There is a major nationwide shortage of Technitium-99m (Tc-99m), also known as sestimibi.
Tc-99 is used in 80% of this nation's radiopharmaceuticals, including nuclear stress testing.
All summer long, Cardiologists have had to ration their use of this agent. This has greatly affect their use of nuclear stress testing.
They have also reverted back to using thallium-201. This was the agent used prior to Tc-99m. Unfortunately, thallium is a less that ideal substitute. Its test requires more time for acquisition, it has a lower-energy which leads to lower quality pictures and there is also a higher rate of false positives. Importantly, there is also a higher radiation exposure to the patient.
How did this happen?
- In mid-May, Atomic Energy of Canada announced that the Chalk River high-flux reactor would be shutting down due to a heavy water leak
- This lead to a shortage of Tc-99m since the reactor produces the largest amount of molybdenum-99 - which decays into Tc-99m.
- Making matters worse, a reactor in the Netherlands also shut down this summer for maintenance
We are doing what we can but we need a more stable supply of these important radiopharmaceuticals.
Please support Rep. Edward Markey's American Medical Isotopes Production Act. This legislation calls for the production of molybdenum-99 in the USA. It is supported by ASNC, the ACC and ACR.
For more info on this important topic, you can read Dr Mylan Cohen's (President-Elect of ASNC) interview.