Matthew Vella
Mater Dei Hospital’s medical imaging department is preparing itself for an isotope shortage that is expected to put important hospital tests worldwide on hold.
A global shortage of a radioactive isotope, molybdenum, is at hand after three of the five reactors that produce the element were shut down.
The problem is likely to continue until the end of September.
Bone scans, MRI scans, heart and kidney function tests, tumour scans, all involve the injection of dyes that use molybdenum. It is produced from uranium using a nuclear reactor.
But it cannot be stockpiled because it lasts less than three days, so it has to be used upon delivery.
Dr Anthony Samuel, chairman of medical imaging at Mater Dei Hospital, said the department was fully aware of the situation and that it had taken all necessary steps to minimise the impact on scheduled patients.
“As national delegate to the European Association of Nuclear Medicine (EANM), I was informed immediately about this critical situation and informed hospital management and the health division accordingly. Furthermore, a coordinated effort by the EANM has ensured that the problem of old reactors in Europe is on the agenda of the upcoming European health ministers meeting,” Dr Samuel said.
Dr Samuel said the department had carried out several extra afternoon sessions over the past two weeks, to bring forward most of their scheduled September appointments.
“We have enough technetium (the decay product derived from molybdenum) this week, more than we usually do in fact, as we have used a new supplier together with our usual supplier.
“The problems will really begin next week as we do not have a guaranteed delivery. However, the EANM has stated that most customers can expect delivery of technetium generators with at least 50% of their normal strength. This will allow us to cater for the urgent cases and even some of the scheduled cases. I am expecting this situation to be rectified by mid-October.”
Dr Samuel said that so far no cases had been postponed or cancelled. “The most critical lists will be two cardiac sessions scheduled for the week starting 22nd September – 24 patients. We are doing all that is possible to ensure that not one single appointment is delayed. However, as there is still uncertainty as to start-up date of the reactors, so no guarantees can be given. We will be monitoring the situation on a daily basis.”
In the United Kingdom, the NHS has also been receiving half its normal supply, and expects delays in tests and scans. Hospitals are expected to provide tests for patients inside six weeks, and doctors fear that non-urgent patients approaching that deadline might be given priority instead of one with an immediate need.
In the meantime, the Parliamentary Secretary for Health, Dr Joe Cassar, was in Brussels this week for the informal health ministers’ meeting.
The minister also discussed the shortage of the radionuclide isotopes and agreed upon a solution to increase the production of these isotopes, and a system to ensure a fairer distribution of isotopes.
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