Four healthcare providers serving the Lake Norman region have each filed applications with North Carolina regulators to install a fixed PET scanner in the area, but state rules mean only one will actually get built. Atrium Health, Duke University Health System, Novant Health, and independent physician group Southern Oncology Specialists have all submitted competing proposals, setting up a months-long administrative fight over which project gets the green light.
The scanners use a radioactive tracer to produce detailed images of organs and tissue, helping doctors detect diseases including cancer. Under North Carolina law, healthcare providers must receive state approval before acquiring, replacing, or expanding major facilities and equipment, a process known as Certificate of Need review. As reported by the Charlotte Observer, hospital systems across the region filed their applications after the 2026 State Medical Facilities Plan listed a single fixed PET scanner as a documented need for the eight-county service area, which stretches from Mecklenburg and Iredell counties down through Cabarrus, Gaston, Lincoln, Rowan, Stanly, and Union counties, according to the North Carolina Department of Health and Human Services.
That need determination didn't come out of nowhere. The state's 2026 plan relied on a formula weighing major cancer centers that operate multiple linear accelerators and handle high volumes of radiation procedures, per the NC DHSR State Health Coordinating Council.
Four Very Different Bids
Atrium Health wants to add a fixed PET scanner at Lake Norman Medical Plaza II in Cornelius, at 1130 Tree of Life Lane, at a projected cost of $11.6 million. The health system expects the project to reduce average patient drive times from more than 34 minutes down to 17 minutes, with completion projected for January 2030. Atrium projects 847 scans in the scanner's first year, rising to 2,089 annually by 2032.
Duke University Health System is seeking approval for a fixed PET/CT scanner at its Lake Norman hospital in Iredell County, at 171 Fairview Road in Mooresville, a $9.3 million project that would include renovating 1,900 square feet of hospital space. Duke's application states that more than 70% of Iredell County residents currently travel outside the county for PET imaging, according to Duke Health's own filing. That project would be completed by July 2028, with Duke expecting 2,303 PET scans annually by its third year of operation.
Duke's presence in the Lake Norman hospital market itself is fairly new. Duke Health completed its $284 million acquisition of the former Lake Norman Regional Medical Center on April 1, 2025, renaming the 123-bed facility Duke Health Lake Norman Hospital, a deal Hoodline previously reported came together after Novant Health had abandoned its own $320 million bid for the same hospital in June 2024 following a Federal Trade Commission antitrust challenge, as detailed by Healthcare Dive.
Novant and an Independent Practice Round Out the Field
Novant Health, meanwhile, is proposing to acquire a fixed PET scanner for Huntersville Medical Center, to be located at 10030 Gilead Road in Huntersville, Mecklenburg County. The $9.1 million project would be completed by January 2029, with Novant projecting 1,867 scans in its first year and 2,629 scans by its third year.
The fourth applicant, Southern Oncology Specialists, is the only independent physician practice in the race, competing against three major hospital systems. The group operates outpatient cancer clinics across northern Mecklenburg, Iredell, and Lincoln counties and is proposing to acquire one fixed PET/CT scanner for a location at 268 Gillman Road in Denver, Lincoln County. At $1.2 million, it's by far the least expensive of the four proposals, with an expected completion date of May 2027. Southern Oncology projects 596 PET scans in its first partial year of operation, growing to 1,566 annually by 2030.
Public Comment Window Closes October 1
The North Carolina Division of Health Service Regulation published a public notice on September 3, opening a 30-day public comment period on the four competing applications that closes October 1 at 5 p.m. Written comments can be submitted by email or mail to the state's Healthcare Planning and Certificate of Need Section, and any comments received by the deadline become part of the official state review record.
State regulators will hold a public hearing on all four PET scanner proposals on October 20 at 10:30 a.m. at the Iredell County Public Library's Statesville Main Branch, giving competing applicants and area residents a chance to make their case directly to state analysts before the North Carolina Department of Health and Human Services chooses just one proposal to move forward.
A Separate Novant Bid Nearby
In an unrelated proceeding playing out on a nearly identical timeline, Novant Health is also seeking Certificate of Need approval for a $13.4 million freestanding emergency department in Pineville, at 9610 Pineville-Matthews Road. That project would feature eight exam rooms, an observation room, a triage room, clinical support areas, and imaging equipment, with a projected completion date of April 2029. Its own public hearing is scheduled for October 19 at 10:30 a.m. at the University City Regional Library in Charlotte, one day ahead of the PET scanner hearing in Statesville.
The scanner competition is playing out against a backdrop of rapid health system expansion around Lake Norman. Atrium Health opened a new Lake Norman hospital campus in north Mecklenburg County in mid-2025, part of what Hoodline has tracked as ongoing expansion by competing health networks racing to capture market share in the high-growth suburban corridor north of Charlotte. North Carolina's 2023 Certificate of Need reform law began phasing in deregulation of certain diagnostic imaging equipment for lower-population counties starting in late 2025, though urban multi-county allocations like this PET scanner remain under strict state control, according to policy tracker CSG South.
