["Technetium crisis" -  causes, possible solutions and consequences for planar scintigraphy and SPECT diagnostics]

Area of Science:

• Nuclear medicine
• Radiopharmaceutical production
• Medical imaging

Background:

• Nuclear medicine imaging, particularly planar scintigraphy and SPECT, heavily utilizes technetium-99m (99mTc).
• Radiopharmaceuticals are prepared using 99mTc eluted from molybdenum-99/technetium-99m (99Mo/99mTc) generators.
• The global supply of 99Mo, the precursor to 99mTc, depends on a few research nuclear reactors nearing the end of their operational life.

Purpose of the Study:

• To analyze the historical context, current status, and future prospects of SPECT diagnostics.
• To investigate the critical supply chain issues surrounding molybdenum-99/technetium-99m (99Mo/99mTc) production.
• To explore potential solutions to mitigate future technetium crises.

Main Methods:

• Review of historical data on nuclear medicine imaging techniques and radiopharmaceutical supply.
• Analysis of the global production landscape for molybdenum-99 (99Mo).
• Assessment of the impact of research reactor lifespans and potential shutdowns on 99mTc availability.

Main Results:

• Past shutdowns of 99Mo production facilities have led to critical shortages of 99mTc, impacting nuclear medicine diagnostics.
• The aging infrastructure of global research reactors poses a significant risk of a permanent and severe 99mTc supply crisis.
• Current reliance on a limited number of aging reactors creates a vulnerable supply chain for essential diagnostic isotopes.

Conclusions:

• The continued reliance on aging nuclear reactors for 99Mo production is unsustainable and jeopardizes SPECT diagnostics.
• Proactive development and implementation of alternative production methods and supply chain strategies are crucial.
• Addressing the impending 'technetium crisis' requires immediate attention to ensure the future availability of 99mTc for medical imaging.