10 Feb (NucNet): Participants at an OECD Nuclear Energy Agency (NEA) workshop on the supply of Technetium-99m (Tc-99m) have drawn up a list of measures that should be taken to help ensure supplies of the key medical isotope by strengthening the �vulnerable� supply chain.

The agency�s workshop on the security of supply of medical radioisotopes was held in Paris on 29-30 January 2009 at the request of the Government of Canada to address present and future challenges to the reliable supply of Tc-99m, a medical isotope derived from Molybdenum-99 (Mo-99).

The workshop chairman, the NEA�s director-general Luis Echávarri, said in a concluding report that the international community had become �increasingly concerned� about shortages of Tc-99m, which is widely used for medical diagnostics. More than 30 million diagnostic nuclear medical procedures using Tc-99m are carried out every year. �Currently 95 percent of the world�s needs are supplied by only five reactors, all of them over 40 years old,� the agency said. �Outages of these reactors and of the downstream processing facilities have recently resulted in significant shortages of Tc-99m.�

Shortages of medical isotopes have arisen as a result of a combination of events at European facilities, including the unplanned outage of the Petten high-flux research reactor (HFR) in the Netherlands. The HFR�s operator, the Nuclear Research & Consultancy Group, is waiting for government permission to restart the reactor. Supplies were also hit in 2007 when Atomic Energy of Canada Ltd (AECL) extended the outage of its National Research Universal (NRU) research reactor to complete the installation of safety-related equipment.

The workshop, organised with the assistance of the International Atomic Energy Agency (IAEA), brought together over 80 participants including government policy and regulation officials, specialists in nuclear medicine, health industry professionals and nuclear research reactors operators.

Mr Echávarri said participants at the workshop recognised the vulnerability of the global medical isotope supply chain, which depends on a limited number of ageing nuclear research reactors for isotope production and a complex processing and distribution chain for delivery of short-lived isotope products to the health system.

�The vulnerability of the chain has manifested itself in several regional and global supply disruptions over the last decade that were due to reactor outages and various complications in the processing and distribution system,� Mr Echávarri said.

�Because of the age and increasing maintenance requirements of the major production reactors, the vulnerability of the isotope supply chain is likely to persist, if not to increase, for several years.�

The workshop�s main recommendations were:

� Reactor owners and operators should continue to share information and to improve co-ordination of reactor maintenance schedules, with a view to ensuring an uninterrupted global supply of isotopes;

� Options for increasing production from existing reactors in times of global shortage should be further explored;

� Current economic conditions for irradiation services should be reviewed to provide better incentives to reactor operators;

� Unnecessary impediments to the distribution of medical isotopes, such as restrictions in transport capabilities and denial of shipment by airline companies, should be removed.

Participants emphasised the need to develop contingency plans for future supply disruptions. They called for industry efforts to improve the flexibility and efficiency of the distribution chain, as these could make a significant contribution towards increasing the supply of Tc-99m ultimately delivered to patients.

Mr Echávarri said there was broad agreement that increased transparency among reactor operators, isotope processors and distributors, government regulators, and health care professionals would be a significant help. �In particular, it is important that the health care community obtains early information from all participants in the supply chain concerning potential and real disruptions, including estimates of the timing, duration and severity,� he said.

Participants said the NEA should consider establishing a working group, also involving the IAEA, to implement the agenda of the workshop and to review additional practical measures that could be taken. Special attention should be given to the economics of the supply chain, and to means of increasing its flexibility, for instance through improved standardisation.

When Canada announced the workshop in December 2008, its minister of natural resources, Lisa Raitt, said the supply of medical radioisotopes was a global issue which warrants a global response.

Earlier in December 2008, the Vienna-based European Association for Nuclear Medicine said a short-term shortage of isotopes for nuclear medicine was becoming a �chronic disease�.

Ms Raitt said the Canadian government had asked AECL to determine what would be needed to extend the operating licence of the company�s NRU reactor, which produces about 50 percent of the world�s medical isotopes. The NRU�s current operating licence expires in October 2011.

>>Related reports in the NucNet database (available to subscribers)

Shortage Of Nuclear Medicine Supplies Is Becoming �Chronic Disease� (World Nuclear Review No. 48, 12 December 2008)

Canada Leads Call For Global Talks On Isotope Supplies (World Nuclear Review No. 49, 19 December 2009)

The NucNet database currently contains more than 13,000 reports published since 1991. To subscribe or ask for any further information email info@worldnuclear.org

Source: NucNet

Editor: david.dalton@worldnuclear.org