Nuclear Medicine, Radiopharmaceuticals, and Chalk River Labs

Without the key radionuclides that are used in radiopharmaceuticals, we would not have nuclear medicine as we know it today: by definition, without the radiopharmaceuticals we cannot have the nuclear diagnostic and therapeutic modalities that we depend upon for life-saving medical care. The concept of nuclear medicine was rooted in early discoveries about radioactivity by George de Hevesy in the 1920s, but really took off when in 1946 two key events took place: one, Oak Ridge National Laboratory started to produce radionuclides for medical use and secondly, a physician was successful in treating a patient using nuclear medical techniques and reported his clinical approach in the Journal of the American Medical Association, providing wide-spread information to the American medical community on the value of nuclear modalities. Later, the Anger Camera and other specific technologies were developed and refined and by the 1970s, several professional groups were established for the support of training and research in nuclear medicine. By the 1990s, there was also a Society of Veterinary Nuclear Medicine as these same techniques made in-roads also in the veterinary community.

However, once again, without the radionuclides involved, we would have none of this, a fact that many of the lay public may not directly connect to the life-saving treatments that they and their loved ones benefit from in our world of modern medicine. But where do the radionuclides for these radiopharmaceuticals come from, anyhow? For most used in North America, the source is the Chalk River Nuclear Laboratories in Canada which produce about a third of the world's entire supply of medically-useful radionuclides. As one may imagine, the demand for these substances is great and constant, so any interruption in their production is going to cause problems aplenty. Such an interruption transpired in 2007 when the Chalk River reactor that produced the lion's share of the medically-useful isotopes was shut down and remained in shut-down longer than expected due to a variety of both technological and administrative problems. The aftermath of this was that one of Canada's top nuclear officials, Linda Keen, was fired from her post and there was an outcry for further firings and changes in how the labs and agencies over the labs were run. Instead of retelling that whole story, I will offer the following newspaper article which does a fine job explaining immediate administrative outcomes involved if less of a nuanced job explaining the technical origins of the mess in the first place:

http://www.canada.com/topics/news/national/story.html?id=c70b1f37-7efe-46c1-a165-8b0efd4dfcaa

What is most interesting to me about all this however is that for America, which is still the world leader in so many areas of nuclear technology and modern medicine alike, the main source that we depend upon for our medical radionuclides is actually a Canadian lab. While Canada is doing a great job in general providing the substances needed, it is clear from the 2007 incident just how quickly a supply crisis can arise when for whatever reason Chalk River is unable to produce at its normal levels. 

Two observations therefore on Chalk River:

1) Having a single major source of radionuclides in North America seems rather unwise: all of Canada and the US depends on this one facility to produce radionuclides that are not only in great demand but can run very low in inventory if they are not in production for even a month, as the 2007 incident illustrates. Another third of the world's supply of medical radionuclides are produced in the Netherlands, and the rest are produced in Russia and at facilities scattered elsewhere in Europe and the US, however, without Chalk River's contribution, the US is apparently in dire straits. That's a disturbing situation. Even when it's a good friend like Canada, I find it bothersome that the US must depend on a single facility in another nation for something essential to crucial medical practices.

2) Nuclear medicine is possibly the only aspect of the nuclear industry no one, no matter how anti-nuclear they may be, can really hate or call to be reduced in numbers or utility. We're talking about life-saving capacities that come only from these radionuclides and the drugs produced from them, and that's a very good entry to any argument that is pro-nuclear: who will argue that something that clearly benefits medicine in a big way is bad for the environment, evil, or whatever other crazy claim someone may make of the nuclear industry in general? So we need to draw more public attention to what nuclear medicine is and how it works, how the radionuclides are produced and where they come from, because then even the most stubborn of critics will have to pause and consider the advances in life and society brought forth via nuclear technologies. 

Chalk River Labs have overall done a great job of contributing the radionuclides needed to medicine, but should they be doing this alone or with as vast a market-share as they currently encompass? I open that up as a valid question to consider and encourage people to read up on the 2007 incident and where radionuclides are sourced from in general. 

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I know I've promised a long article on the USAF's nuclear aircraft program, and I still plan to post that, but since I write for the Russian and Eastern European press on aviation and aerospace issues a lot and we just had a horrible airliner crash in Kazan, Russia, I've been rather caught up in the dismal business of writing about that this past week.