Earlier I wrote that the American Medical Isotopes Production Act was still stuck in the House Energy and Commerce Committee. A hopeful sign that progress is about to be made is a hearing on the bill by the Subcommittee on Energy and the Environment that took place on Sept. 9.
Transcripts of the hearing are available here. Nothing really surprising was said; all three expert witnesses stated the reality that the United States is heavily dependent on foreign sources of Mo-99 and a switch to domestic sources using Low Enriched Uranium is needed. Michael Duffy, a vice president of Lantheus Medical Imaging, had this to say:
In the face of the Mo-99 supply crisis, important diagnostic procedures often relating to life-threatening conditions such as heart disease and cancer are being postponed or cancelled because of the decreased volume of Tc-99m available to the nuclear medicine community. In addition, clinicians appear to be turning to older nuclear modalities with potentially less diagnostic certainty and more patient risk. Clinicians may also be foregoing nuclear medicine completely, opting for more invasive, more expensive, higher risk, surgical procedures. The nuclear medicine community seems widely affected by the supply crisis and appears to be adopting a variety of strategies to try to conserve the Mo-99 which is available.
The lack of controversy at the hearing is a good sign that hopefully indicates that the committee will report the bill to the whole House soon. On a personal note, I happened to be on an elevator yesterday when a courier was carrying a shipment of Tc-99m to a cardiologist’s office. I said to him, “I hear that you’re having a shortage of that.” “Yeah,” he replied, “in fact this is my last shipment of this. They’re having to switch over to Thallium.” As this presentation on the benefits of Tc-99m makes clear, that will result in poorer image quality and higher radiation dose for their cardiac imaging patients. It will take years for a domestic source of Mo-99 to become operational. We need to get the ball rolling right now.
