Table 1.

Commission-recommended Imaging Technologies for Cancer Care Facilities, Adapted for WHO Health Care Levels^42*

Level	Imaging Modality
WHO Health Care Level I	Level 1 (Primary Health Care) does not have the level of equipment or facilities to undertake cancer care; it may have a triage role to the next level.
WHO Health Care Level II	Radiography with fluoroscopy Ultrasound with Doppler Mammography Angiography Computed tomography (CT) Radionuclide scintigraphy, including single photon emission computed tomography (SPECT/CT)
WHO Health Care Level III	Magnetic resonance imaging (MRI) Positron emission tomography (PET/CT) Theranostics

^*The Commission recommendation for this Table comes from a consensus development process that involved discussion at LOCI meetings, where input from imaging experts into this topic was obtained.

The differences in the recommendations from the WHO Health Care Level imaging equipment (as identified in the reference 42) are as follows:

1) The Commission suggests explicitly that Health Care Level 1 should not be a site where cancer care should be performed, as the full range of imaging equipment (including CT as a minimum) is not adequate for appropriate diagnosis and staging, and likely does not have the medical expertise or services required for complete cancer care.

2) The Commission recommends the inclusion of SPECT/CT (compared to SPECT) in Health Care Level II, as the use of these modalities is now standard at this level.

3) The Commission recommends the inclusion of Theranostics in Health Care Level III, as this replaces Radioimmunoscintigraphy.