Abstract Objectives This study aimed to provide a comprehensive analysis of the increasing demand for PET-CT imaging in England, driven by advancements in technology and updated clinical guidelines. By comparing the 2013 and 2022 guidelines issued by the Royal College of Radiologists, the analysis sought to quantify the gap between actual PET-CT provision and modelled requirements, benchmarked against international comparators, to inform strategic planning for equitable access to advanced imaging. Methods A detailed modelling approach was developed, mapping guideline-based PET-CT scan requirements to disease incidence and stage for major oncological indications (prostate, lymphoma, neuroendocrine tumours, lung, breast, gynaecological cancers) and key non-oncological conditions (dementia, cardiovascular disease). Actual scan volumes were extracted from the NHS Diagnostic Imaging Dataset and cross-referenced with provider data. Unmodelled indications were estimated using proportional scaling. Model outputs were validated against PET-CT utilisation rates in Finland, adjusted for UK disease incidence. Future demand projections incorporated population growth, demographic shifts, and evolving disease prevalence. Results For 2021, modelled estimates indicated a substantial shortfall in PET-CT provision for several high-impact indications, notably prostate cancer, dementia, neuroendocrine tumours, and breast cancer, where actual scan volumes were 2–7 times lower than modelled need. Modelled demand for England (361,900 scans/year) exceeded actual provision (239,367 scans/year) by over 50%. Comparative analysis with Finland confirmed that England’s PET-CT rates lagged for most indications except lung cancer. Projections suggest continued growth in demand, particularly for dementia and neuroendocrine tumours, with overall PET-CT needs expected to rise sharply by 2040. Conclusions England’s current PET-CT capacity falls significantly short of evidence-based requirements, especially for emerging indications in neurology and oncology. Without strategic investment and expansion, this gap will widen, risking delayed diagnosis and suboptimal care. Enhanced data collection and ongoing validation are critical for responsive service planning.
Smith et al. (Wed,) studied this question.