Government punch line defines nuclear medicine nightmare

Barely three months after the Dutch High Flux Reactor at Petten in the Netherlands came back on line -- ending a half-year hiatus that threw a monkey wrench into the world supply of the technetium-generating molybdenum radioisotope -- practitioners of nuclear medicine are facing a new crisis. A shutdown at the Canadian nuclear reactor at Ontario's Chalk River less than two weeks ago threatens to cut in half the supply of technetium to sites in the U.S.

The reason for the shutdown hardly matters. It was inevitable, given the decade-plus history of hiccups at the reactor, which split its first atom more than 60 years ago.

Opportunities to cut U.S. dependence on this reactor have popped up repeatedly, opportunities whose critical importance should have been easy to see in the context of similar problems at the handful of other Mo-99 suppliers scattered around the world.

But the fact that nothing was done doesn't matter any more than defining exactly what caused the most recent shutdown at Chalk River. No matter how tantalizing a prospect may seem, it is always just beyond reach of our political fingertips. Take, for example, the opportunity presented by the Annular Core Research program at Sandia National Laboratories, whose nuclear reactor could handle the entire demand for Mo-99 for medical applications in the U.S. with a conversion costing no more than $50 million. The problem: the reactor is currently designated for Department of Defense use only. Making the supply of Mo-99 a national security issue might be enough to convert this opportunity … but don't count on it happening.

Grand opportunities for the U.S. government to resolve the issue rise and fall away with each Mo-99 supply problem. The ability of the nuclear medicine community to weather each storm seems to make a government solution less likely by reducing the urgency that once accompanied the debate over developing new sources of this isotope.

Simply put, waiting for the feds to step in is not an option. Covidien and Babcock & Wilcox Technical Services Group appear headed in the right direction. Last January the two companies agreed to jointly develop technology to produce Mo-99. Their collaboration is focusing on the development of modular producers of Mo-99. Their solution, however, will be neither cheap nor easy.

Costs may range as high as $100 million apiece. And they will require Nuclear Regulatory Commission approval for construction, as well as special oversight to run such facilities, as they are fueled with plutonium. But the interest of private funding makes them the most likely chance of flattening the roller coaster of Mo-99 crises.

While the development of such an alternative may not solve the problem, it will at least ease the strain. Its success could also lead to further investments and the development of other technologies whose construction could dig deeper into the problem.

Someday, maybe, private sources will be enough to satisfy demand. And the nuclear medicine community can stop living the punch line of an age-old Washington joke: "I'm from the government … and I'm here to help you."