Nuclear medicine industry loses key isotope production opportunity

DOE chooses commercial reactor rather than APT

The biomedical and radiopharmaceutical communities received disappointing news in December when U.S. Secretary of Energy Bill Richardson awarded a key tritium production contract to federal utility company Tennessee Valley Authority of Knoxville rather than to Westinghouse Savannah River Company of Aiken, SC. Since Westinghouse's proposed Accelerator Production of Tritium (APT) facility was to include the production of medical isotopes used in nuclear medicine, Richardson's decision closes the door on the possibility of a large-scale, nationwide distribution system of these isotopes in this country, at least for the time being.

In partnership with Los Alamos National Laboratory in New Mexico, Westinghouse had proposed building an accelerator for the production of tritium, a hydrogen derivative used by the Department of Defense in nuclear weapons. There has been no U.S. source of the radioisotope since the last operating nuclear reactors at the Savannah River site were shut down in the late 1980s. The DOD has been recycling tritium since then, according to Mel Buckner, technical lead for the Savannah River Company. Tritium supplies are expected to run out by 2005, Buckner said.

More important for the medical imaging community, however, LANL and Westinghouse had included the production of research, diagnostic, and therapeutic medical isotopes in the APT facility's design plans. The majority of the radiotracers used in this country are single-photon emitters produced in reactors outside the U.S., specifically at the Chalk River Laboratories site of Atomic Energy of Canada. U.S. dependence on this site, and others in the Netherlands and South Africa, means that patient care can be jeopardized when production is interrupted, as occurred last spring when workers at Chalk River went on strike (SCAN 5/27/98).

The U.S. nuclear medicine community would like a reliable, domestic source of low-cost, high-quality medical isotopes, said Dr. Kenneth Spicer, a professor of radiology at the Medical University of South Carolina (MUSC) in Charleston. Spicer moderated a panel that met in June at the National Press Club in Washington, DC, to discuss the Savannah River Site APT facility and its medical isotope potential (SCAN 6/24/98). Panelists expressed hope that the DOE would indeed build the accelerator and therefore provide a stable supply of radiotracers.

"The reason we were interested in APT is that it was a real paradigm shift," Spicer said. "An accelerator that we would use to make medical isotopes right now might have a beam path about the size of your thumbnail and energy of 10 to 20 millions of electron volts (MEVs). (The APT) had a beam path about the size of a door and 1.3 billion MEVs."

But despite APT's potential to produce large, stable quantities of radiotracers, the DOE chose TVA on Dec. 22, citing cost and flexibility concerns. The department wanted to avoid the large capital investment that a new facility like the APT site would have required. It also wanted the flexibility to manage production of tritium at TVA's Watts Bar and Sequoyah reactors according to nuclear nonproliferation treaty negotiations. The contract between TVA and the DOE is under negotiation, according to Barbara Martocci, TVA spokesperson. The utility has no plans to produce medical isotopes, Martocci said.

Although Richardson decided in favor of TVA, some industry watchers believe that hope still exists for the APT facility and for other sites for medical isotope production in the U.S. Richardson designated Savannah River as a backup tritium production site and has encouraged Los Alamos National Laboratory to continue its design work on the accelerator. The DOE's Oak Ridge National Laboratory in Oak Ridge, TN, produces small amounts of medical isotopes, and the DOE is working to bring a nuclear reactor at Sandia National Laboratory in New Mexico online for the production of medical isotopes (SCAN 6/10/98).

In any case, many of the industry experts that gathered at the June meeting in Washington are beginning to lobby the DOE directly for a stable production site, according to Spicer. The DOE has underwritten a grant initiated by MUSC that will support a Washington, DC, meeting March 10 through 13. Participants will discuss both the uses of and the need for medical isotopes in the U.S. The meeting, called Accomplishments with Medical Isotopes: Advanced Health Care for the 21st Century, will be administered by MUSC and may include speakers such as Richardson and Vice President Al Gore, as well as physicians, congressional representatives, and industry experts.

"The key is to get the press and the public interested in the issue so that they will lobby politicians to follow through with an APT-type project-maybe not the same scope, but something a little smaller that still makes new isotopes," Spicer said.