PET Scan Services in Ontario

About PET Scanning

Positron emission tomography (PET) scanning is a type of nuclear medicine imaging exam that shows the structure and function of organs and tissues.

Traditional imaging exams, such as ultrasound, X-ray, CT or MRI, provide information on physical changes to a person’s anatomy. PET scanning reveals changes in biochemical processes, for example sugar metabolism, that may occur before any changes in anatomy are visible. This may show more extensive disease than CT or MRI, which could change how illness is managed and treated. For example, whether a patient is offered aggressive, potentially curative treatment as opposed to palliative treatment.

Ontario uses evidence to inform decisions about the use of PET scans.

Evidence-Based Approach to PET Scanning

High-quality clinical trials and research studies over the years have shown PET scanning benefits patients in some specific clinical scenarios but not all.

The indications (diseases or conditions) where PET scanning affects clinical decisions or provides value over other tests, based on established criteria through the PET Scans Ontario Program, are routinely funded under the Ontario Health Insurance Program (OHIP).

The PET Scans Ontario Program continues to build evidence by assessing new indications through the PET Registry. For clinical scenarios where the evidence is more limited and does not meet the criteria of eligible indications, we operate the PET Access Program for case-by-case reviews.

A provincial PET Steering Committee regularly reviews and makes recommendations on new evidence-based clinical indications.

Funded PET Scan Services

In Ontario, there is no charge to the patient for any PET scans funded as part of the PET Scans Ontario Program. PET scans are funded based on established criteria (Routine PET services), as well as where evidence is being built in the province (Evidence-Building PET services).

Routine PET services

PET scans are routinely funded for indications (diseases or conditions) that meet all of the following criteria:

• There is enough evidence that the PET scan has the potential to benefit the patient.
• PET scanning has advantages over other imaging tests.

The PET Scans Ontario Program provides referral forms for all indications, by disease site, which physicians may use to submit requests to PET centres. Visit Indications and Referrals for PET Scans for eligibility criteria and requisition forms.

Evidence-Building PET services

In certain cases, the PET Scans Ontario Program may fund PET scans for patients who do not meet the eligibility criteria for routine indications.

PET Registry

The Ontario PET Registry makes PET scans available to patients in certain cases where some evidence supports the benefit of PET scanning, but the evidence is too weak to support routine funding.

The Registry collects data on participating patients to strengthen the evidence supporting the use of PET scans for eligible indications.

PET Access Program

The Ontario PET Access Program considers requests on a case-by-case basis to fund PET scans for patients who may benefit, but who do not meet the eligibility criteria for funding under any other program. For funding to be granted, a panel of experts must agree that a PET scan will provide more benefit to the patient than other available tests.

Physicians applying through this program have to confirm in the application that other diagnostic tests do not provide the clinical information needed. They must also explain how a PET scan may influence the clinical management of the patient.

For more information on the PET Access Program, including policies and processes, please see the PET Access Policy.

If a request for a PET scan through the PET Access Program is not approved, the referring physician can submit a request for a resubmission, a reassessment or an appeal. For information on the eligibility criteria, filing process and review process, download the PET Access Program Resubmission, Reassessment and Appeals Policy.

PET scans not funded in Ontario

PET scans are not funded for Ontario Health Insurance Plan (OHIP) eligible residents who receive a PET scan

• within Canada for services outside of those routinely funded or part of the evidence-building program (PET Registry and PET Access Program); or
• out of country without prior approval from the Ministry of Health’s Out of Country unit.

Find a PET Scan Centre

View the list of PET Centres across the province.