Assessment of Using 99Mo and 99mTc Isotopes in Kuwait Medical Sector

The Ministry of Health (MOH) in the state of Kuwait currently depends on importing the radioisotope molybdenum (Mo) in its isotopic form (Mo) to fulfill its demands. The present study was conducted on all nuclear medicine departments in the state of Kuwait. Daily, weekly, and monthly data were analyzed to statistically determine the current and future demands for the isotope Tc. This analysis was performed by collecting and analyzing data on MOH consumption of Tc for different diagnostic applications. The overall results indicate a partial decrease of 1.012% in the overall total demand for Tc up to the year 2018 for the state of Kuwait.

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

Nuclear medicine is an important field of nuclear medicine, especially thanks to its role in in vivo imaging of important processes in human organism. An overwhelming majority of nuclear medicine examinations comprises of planar scintigraphy and single photon emission computed tomography, for decades relying on the labeling by metastable technetium nuclide (99mTc), used with a great diversity of ligands for various applications. Nuclear medicine departments utilize commercially available molybdenum technetium generators, being able to elute the nuclide at any time and prepare the radiopharmaceutical. The mother nuclide, molybdenum-99 (99Mo), is produced in just a handful of places around the world. The production places are without exception research nuclear reactors working far past their life expectancy. A concurrent temporary shutdown of two of them in the year 2009 caused a critical worldwide shortage of 99mTc. An unavoidable permanent shutdown of part of these capacities in the second decade of the 21st century will cause the second, and this time rather permanent "technetium crisis". The article focuses on history, present, potential future and possible solutions in regard to SPECT diagnostics.

Alternative production methods to face global molybdenum-99 supply shortage

The sleeping giant of molybdenum-99 ((99)Mo) production is grinding to a halt and the world is wondering how this happened. Fewer than 10 reactors in the world are capable of producing radio nuclides for medicine; approximately 50% of the world's supply of raw material comes from National Research Universal (NRU) reactor in Canada. Many of these reactors, like the NRU, are old and aging. No one of these reactors, and probably not even all of them in combination, can replace the production of NRU. As the healthcare industry faces an aging population and the demand for diagnostic services using (99m)Tc continues to rise, the need for a consistent, reliable supply of (99)Mo has become increasingly important, so alternative methods to produce (99)Mo or even directly (99m)Tc had to be considered to avoid a supply shortage in the coming years. This need guides to the production of (99)Mo by replacing the Highly Enriched Uranium (HEU) target in a nuclear reactor with Low Enriched Uranium (LEU) and furthermore to the use of accelerators for manufacturing (99)Mo or for directly producing (99m)Tc.