring a steam engine in the coal-fired power plants certainly takes time. We've been working on the hydrogen highway for how many years? Hybrid cars are part of that bridge.
So I just want to point out that the resistance to moving from technetium-based SPECT technology, which I will define in a moment, toward the next generation of PET technology is not bottlenecked with any particular element of the business practice or the clinical practice. It's really the precautionary movements about the medical community and the regulatory bodies, which are serving the best interest of Canadians.
What we're saying is that we are at that cusp where the future technology is going to become the predominant element. The challenge with PET technology, as we've heard from the previous experts, is that right now it's twice as expensive to obtain the imaging equipment in the clinic. That's a challenge for health care systems that have burgeoning costs. However, the payoffs of using that technology would be tens of thousands of dollars per patient if fully implemented. That's where it takes these cancer care delivery agencies in Quebec and British Columbia and some of the other provinces to really push the envelope.
Other challenges within the medical community are establishing the correct basis for prescribing the new types of scans. Doctors like Sandy McEwan at Cross Cancer Institute are some of the pioneers in that area of looking at how to integrate that fully into the clinical practice.
My view is that resistance is really.... It took me a long time to learn how to program my VCR. That's both my fault and the fault of Sony and Panasonic for having complicated instruction manuals. But now I do it from the web.
The second point is how a PET scanner actually works, and whether that influences this resistance in adopting the new technology.
As I said, there are physics, chemistry, and biology here, and the basic difference here is in the physics. When we talk about a medical isotope, we're talking about an unstable, or some would say a radioactive, atom. There's a nucleus, and it decays by emitting a particle. In the technetium-based imaging products, we have a nucleus that decays and emits a photon, which is a small particle of light that exits the body and can be picked up by a camera.
In PET isotopes, “P” is for positron. When a PET isotope decays, it emits a piece of antimatter. It's an anti-electron. When that anti-electron annihilates, as we all know from Star Trek and Angels and Demons--Tom Hanks has not yet come to TRIUMF--matter and antimatter annihilate. When that positron meets its neighbouring electron within a few micrometres, it annihilates and what's emitted are two photons. So already the physics is different. One medical isotope of technetium gives you one photon; one medical isotope of a PET isotope gives you two photons.
Now, there's an advantage there, which is twice the count rate, but also some physics governs the emission of those photons, so you have a lot more information about the geometry of where was that medical isotope.
That's the basis of scanning. It's identifying where is the medical isotope.