Multi-society coalition advocates U.S. support for Mo-99 development

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The American College of Radiology (ACR), SNM and a coalition of seven other organizations are urging Congress to take steps to maintain adequate supplies of molybdenum-99 (Mo-99).

The coalition jointly issued a white paper to ensure that patient care is not compromised by a worldwide shortage of Mo-99, in addition to nuclear non-proliferation measures in place that curtail the use of high-enriched uranium (HEU) in radionuclide production. In response, U.S. Representative Edward Markey, D-Mass., introduced legislation (H.R. 3276) reflecting many of the coalition's concerns. The coalition has endorsed the proposed bill.

In addition to SNM and ACR, the coalition includes the American Association of Physicists in Medicine (AAPM), American Nuclear Society (ANS), American Society of Nuclear Cardiology (ASNC), American Society for Therapeutic Radiology and Oncology (ASTRO), Council on Radionuclides and Radiopharmaceuticals (CORAR), Health Physics Society (HPS) and the Nuclear Energy Institute (NEI).

"Recent closures of nuclear facilities abroad are putting a severe strain on our ability to meet demand for this critical medical isotope," said Michael Graham, MD, PhD, president of SNM. "Congress should take steps to boost production domestically and to ensure that the transition away from using highly enriched uranium in medical isotope production does not further strain supplies. We applaud Congress for taking up this issue and urge the government to act without delay."

To address shortage concerns, the coalition's white paper recommends that the government explore a public-private partnership to speed the availability of Mo-99 and ensure continued diagnostic imaging for patients.

"It is imperative that domestic sources of Mo-99 be developed to guarantee a reliable supply," they wrote.

The paper identifies two potential domestic sources of Mo-99 as the most viable: the University of Missouri Research Reactor Center (MURR) in Columbia, Mo., and the collaborative effort between Babcock & Wilcox (B &W) and Covidien to build a reactor running strictly on low-enriched uranium (LEU).

MURR could meet approximately 50 percent of the U.S. demand for Mo-99 with little change, the paper noted, and it could also help fill gaps in supplies during planned shutdowns of other reactors. B &W and Covidien estimate that their new reactor technology could be operational in about five years and supply half of the U.S. demand for Mo-99. Together, the two sources could eventually meet 100 percent of the U.S. demand for Mo-99.

The coalition also urges the government to speed approvals for these facilities and support the Markey bill, which provides federal funding for the projects.

Finally, the organizations stressed that any requirement to transition from HEU  to LEU in the production of medical isotopes must ensure that supplies of Mo-99 are sufficient and that patient needs are not compromised.