China limits exports of rare earth elements, targets CT x-ray tubes

As part of a retaliation against new tariffs imposed by the Trump administration, China announced April 4 that it would limit export of rare earth elements, including several used in medical imaging and treatments. It also launched investigations related to imports of CT x-ray tubes.

Gadolinium, lutetium, and yttrium were included on the list released by China’s Ministry of Commerce of medium and heavy rare earth elements now under export control measures. The announcement raises questions about the potential for supply interruptions for MRI contrast agents and radiopharmaceuticals based on these elements.

Gadolinium is used in a variety of MRI contrast agents from several vendors, including Bayer, Bracco, GE HealthCare, and Guerbet.

A radioisotope of lutetium, lutetium-177 (Lu-177), has been commercialized as a theranostics agent under the brand name Pluvicto by Novartis. Pluvicto (lutetium-177) was approved in 2022 for the treatment of patients with prostate-specific membrane antigen (PSMA) metastatic castration-resistant prostate cancer.

“Novartis has built a robust global manufacturing and supply network which enables us to adapt and continue to deliver treatments to patients around the world when and where they need them,” a spokesperson from Novartis told AuntMinnie.com.

In addition, radiopharmaceutical firm Curium Pharma is currently developing Lu-177 drug candidates for prostate cancer treatment and submitted a new drug application (NDA) with the U.S. Food and Drug Administration (FDA) for treatment of gastropancreatic neuroendocrine tumors (GEP-NETS) neuroendocrine tumors.

Meanwhile, yttrium-90 (Y-90) is used primarily for radioembolization therapy of liver cancer. Boston Scientific’s TheraSphere Y-90 glass microspheres are indicated for use as selective internal radiation therapy for local tumor control of solitary tumors in patients with unresectable hepatocellular carcinoma.

Another vendor, Sirtex Medical, offers SIR-Spheres Y-90 resin microspheres for the treatment of unresectable metastatic liver tumors from primary colorectal cancer with adjuvant intrahepatic artery chemotherapy.

In a statement to AuntMinnie.com, Society of Interventional Radiology (SIR) President Robert Lookstein, MD, said, “SIR is closely monitoring the news and will be seeking more information about how this will impact the export of yttrium for medical uses. We are committed to maintaining our members’ and their patients’ access to lifesaving radioembolization therapies for conditions such as hepatocellular carcinoma.”

CT x-ray tube investigations

China also announced two investigations related to CT x-ray tubes. In the first, the Ministry of Commerce is acting on a request from Chinese x-ray tube supplier Kunshan Yiyuan Medical Technology to investigate their concerns that certain ball-bearing CT x-ray tubes originating from the U.S. and India are being "dumped" on the market in China.

A Ministry of Commerce official said that preliminary evidence showed that volume of these CT x-ray tubes had increased in China by 13% from 2022 to 2024 while their prices had declined, according to a report from Chinese news agency Xinhua. Kunshan Yiyuan Medical Technology said that this had depressed domestic prices and resulted in operating difficulties and losses for domestic producers, Xinhua reported. The investigation is expected to be completed by April 4, 2026.

The second investigation will be broader and assess the impact of imported CT x-ray tubes on Chinese companies and their competitiveness. The Ministry of Commerce is basing its investigation on Kunshan Yiyuan Medical Technology’s assertion that the competitiveness of the domestic CT x-ray tube industry is adversely affected by the impact of imports.

Notably, Kunshan Yiyuan Medical Technology was recently charged in the U.S. for allegedly stealing trade secrets involving CT tube technology from Philips in 2017. In February, the U.S. Attorney’s Office for the Northern District of Illinois announced an indictment of that company, a related firm, and four individuals for allegedly conspiring to steal CT x-ray tube secrets from internal Philips databases at an Aurora, IL, facility then operated by Philips’ Dunlee brand. That facility was sold to Chronos Imaging in 2018.

Philips declined to comment on today’s investigation announcements.