Technetium-99m production issues in the United Kingdom

Nuclear Medicine developed when it was realised that a radioisotopic substitution of Iodine-131 for the stable Iodine-127 would follow the same metabolic pathway in the body enabling the thyroid to be imaged and the thyroid uptake measured. The Iodine could be complexed with pharmaceutical substrates to enable other organs to be imaged, but its use was limited and high gamma energy and beta emission restricted the activity of each radiopharmaceutical used, leading to long acquisition times and degraded images. As a pure gamma emitter of 140 keV and with a 6-h half-life, Technetium-99m is a better radionuclide and images a wider range of bodily organs. However, its short half-life also requires it to be eluted from its mother radionuclide, Mo-99, in a generator, delivered weekly from radiopharmaceutical companies who obtain the Mo-99 in liquid form from high-flux research reactors. All went well till around 2007, when the NRU Reactor in Canada was closed and all other reactors went down for various periods for unrelated problems, leading to widespread Mo-99 shortages. Although the reactors have since recovered, they are 48 to 57 years old, and it seems that few governments have made any future provision such as building replacement reactors.