Alan Perkins, a medical physicist from the University of Nottingham in England, has warned that the government of the United Kingdom should start producing medical isotopes or "face a dangerous shortage that threatens to compromise patient healthcare."
Perkins, professor of medical physics at the University of Nottingham and president-elect of the British Nuclear Medical Society (BNMS), said that a series of disastrous setbacks in the worldwide production of radionuclides had recently caused disruption to clinical services. Although that crisis has now passed, the time is now to "plan for failure" to ensure the future provision of essential diagnostic imaging procedures for thousands of U.K. patients.
"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," Perkins said.
Around 80 percent of clinical nuclear medicine work is dependent on the routine availability of the radioisotope molybdenum-99 (Mo-99).
Ninety-five percent of the world's Mo-99 is produced by five commercial nuclear reactors -- NRU at Chalk River in Canada, HFR at Petten in The Netherlands, BR-2 at Fleurus in Belgium, OSIRIS at Saclay in France and SAFARI-1 at Pelindaba in South Africa. The U.K. has no facility of its own for Mo-99 production.
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 that began in August 2008 after corroded pipes were discovered in its primary cooling circuit.
"The recent supply disruptions at the end of 2008 and early 2009 have adversely affected patient services in many countries including the U.K., the majority of Europe, the U.S. and Canada and beyond," Perkins said.
"In the U.K., the supply of Mo-99 to some hospital departments was down to 30 percent of normal levels. As a result departments have had to prioritize to make the most effective and efficient use of supplies and ensure that tests were provided for those patients most in need. However, with pressure on hospitals in England to provide tests within six weeks, there has been concern that this may not have happened in all cases and that priority would be decided based on waiting lists and not clinical judgement," he wrote.
Perkins concluded that Britain needs 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.