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Iceland’s Cancer Patients No Longer Have to Travel 1,808-Kilometers to Receive a PET/CT Scan

Iceland Acquires State-of-the-Art Medical Tech to Improve Cancer Patient Care and Comfort

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The 3.5 hours it takes to travel from Iceland’s Reyjavik Airport to Denmark’s Rigshospitalet can feel like an eternity for those who are making the trip to learn whether they have cancer or if their treatment is working.

“Until recently, Iceland lacked the tracers and technology necessary for PET/CT scans. We annually had to refer up to 250 patients to Rigshospitalet in Copenhagen,” said Petur Hannesson, Head of Radiology at Landspítali Hospital. “As a result, it took extra time to diagnose patients, identify the best course of treatment, and determine whether that treatment was working.”

Recognizing the need for a solution, the hospital decided to bring three new pieces of medical technology to the island: a PET/CT scanner, a cyclotron, and a state-of-the-art PET radiochemistry facility.

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Last year, almost 250 patients traveled approximately 1,808-kilometers from Reykjavik, Iceland to Copenhagen, Denmark to receive a PET/CT scan. Photo courtesy of Google Maps

Positron Emission Tomography (PET) is a type of nuclear medicine imaging that uses tiny amounts of radioactive drug – referred to as a “tracer” – to diagnose, stage and monitor diseases, including cancer and neurological disorders such as dementia and seizures.

The tracer releases emissions that are detected by the PET camera. These emissions provide molecular information, which is used to create pictures with highly detailed information about both the structure and function of organs and tissues in the body.

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PET/CT images show changes at the cellular and molecular levels, helping clinicians diagnose disease in its earliest stages and monitor patients’ response to therapy as soon as it happens. Photos courtesy of Landspítali Hospital

 “PET images can show changes at the cellular and molecular levels, helping clinicians diagnose disease in its earliest stages and monitor patients’ response to therapy as soon as it happens,” explains Erik Strömqvist, Cyclotron and TRACERcenter General Manager at GE Healthcare. “However, to use PET/CT technology, hospitals must either be within travel distance of a tracer distribution network or be located near a cyclotron, a device which produces the isotopes needed to make tracers.”

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A radiographer at Landspítali Hospital injects a tracer into a patient’s arm in anticipation of a PET/CT scan. Tracers may be injected, swallowed or inhaled as a gas. Photo courtesy of Landspítali Hospital

The challenge for an isolated island such as Iceland, is that tracers have short half-lives, meaning they lose half of their potency and effectiveness within a matter of hours. In fact, the most commonly used isotope in PET imaging, Fluorine 18, has a half-life of two hours; while others, like Oxygen-15, have a half-life of two minutes.

Since no tracer network existed close enough to deliver tracers to Iceland on time, it was decided that Landspítali Hospital would partner with GE Healthcare to install the country’s first TRACERcenter to enable PET/CT diagnostic scanning in Iceland. This total PET radiopharmacy solution includes GE Healthcare’s Discovery 710 PET/CT and MINItrace cyclotron as well as FASTlab and TRACERlab FX2 chemistry systems for routine clinical tracer production and future research capabilities.

“Like many Western countries, Iceland’s population is aging, which increases the burden on our healthcare system and medical professionals,” said Hannesson. “Every year, we found ourselves referring more patients overseas and waiting on the results to make diagnostic and treatment decisions. Ultimately, it was unavoidable to have access to our own PET/CT, cyclotron and PET radiopharmacy to provide our clinicians with faster access to information and help increase our patients’ quality of care.”

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Technicians at Landspítali Hospital in Reykjavík, Iceland produce tracers, radioactive materials in GE Healthcare’s TRACERcenter for use during PET scans. Photos courtesy of Landspítali Hospital

Cyclotrons are giant electromagnets made from tightly wound copper coils. The technology uses a significant amount of energy to heat hydrogen to nearly the same temperature as the surface of the sun. This extreme heat converts hydrogen into negatively charged hydrogen ions which are then accelerated towards the speed of light, transforming them into the radioactive isotopes that are used to create PET tracers.

“It’s really quite amazing,” said Strömqvist. “All this technology – including the cyclotron, the radiopharmacy, and PET/CT – completes a different part of the puzzle to create pictures with highly detailed information about both the structure and function of organs and tissues in the body. This has become essential technology for clinicians to look at how certain diseases progress and develop in the body.”

Landspítali Hospital celebrated the opening of its TRACERcenter and the installation of a Discovery 710 PET/CT device in December 2018.

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Landspítali Hospital celebrates the unveiling of the country’s first TRACERcenter and PET/CT scanner on December 12, 2018. Photos courtesy of Landspítali Hospital

“We’ve already scanned more than 130 patients and expect to perform between 1,700-2,000 PET/CT scans annually, once fully operational,” said Hannesson “Previously, many patients who could have benefitted from this imaging technique were not examined for various reasons, including lack of access. Now, we can spare patients the inconvenience of having to travel across the ocean for a PET/CT scan and can replace other imaging techniques that were used to diagnose and stage disease.”

Adoption of PET/CT has risen steadily in recent years. In 2000, Time Magazine named the PET/CT scanner the medical invention of the year and by 2011, 90% of PET/CT scans were used to diagnose and monitor many kinds of cancers.

“The wider availability of PET imaging technology and its benefits for early diagnosis and staging of diseases has increased interest and demand for PET solutions,” said Strömqvist. “We are proud of the work we’ve done with Landspítali Hospital to bring this cutting-edge technology suite to Iceland and its patients.” 

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A hospital radiographer places a patient in GE Healthcare’s Discovery 710 PET/CT for a scan. Photo courtesy of Landspítali Hospital

“The community’s reaction to this new technology is overwhelmingly positive,” said Hannesson “We expect this technology will put us at the forefront of imaging and enable us to provide equal or better service as our neighboring institutions overseas.”