NUCLEAR MEDICINE’S DOUBLE HAZARD Imperiled Treatment and the Risk of Terrorism

This article examines the production of metastable technetium-99 (Tc-99m), the world’s most important radiopharmaceutical, focusing on reliability of supply and risks of nuclear terrorism. Only four producers manufactured about 95 percent of the world’s Tc-99m; a closure of any of them could cause worldwide shortfalls. Moreover, all four employ highly enriched uranium in their production process, in a form relatively easy to convert into the metal needed for a nuclear bomb. The technology to employ low-enriched uranium (LEU)*not usable in weapons*to produce Tc-99m is proven, available, and has been used by smaller producers. However, political determination and sufficient funding are needed to convert the major producers’ isotope production to LEU and encourage new LEU-based production. Such efforts are needed to ensure supplies and reduce security risks.