In America, 16 million nuclear medicine procedures are used to diagnose and treat cancer, cardiovascular disease and neurological disorders each year. What started as an experimental procedure has now become a routine part of clinical care, with additional applications in biomedical research and disease management. Many medical physicians say the use of radioactive elements is one of the most promising areas of new research. Yet just as this field begins taking off, they’re already worried that an isotope shortage could bring the whole field crashing down.

Many nuclear medicine procedures use the radioactive isotope Technetium-99. Half of all diagnostic imaging involving the heart uses this isotope. According to medical professionals, the only other alternatives are more invasive procedures, like cardiac catheterization. Bone scans are the second-most popular use for this isotope. There are no other substitutions for the accuracy and quality of this important test. Additionally, kidney function evaluations are done using this isotope, with no existing alternative test options. Sometimes other isotopes can be used, but the radiation dose is higher, the procedure takes longer to do and the image quality is not that good. Given our dependency on such an important isotope, it seems logical to suggest we need to update existing nuclear reactor facilities (most of which are over 40 years old) and put a greater focus on preventative measures using imaging technology.

In addition to these tests, nuclear medicine is also used to treat certain patients. Since cancer is characterized by quick, uncontrolled cell division and rapidly reproducing cells are sensitive to the effects of ionizing radiation, they can be targeted and treated with radiation therapy. During this treatment, radioactive wires are placed near the tumor and they cause rapidly reproducing cells to self-destruct. One negative consequence is that cancer cells aren’t the only cells that quickly reproduce. Hair cells, stomach lining cells, skin cells and blood cells also reproduce quickly, so there are many side effects (particularly hair loss and nausea) as these cells self-destruct.

As with anything, nuclear medicine has its caveats. For one, 80% of nuclear radiology scans depend upon a radioactive isotope called Technetium-99. Most of the U.S. and European supply is produced by a nuclear reactor in Chalk River, Ontario and another one in the Netherlands. However, the Canadian reactor just shut down due to large operational expenses and the Netherlands reactor will be offline for six months next year for maintenance on its aging infrastructure. In America, there is a Missouri plant that produces isotope supplies but it’s old and in need of a major overhaul that won’t be possible for another couple of years. Another problem with Technetium-99 is that its effects only last for six to twelve hours, so it needs to be produced daily and used immediately.

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