Isotope shortage threatens medical care

Reactor in Canada has been shuttered

By Sue Major Holmes
Associated Press / August 15, 2009

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ALBUQUERQUE - The shutdown of a nuclear reactor in Canada has caused a shortage of a radioactive isotope used to detect cancers and heart disease, forcing doctors into costlier procedures that can be less effective and expose patients to more radioactivity.

Some 16 million people in the United States - 40,000 patients each day - undergo medical imaging procedures using the isotope, technetium-99. Eighty percent of nuclear medicine scans use it.

Ninety-one percent of hospitals, pharmacies, and commercial imaging groups that answered a June survey by the Society of Nuclear Medicine said the shortage had affected them.

“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.

Technetium-99 is processed from molybdenum-99 and used in body scans for cancer, heart disease, or kidney illness. It is combined with a substance to target a specific organ or tumor, then that tracer is injected and a gamma camera looks at the distribution of radioactivity to spot problems.

The shortage began with the shutdown of a Canadian nuclear reactor in Chalk River, Ontario, that produces half the US supply of molydenum-99. Technetium-99 must be made daily because it lasts only six to 12 hours.

The Canadian reactor and another in the Netherlands produce most of the US and European supply. The Dutch reactor is down for maintenance for several weeks, then will be offline for up to six months next year.

In the meantime, the United States is getting a smaller supply from South Africa.

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