The High Flux Reactor in Petten resumes the vital roles of production of medical radioisotopes and nuclear research
E.J. de Widt, MSc
Covidien’s role in the supply chain of Molybdenum-99 and Technetium-99m generators
F. de Lange, MSc
How to make nuclear medicine a killer app for medical imaging?
J.F. Verzijlbergen, MD, PhD
The economics of the Molybdenum-99/Technetium-99m supply chain
An increase in the sales price at the reactor level might be unavoidable
H.J.J. Seeverens, MD
Alternative methods for producing Molybdenum-99
Prof. D.M. Lewis
Molybdenum-99 supply shortage: is cyclotron-produced Technetium-99m a realistic alternative?
R.G. Zimmermann, PhD
Delft University of Technology working on short and long-term solutions to the molybdenum crisis
Prof. H.Th. Wolterbeek
PALLAS : the new nuclear research reactor in the Netherlands
B. van der Schaaf, MSc
Service in the spotlight Department of nuclear medicine and molecular imaging, University Medical Center Groningen
A.W.J.M. Glaudemans, MD
SOCIETAL NOTICES
COURSES & CONFERENCES
Editorial
The good news or the bad news first?
Well, we had many crises the past years and some of them are still continuing. Dear reader, we decided to analyse in-depth the latest crisis on molybdenum production. Because of its importance and world-wide impact, we invited both national and international professionals to make their contribution. Consequently, this issue is published in English. We have got good news and bad news for you. To start with the good: Molybdenum-99, the raw material generally used for the production of our beloved Technetium-99m, is now once again widely available for nuclear medicine purposes. The bad news is, however, that without structural changes, the current and future supply chain of this essential isotope is far from guaranteed. For this Special Issue ten outstanding professionals were asked to describe the causes of the shortages and how they were dealt with, to analyse the underlying economics, and to suggest improvements and alternatives that may help prevent or alleviate future crises. De Widt, as manager of Irradiation Services, was directly involved in the repair project and restart of the High Flux Reactor (HFR) in Petten. HFR is a key supplier of medical isotopes, covering about 70% of the European demand. It is the world’s second largest supplier of Molybdenum-99, right after National Research Universal Chalk River in Canada. De Widt provides us with a very personal eye-witness and project manager’s report of the recent outage of the HFR and the unique repair project that finally returned it to full production last September. De Lange, site director at Covidien’s Petten plant, describes the short-term shortage impact and the way the Molybdenum-99 processing industry has dealt with it. He even successfully called in Maria’s help, Maria being the Polish research reactor Covidien recently contracted into the supply chain. During the latest crisis, Verzijlbergen, as president and spokesman of the Dutch Society of Nuclear Medicine, was closely involved in communication about the Molybdenum-99 shortages. He discusses alternatives to the use of Technetium-99m labeled tracers. Although conversion towards PETtechniques might reduce our dependency on Technetium-99m to some extent, Technetium-99m labeled agents will still remain the workhorse of Nuclear Medicine for many years, he reveals. In his article Seeverens presents a summary of the recent report of the High-level Group on the security of supply of Medical Radioisotopes. This international group of 20 experts analysed the economics of the current Molybdenum-99 supply chain and came up with a number of highly relevant conclusions and suggestions. As former medical specialist and current policy advisor within the Dutch government, Seeverens gives his personal opinion on the report. Three separate contributions, by Lewis of CERN, Zimmermann and Geets of IBA and Wolterbeek of Delft University of Technology, discuss several alternative methods for producing Molybdenum-99. A variety of methods, in various states of maturity and feasibility, is summarized. Recently Delft has offered to make its research reactor available for back-up Molybdenum-99 production, using conventional fission of Uranium-235 targets. A novel production method Delft is investigating might eliminate the need for Uranium-235 targets in the future. This in-depth analysis is concluded by Van der Schaaf and De Jong who present PALLAS, the projected successor of the aged High Flux Reactor in Petten. They report on the progress made towards its realisation. We hope this Special Issue will illuminate the way forward to a stable long term supply of all medical isotopes.
Editors-in-Chief of this Special Issue
Bertjan Arends
Nuclear medicine physicist, Catharina-ziekenhuis, Eindhoven,
Filiz Celik
Nuclear medicine physician, Deventer Ziekenhuis, Deventer,