Tc-99m: How Canada is affected by the global isotope shortage

A Belgian nuclear reactor, BR2, is at the center of an isotope shortage in Canada.

The reactor that produces the isotope Technetium-99m (Tc-99m), which is used in medical scanners to look for tumors and the bloodstream, began having problems on October 28. Workers discovered mechanical problems and it had to be taken offline.

Tc-99m is created from Molybdenum-99 (Mo-99) when it breaks down. Mo-99 has a half-life of 66 hours, when it decays to Tc-99m the isotope should be used up in six hours.

The problem occurred just when three of the five reactors needed routine maintenance. BR2 is one of only six global Tc-99m plants in the world and supplies Canadian hospitals.

Without the isotope, imaging specialists “rearranged” appointments in order of urgency.

“So the shortage has become very significant because … in Canada, for example, we perform about 1.1 million of these tests for cancer, heart disease, infections,” said François Lamoureux, president of the Canadian Association. of nuclear medicine on CTV’s Your Morning. Thursday.

Although the brief period of disruption has caused planning problems at hospitals, Lamoureux says the shortage should be resolved by November 21 as other reactors are set to delay scheduled maintenance to improve the situation. .

Radioactive isotopes are essential for imaging, but also for the treatment of common forms of cancer, including skin and prostate cancers.

“This week was the worst, some departments had to cancel 90% of their tests,” Lamoureux said, expressing hope for a return to normal from the end of next week.

This comes as the Canadian Cancer Society released a report detailing how 1.5 million Canadians have or are living with cancer. During the pandemic, cancer screenings took a back seat as hospitals were overwhelmed with COVID-19 patients. Pandemic-related disruptions have since caused delays and interrupted cancer patient care, which can lead to later diagnoseswe read in the report.

Canada was once one of the world’s largest suppliers of Tc-99m, which was produced at NRU’s Chalk River reactor, northwest of Ottawa. In 2013, the federal government cut funding for the reactor. It fell into disrepair and ceased production in 2016.

In its heyday, the Chalk River reactor supplied the world with isotopes and in 2007 when it shut down unexpectedly, it was remembered as the most serious shortage of Tc-99m ever.

A reactor in British Columbia produces the isotope, but due to the short six-hour lifespan, Lamoureux says it can only be used locally.

“So that’s a major issue,” he said of the technology around digitization. “They (researchers) will try to develop new technologies, but it will take years.”