ATA News Release 2009

There may be an upcoming shortage of isotopes used for the diagnosis and therapy of thyroid and parathyroid disorders. The duration of the shortage is uncertain and originates from the shutdown of a nuclear reactor in Chalk River, Ontario, Canada, which has been North America's main supplier of radioisotopes. The isotope shortage should only impact supply of fission products such as Mo99 (the parent to Tc99m, used in parathyroid Sestamibi scans) and potentially I131. The shortage will not affect I123 (cyclotron produced) products used in thyroid imaging. The extent to which I131 will be affected is not known, but this isotope is in greater abundance and also has a longer shelf-life, which are advantages for maintaining a readily available supply.

Chalk River supplies over half of the Mo99 consumed in North America for medical imaging. There are also alternative global sources of the radioisotopes, and production at these other facilities (Petten in The Netherlands, for example) is expected to meet the new demands. Similar radioisotope shortages have occurred in the past and were limited in duration; however, the recurring difficulties with the Chalk River reactor and implications for long-term stability of radioisotope supply for North America are being addressed by the Society of Nuclear Medicine. A prolonged or permanent shutdown of the Chalk River facility places hospitals and imaging centers in a fragile state, ultimately relying on a single supplier to produce >70% of the world's demand for Mo99 generators. Information from sources familiar with repairs of the Canadian reactor predicts that the temporary shutdown may become permanent.

The ATA advises physicians whose patient care may be affected by these developments to consult first with the nuclear medicine professionals at their local institutions, hospitals and treating facilities about contingency plans. For now, it is possible that the shortage of these isotopes may only affect patient scheduling for tests or treatment, but unlikely that it will affect the ability or access of patients to receive their intended therapies. The ATA will issue further news updates on this topic as they become available.