Tc-99m shortage expected into November

The delayed restart of a nuclear research reactor in the Netherlands is expected to cause supply shortages of the imaging agent technetium-99 m (Tc-99m) into November, according to reports.

“We anticipate that shortages of Mo-99 [Molybdenum-99] to Tc-99m generator manufacturers will begin later this week and increase next week,” said industry association Nuclear Medicine Europe (NMEU), in an October 14 letter to stakeholders.

In an October 17 alert, the American Society of Nuclear Cardiology (ASNC) noted the looming shortage is due to a “pipe deformation” at the aging High Flux Reactor (HFR) located in Petten and operated by the Nuclear Research and Consultancy Group (NRG).

"A reactor inspection determined that a previously identified pipe deformation must be corrected immediately, rather than as a planned fix scheduled for the December 2024 maintenance period," the ASNC said. "NRG, the operator of the HFR reactor, has not announced a start date; however, the fix will likely take a few weeks to complete."

The HFR reactor produces and ships molybdenum-99 (Mo-99) to generator manufacturers around the world. Tc-99m is then eluted from Mo-99 at radiopharmacies prior to being transported to hospitals. According to estimates, Tc-99m is used in 40,000 diagnostic imaging scans per day, a majority in nuclear cardiology.

“As the situation may evolve quickly, ASNC is encouraging members to contact their local nuclear pharmacies for up-to-date information on Mo-99 supply,” the ASNC noted.

The Society of Nuclear Medicine and Molecular Imaging (SNMMI) also informed its members of the imminent delay.

“These delays may result in supply shortages of up to 40% and may vary across different geographic regions. Currently, no date has been set for the continuation of normal operations, but we expect an update on this shortly. Supply issues are expected to persist until November,” SNMMI said, in a statement.

Such supply chain issues were the subject of a meeting last week in Washington, DC, where U.S. government and nuclear medicine stakeholders discussed progress on efforts to secure U.S. domestic supplies of Mo-99. That goal isn’t expected to be reached for two years, according to officials.