NCPA - National Center for Policy Analysis


August 14, 2009

The abrupt shutdown of two aging nuclear reactors that produce a radioisotope widely used in medical imaging has forced physicians in the United States and abroad into a crisis, requiring them to postpone or cancel necessary scans for heart disease and cancer, or turn to alternative tests that are not as accurate, says the Los Angeles Times.

The focus of this shortage is a short-lived radioisotope technetium-99m. With a half-life of only six hours, the isotope allows physicians to examine bones and blood flow, and then quickly disappears from the body minimizing the dose of radiation received.  It's produced in five reactors around the world, all of them at least 45 years old and none of them in the United States, says the Times:

  • Radiologists are already feeling the effects; about 91 percent have suffered shortages of some sort.
  • The shortage is also straining hospital finances; when a shipment does come in, some hospitals are scheduling tests far into the evening and on weekends to use up the technetium before it disintegrates -- frazzling the nerves of some technicians and boosting overtime costs.
  • The cost of the radioisotope itself has also gone up, by at least 20-30 percent.
  • With the shortage of technetium-99m, some radiologists are using fluorine-18 and thallium-201 instead, but Medicare and insurance companies typically don't cover the cost of that test.
  • Moreover, both alternatives are more invasive and less accurate, and can sometimes inadvertently result in large radiation doses to patients.

Reactor builder Babcock & Wilcox Co. is planning to construct a reactor to produce medical isotopes, but construction could take five to six years.  And companies in both the United States and Canada are developing alternatives but results are unlikely in the near future, says the Times.

Source: Thomas H. Maugh II, "Isotope shortage means a health care crisis," Los Angeles Times, August 9, 2009.


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