CORVALLIS, Ore. – If someone has chest pains, he or she might have tests done to see if it is a cardiac issue. But what if those tests cannot be done because of a medical isotope shortage?
Doctors say they have seen a shortage of a vital medical isotope, molybdenum-99, in North America before. The isotope, also known as Mo-99, is only produced in several spots around the world. The nearest location is in Canada at a site that is said to be de-commissioned in 2016 because of its aging reactor.
Cardiologists perform nuclear stress tests daily around the world, which require the use of Mo-99.
“We inject a nuclear material into the vein, which preferentially goes to the heart,” said Dr. Matthew Lindberg, a cardiologist at Samaritan Health Services. “What we want to see is that the heart looks the same, both at rest and when it’s stressed.”
Lindberg says the procedure is important in the diagnosis process.
“It can be a life-saving procedure,” he said. “If you know the heart is not to blame, then you can go figure out what is to blame.”
Lindberg says cardiologists would not be able to perform the nuclear stress tests without medical isotopes.
The test requires an isotope called technetium-99m, a breakdown product of Mo-99. Despite the threat of a Mo-99 shortage by 2017, hospitals across the country have already seen shortages because of maintenance issues at the Canadian facility.
“A few years back, there were supply chain issues with obtaining that isotope, and it caused a lot of challenges as we tried to figure out the best thing to do for patients,” Lindberg said.
Technetium-99m is vital for diagnostic procedures for scans for cancer, heart disease, or bone or kidney disease.
A team in Corvallis is taking matters into its own hands to make sure the nation has a reliable source of Mo-99 once the Canadian site closes.
Samaritan Health Services teamed up with CAC Isomed to create Northwest Medical Isotopes, a company that is licensing new technology that has been developed at Oregon State University.
“The problem is that we don’t have a consistent, reliable supply chain on the North American continent,” said Larry Mullins, CEO and President of Samaritan Health Services.
Researchers at OSU have designed a target that they will stick into a small-sized research reactor that will be able to make commercial quantities of Mo-99.
“This is our nuclear reactor,” said Dr. Steve Reese, the Director of the OSU Radiation Center. “If you look down into the pool, what you will see is a ring of positions within the core. This target slips into the core, and is exposed to neutrons.”
By using the smaller reactors, researchers say producing Mo-99 will be safer, simpler, cheaper, and reduces the waste of nuclear materials in the process.
“It’s a fantastic opportunity,” Reese said, “There’s a lot of pride that goes into being able to develop a technique and come up with the technology that surmounts a very significant issue.”
Northwest Medical Isotopes plans to build a central production facility by 2017 near the University of Missouri in Columbia. It is also working with other universities around the country to supply the facility.
Mullins says he hopes the facility will be able to supply Mo-99 to hospitals around the nation, even around the world, that need it.
“We’ve really come together to solve a really unique and interesting technological issue,” Reese said. “It’s really important to us that this will actually make a difference.”