Marianne Matthews

Americans of my generation have had it good. We’ve never had to ration sugar. Immediate gratification is our middle name. When was the last time we had to wait for something that was in short supply? Let’s see ? There was the Cabbage Patch Kids crisis back in the ’80s—a shortage of quirky-looking-but-cuddly dolls. Then there was the post-9/11 boycott on French wines. No matter how hard you sniffed, there wasn’t a good Bordeaux to be found.

Recently, there was a serious shortage. But I wonder how many Americans really understood the possible consequences. For nearly a month, Technetium-99 was being rationed. When a nuclear reactor in Chalk River, Ontario, shut down for maintenance on November 18, it was cause for alarm in the medical community worldwide. The 50-year-old reactor is North America’s biggest source of the radioactive isotope that makes Technetium, supplying more than two thirds of the world’s radioisotopes.

The sudden shortage of Technetium-99 had the potential to negatively affect the proper diagnosis and treatment of countless American patients. According to The Associated Press, the substance is used in at least 15 million medical scans per year in the United States. Technetium-99 plays a key role in helping to diagnose and assess a wide variety of conditions, including heart disease, cancer, and bone or kidney illnesses. It’s also crucial for determining whether cancer has spread.

When the Canadian plant closed its doors, medical treatments were delayed at hospitals worldwide. NBC News reported that 60% of US hospitals were experiencing shortages of the isotope. The Ontario Association of Nuclear Medicine estimated that approximately 50,000 Canadians and 160,000 Americans would have their tests postponed for each month the reactor remained dormant.

The American College of Radiology (ACR) issued a statement on the subject, saying “Mo-99 supply is now having an impact on the ability of physicians to perform diagnostic cardiac nuclear medicine studies which depend on a reliable daily supply of isotope Technetium.” The ACR also noted that for noncardiac imaging with nuclear medicine materials, like tests for cancer, there are “very few practical alternatives to Tc-99m radiopharmaceuticals.” Few alternatives: therein lies the problem.

Fortunately, Atomic Energy of Canada returned its National Research Reactor to service on December 16. So what did we learn from this crisis?

As Americans, we are finally waking up to the fact that reliance on the Middle East for oil is unwise. But what about relying on foreign sources for medical isotopes? Experts say we should build our own medical isotope reactors. Makes sense.

However, I believe the recent situation teaches us even more. The sudden shortage of a medical necessity should be a lesson in innovation. We must seek out alternatives instead of relying on a singular resource. Our community must encourage new and different imaging methods. Necessity is the Mother of Invention.

It is up to us to inspire young people to explore and pursue the sciences as a career path. We need young scientists, researchers, trailblazers to take medical imaging to the next level. But are we doing enough to attract top talent to the field? It seems to me that the real “shortage” we should be worried about is a shortage of human resources. We live in a celebrity-driven era when so many young people aspire to be rich and/or famous. The sciences simply aren’t sexy enough for some. But sharp, inspired, inquiring minds are what we need most for long-term solutions. People—not radioactive substances—are our most valuable resource.

The recent shortage of Technetium-99 should be a reminder to all of us that we shouldn’t take precious resources of any kind for granted. There is no such thing as an endless supply.

Marianne Matthews, editor