NPR logo Nuclear Isotope Shortage Hurting Health Care

Nuclear Isotope Shortage Hurting Health Care

A patient gets a CT scan at New York Hospital - Cornell Medical Center, Friday Aug. 12, 2005. Richard Drew/AP Photo hide caption

toggle caption
Richard Drew/AP Photo

A patient gets a CT scan at New York Hospital - Cornell Medical Center, Friday Aug. 12, 2005.

Richard Drew/AP Photo

Here's something most people likely don't know: U.S. radiologists get the radioactive isotope they use for many of the diagnostic studies they do for cancer, heart disease and other conditions on 16 million people annually from two main sources, nuclear plants in Canada and the Netherlands. And both are now down.

Which means there's a shortage of Technetium-99, the isotope used on about 40,000 patients daily. Technetium is made from Moybdenum-99.

This isn't exactly a new problem. Nuclear medicine experts have been warning for some time about the threat created by the limited supply of the isotope.

The Society of Nuclear Medicine has a project meant to find alternative sources. The following information is from its web site:

The initiation of this project whose mission is to research alternative means for isotope production within the United States began with the late 2007 shutdown by the Atomic Energy of Canada Limited (AECL) of the aging National Research Universal (NRU) reactor. At that time, it was noted that the US capacity for domestic medical radioisotope production in support of nuclear medicine had declined sharply over the past 10 years. This, coupled with recent efforts to curtail the use of highly-enriched uranium (HEU) in radioisotope production as a non-proliferation strategy and to deter terrorism, now poses a significant threat to Mo-99 availability within the US.

As the SNM web site notes, pressure on the availability of the isotopes is also coming from homeland security types worried that the materials could be used in making dirty bombs.

Anyway, the present shutdown of the reactors that account for most of the U.S. supply is renewing attention to the problem.

An excerpt from an Associated Press story:

"You already have a vulnerable population with cancer, so it's not trivial," said Dr. Jeffrey Norenberg, who heads the National Association of Nuclear Pharmacies and directs radiopharmaceutical sciences at the University of New Mexico... "With both of them offline, it's very perilous," Norenberg said.

The Los Angeles Times recently reported on the health-care fallout from the shortage:

The abrupt shutdown of two aging nuclear reactors that produce a radioisotope widely used in medical imaging has forced physicians in the U.S. and abroad into a crisis, requiring them to postpone or cancel necessary scans for heart disease and cancer, or turn to alternative tests that are not as accurate, take longer and expose patients to higher doses of radiation.

Because of limits on testing produced by the shortage, some patients will undergo heart or cancer surgeries that could have been prevented by imaging, and others will miss needed surgeries because of the lack of testing, said Dr. Michael Graham of the University of Iowa, president of SNM, formerly the Society of Nuclear Medicine. "It's possible that some deaths could occur," he said.