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Jul 22, 2009: A global shortage of medical isotopes is expected to get worse in two weeks as supplies run down after nuclear reactor closings.

The Petten nuclear reactor in the Netherlands closed for scheduled maintenance Saturday. Together with a Canadian reactor (pictured) in Chalk River, Ontario, that was shut down in May because of a leak, the idled reactors account for two-thirds of the world’s supply of molybdenum-99, the journal Nature reported last week.

The isotope, which decays to technetium-99m, is used for diagnostic tests for heart disease and cancer. When injected into the patient, it gives off energy and is used in diagnostic tests. About 70,000 medical imaging tests use Tc-99m every day.

Michael Graham, president of the Society of Nuclear Medicine and director of nuclear medicine at the University of Iowa Carver College of Medicine, said that most testing locations have enough Mo-99 this week. “Some time during August, there will be a prolonged period with small quantities of isotope,” he said.

Graham also expects a shortage of Iodine-131, an isotope used to treat thyroid cancer and hyperthyroidism, to develop in August. It takes longer to run out of I-131 since it has a half-life of eight days compared with Mo-99’s three days, but the same reactors produce both isotopes. “Hundreds of thousands of tests using I-131 are passed out each week, so it could be a real problem,” he said.

Supplies may be replenished from reactors in Australia and South Africa, but not all demand will be met, according to Graham. Patients may have to chose more expensive diagnostic techniques, and in some cases, wait it out.

In response to the shutdown of the Canadian reactor, the Society of Nuclear Medicine, a professional group involved in nuclear-medicine research and practice, reported in June that 91% of 375 surveyed members had been affected, with 60% of doctors postponing procedures and 31% canceling some.

To avoid such shortages in the future, the White House is looking into technology to produce medical isotopes domestically, according to the National Nuclear Security Administration. See more here.

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