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Medical isotope shortage threatens patient care

Nuclear Medicine - An expert is calling on the Government to provide substantial new investment into the production of medical isotopes or face a dangerous shortage that threatens to compromise patient healthcare.

After a series of setbacks in the worldwide production of radionuclides recently caused disruption to clinical services, Alan Perkins - Professor of Medical Physics at The University of Nottingham and President Elect of the British Nuclear Medical Society (BNMS) - has said we now need to "plan for failure" to ensure the future provision of essential diagnostic imaging procedures for thousands of UK patients.

Professor Perkins said: "The medical use of radionuclides is probably the single most beneficial application of atomic and nuclear sciences to mankind. I am advocating further investment in alternative means for producing medical radionuclides for the benefit of patients who desperately need them."

Globally, nuclear medicine investigations are the second most common diagnostic imaging procedure after x-ray CT and more than 28 million procedures are carried out each year using Technetium-99m (Tc-99m). Around 80% of clinical nuclear medicine work is dependent on the routine availability of the radioisotope molybdenum-99, from which Tc-99m is derived, which has a half-life of three days and cannot therefore be stockpiled.

95% of the world's Mo-99 is produced by five commercial nuclear reactors - NRU at Chalk River in Canada, HFR at Petten in The Netherland, BR-2 at Fleurus in Belgium, OSIRIS at Saclay in France and SAFARI-1 at Pelindaba in South Africa. The UK has no facility for producing Mo-99 of its own.

Since January 2007, there have been five periods of serious disruption to supplies, including a month outage at Chalk River to fix safety back-up systems and a six-month shut down of the Petten reactor from August 2008 after corroded pipes were discovered in its primary cooling circuit.

Professor Perkins added: "The recent supply disruptions at the end of 2008 and early 2009 have adversely affected patient services in many countries including the UK, the majority of Europe, the USA and Canada and beyond."

Professor Perkins added that Britain needed to seriously consider investing in its own production facilities to reduce its reliance on the foreign reactors, which are all more than 40 years old and are approaching their time for decommissioning.

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