The Tc-99m shortage: Lessons learned

The worldwide supply of Mo-99 relies on a limited number of research
reactors and processing facilities. Its production is essential for the nuclear
medicine as Tc-99m, obtained from Mo-99/Tc-99m generators, is used in
about 80% of the diagnostic nuclear imaging procedures. These applications
represent yearly approximately 30 million examinations worldwide. The
short half-life's of Mo-99 (66 h) and its daughter Tc-99m (6 h) require a
regular supply of Mo-99/Tc-99m generators to hospitals or central
radiopharmacies. Several severe disruptions have been experienced since
the fall 2005 due to the occurrence of problems at different stages of the
supply chain: reactor outages, release of activity from processing facilities,
recall of Mo-99/Tc-99m generators by the manufacturers, …. It is not
expected that the situation will improve significantly in the near future. The
world supply of Mo-99/Tc-99m is very critical in 2010 and will remain
vulnerable beyond because of the short term planned temporary shutdown of
some reactors for maintenance and repair, and the medium-term replacement
of some of the main reactors involved in the supply chain. This article
summarizes the current status of the Mo-99 supply, discusses the ongoing
plans for additional Mo-99 production capacity and outlines the issues for a
reliable global supply chain.