An expert review panel on medical isotope production delivered a report to Canada’s minister of natural resources, stating that the path to security of the isotope supply lay in diversied plan, including buidling a new reactor as a source of production.

The expert review panel was established on June 19 to advise the government of Canada on the most viable options for securing a predictable and reliable supply of medical isotopes in the medium to long term.

The panel made these technology-specific recommendations:

• Make policy decisions on the requirement for a new research reactor: The panel recommended the government "expeditiously engage" in the replacement of the NRU reactor as it believes a multi-purpose research reactor represents the best primary option to create a sustainable source of molybdenum-99 (Mo-99). With the NRU approaching the end of its life cycle, a decision on a new research reactor is needed quickly to minimize any gap between the start-up of a new reactor and the end of life of the NRU.
• Support a research and development (R&D) program for cyclotron-based Tc-99m production: A significant advantage of this option is that any new cyclotron infrastructure would also be available for isotope R&D and production of PET isotopes, the panel said. The cyclotron option would have to co-exist with and rely upon other supply options for Tc-99m.
• Achieve better use of Tc-99m supply through advanced medical imaging technologies: Programs were recommended to encourage the replacement of older equipment with more efficient scanners using solid state crystal detectors and resolution-recovery software.

The panel also issued general recommendations, including:

• Strive for diversity and redundancy throughout the supply chain, as the linear accelerator and cyclotron options lend themselves to this supply chain model.
• Leverage multi-use infrastructure, as the shared infrastructure has the added benefit of costs being shared over a larger base of activities.
• Continue with international coordination and seek processing standardization within North America.
• Highly enriched uranium options are only viable solutions in the short to medium term.

The panel also suggested to appropriately invest in PET, which would gradually reduce the dependency on reactor-produced isotopes. The other considerations that rated less favorably were linear accelerator options (photo-fission and Mo-100 transmutation) and dedicated isotope facility.

The panel included Peter Goodhand (chair), president and CEO of the Canadian Cancer Society, Richard Drouin, counsel in the law firm of McCarthy Tétrault and the former chairman of the North American Electric Reliability Corporation, Thom Mason, MD, laboratory director at the Oak Ridge National Laboratory in Oak Ridge, Tenn., and Éric Turcotte, MD, clinical head of the Molecular Imaging Centre at the Centre Hospitalier Universitaire de Sherbrooke (CHUS) in Quebec.