Enlarge / A dose of Tc-99m to be used in an upcoming scan. (credit: Getty | Rene Johnston)
There’s a mad dash for a vital radioactive isotope that’s used in about 50,000 medical procedures every day in the US, including spotting deadly cancers and looming heart problems.

Currently, access to it hinges on a shaky supply chain and a handful of aging nuclear reactors in foreign countries.

But federal regulators and a few US companies are pushing hard and spending millions to produce it domestically and shore up access, Kaiser Health News reports.
The isotope, molybdenum-99 (Mo-99), decays to the short-lived Technetium-99m (Tc-99m) and other isotopes, which are used as radiotracers in medical imaging.
Injected into patients, the isotopes spotlight how the heart is pumping, what parts of the brain are active, or if tumors are forming in bones.
But, to get to those useful endpoints, Mo-99 has to wind through a fraught journey.

According to KHN, most Mo-99 in the US is made by irradiating Cold War-era uranium from America’s nuclear stockpile.

The US Department of Energy’s National Nuclear Security Administration secretly ships it to aging reactors abroad.

The reactors—and five subsequent processing plants—are in Australia, Canada, Europe (Netherlands, Belgium, Poland, and the Czech Republic), and South Africa, according to a 2016 report by The National Academies of Sciences, Engineering and Medicine. Private companies then rent irradiation time at the reactors, send the resulting medley of isotopes to processing plants, book the final Mo-99 on commercial flights back to the US, and distribute it to hospitals and pharmacies.
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