Molybdenum muddle
Isotope issues just keep hanging over the head of nuclear medicine. Once again, when one highly enriched uranium reactor goes down, it takes a significant percentage of the world's production of molybdenum-99 (Mo-99) along with it. When molybdenum is in short supply, so is the capability to produce technetium-99m, the most widely used isotope in nuclear medicine studies. Osman Ratib MD, PhD, professor and chair of radiology and head of the nuclear medicine division at Switzerland's University Hospital of Geneva, noted that Mo-99 producers bear much of the responsibility for the current situation.

"This crisis clearly showed the negative aspect of market globalization and partitioning. In order to make more money, companies bought and shut down production facilities and left only three production sites in Europe. "And of course what should not happen happened and two out of three failed, leaving the third site completely overloaded and unable to produce enough for the whole of Europe," Ratib added.

"Besides, for market protectionism, production from Canada, South Africa or Australia (or even the U.S.) is not allowed in Europe--so we could not buy directly from them without setting up complex and tedious authorizations that would take weeks. This is just greed and marketing (on the part) of large companies to make more money and partition the market. Governments should not allow that to happen."

The Canadian government seems to have had enough of the Chalk River saga, and announced it is getting out of the medical isotope production business. As nature abhors a vacuum, apparently so does the medical isotope industry.

The past few weeks have seen initiatives underway for low-enriched uranium production of Mo-99 at various facilities as well as political posturing for funding to build highly-enriched uranium reactors. The attempt to consolidate isotope production as the purview of only a handful of manufacturers seems as though it will result in a host of new vendors and development processes entering the market.

In related, belated news for this past Father's Day, SPECT/CT prostate cancer imaging using technetium-99m results in better sentinel node detection and localization, according to work conducted by researchers at the Antoni van Leeuwenhoek Hospital in Amsterdam, The Netherlands.

Also recently in clinical news, the imaging of changes in glucose metabolism with PET, as reflected by cellular uptake and trapping of the glucose analog 18F-FDG, can provide a response assessment that is both more timely and more accurate than that provided by standard structural imaging for non-small cell lung cancer, according to a review of PET assessment by Rodney J. Hicks, MD.

If you want to find out more about the possibilities for molecular imaging in your practice head over to our Healthcare TechGuide and check out the variety of systems offered there.

Lastly, if you have a comment or report to share about the utilization of molecular imaging and nuclear medicine in your practice, please contact me at the address below. I look forward to hearing from you.

Jonathan Batchelor, Web Editor