Health committee  The Canadian Society of Nuclear Medicine did a broad study, I think it was about four years ago, looking at distribution of tests across the country. I know the two associations are looking at addressing that. I agree it's something that is important to know.

Health committee  I think we need to be very clear that we understand that many of the PET--and I actually gave many talks last week around this--radiotracers that you're talking about are not in routine use at the moment. So, for example, estrogen-receptor imaging is not a routine test that will be done currently with technetium.

Health committee  Madam Chair, to respond to that, during the Society of Nuclear Medicine meeting in Toronto, I convened a broadly representative meeting. There were members of the two Canadian societies, the European Association of Nuclear Medicine, and the British Nuclear Medicine Society. There was a member of the Australian community there, and obviously my colleagues at the Society of Nuclear Medicine.

Health committee  Let me be clear, the iodine provided to patients in Canada was almost entirely sourced from NRU in the past. The Canadian supplier has been sourcing radioactive iodine from other reactors. We believed that was enough, and that's what the company had told me as an individual clinician, and I'm sure Dr.

Health committee  Madam Chair, I've been in the job three days, so if my span of knowledge is imperfect, forgive me. I do know that the minister has had a number of teleconferences--I believe the figure is three--with her provincial and territorial counterparts on this issue. I do know that at the time of my appointment she spoke to all of her provincial and territorial counterparts as well, so I am assuming there are ongoing conversations.

Health committee  I do know that certainly in Alberta, for example, that document has been widely disseminated through the province through an Alberta Health Services working group that is looking at ways of ameliorating the crisis. I believe it's been available to all the other provinces. I do know the Province of Ontario really started the work on some of the protocols in that.

Health committee  We are routinely in Edmonton, Madam Chair, performing PET scans for patients from Saskatchewan until they get capacity there. There is already interprovincial collaboration in developing protocols to enable...because obviously every PET scan that is done for a bone scan frees up technetium.

Health committee  Madam Chair, perhaps I could just go into the mechanism of producing a bone scan. A bone scan is produced on a gamma camera; a bone scan with fluoride is produced on a PET camera. A gamma camera doing bone scans all day would not be able to do more than 10, maybe 12 bone scans in a day.

Health committee  Madam Chair, I am not trying to minimize the problems we face in the very short term. I agree that we have issues in supply. I do believe, however, it wouldn't be responsible to not look at resolving the medium term as well, and I believe this is one way of addressing that. In terms of addressing the short term, I believe the conversations yesterday, as I mentioned, between the producers are leading to international collaborations.

Health committee  I think those are important elements of the advice that I would be expected to give and to pass on as feedback from my clinical colleagues in the societies. If I can use the Alberta example, the fluoride that is made in Edmonton supports three cities. We are using our PET scanners to maximum--

Health committee  I made those comments before the establishment of the international expert working group by Minister Raitt and before the decision was made. I believe we have an opportunity in working with the Minister of Health, and that is my mandate. It would be unwelcome if I moved beyond that mandate.

Health committee  I rarely disagree with my clinical colleagues. We are usually unanimous in our views. At the Society of Nuclear Medicine meeting in Toronto yesterday and today, there was a meeting with the NEA, which is the OECD nuclear energy authority. The meeting, which also included producers, members, and some government agencies, looked at integrating supply across the world.

Health committee  Madam Chair, thank you, and thank you for the invitation to speak to this committee. By way of background, I am a nuclear medicine physician who works at the Cross Cancer Institute in Edmonton. My clinical interests, as are Dr. Driedger's, are patients with thyroid cancer and also patients with neuroendocrine tumours; both conditions use radioactive iodine as part of their treatment.