Dear Colleagues,

Many of you will learn from the news that there is a shortage of a radioisotope called technetium, which is causing rescheduling of some patient appointments for nuclear medicine tests. Since UHN staff, including myself, are being quoted about this issue, I thought I should update everyone through this Straight Talk.

The company which provides a substantial portion of the nuclear medicine isotopes in North America has shutdown for electrical maintenance and will likely have limited or no production until January 2008. This company ships a radioactive isotope called Molybdenum-99 to hospitals, like UHN, which have radiopharmacies who then prepare isotopes for clinical use. In this case, we prepare technetium from the molybdenum core material.

Technetium is used in a variety of investigations including bone scans and heart scans. Most of the tests are elective for determining, for example the extent of bone disease in the skeleton. However, there are some urgent needs for technetium-based investigation or treatment. For example, on an urgent basis, technetium is used for sentinel node biopsy in cancer surgery, for detection of occult gut bleeding sites in patients with GI bleeds and for staging cancer patients prior to curative surgery.

Dawn Marie King and her staff in Medical Imaging have been busy searching for alternative suppliers and we are awaiting confirmation on securing a Molybdenum-99 generator for this weekend from a supplier in Europe. The availability of isotope from other suppliers during the weekend is greatest and therefore we will optimize use of the available radioactivity. If we continue to get the support from this alternate supplier, we should be able to continue to provide service to urgent care patients here, at our joint department sites (MSH and WC) and at Sick Kids.

Over the next few weeks, we will need to reschedule many of the patients booked for elective diagnostic tests. The waiting time for these tests is relatively short - most patients are usually booked within a week or two - so in general we will not be re-booking patients who have been waiting many months for their tests.

I am very appreciative of the efforts made by our staff in the Radiopharmacy area. In order to prepare as much technetium as possible, the nuclear medicine staff have volunteered to come in on the weekend to image patients who have been put on hold and who are booked in the next few weeks.

It will be frustrating for some of our patients to be rescheduled for elective scans, but we're hopeful that our patients who require urgent access to technetium procedures will not be disadvantaged. Finally, thank you to all the staff in Diagnostic Imaging, Nuclear Medicine and the Radiopharmacy who have worked hard to limit the impact of this supply disruption on patient care.


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