Earlier this month, you may have heard nuclear medicine suffered a setback because a nuclear reactor in Canada that supplies the raw material used in medical procedures was shut down for repairs. Michael Graham, MD, PhD, director of Nuclear Medicine in the Department of Radiology at University of Iowa Hospitals and Clinics, talks about how nuclear medicine works, and why this shutdown affects a lot of hospitals across the country:
What is nuclear medicine?
Nuclear medicine involves injecting low levels of radioactive tracers into patients to test the function of various organ systems, including the heart, liver, kidneys, and brain.
What tests commonly uses radioactive substances?
These kind of agents go where the blood flow goes, in the heart for instance, and shows us the distribution of blood flow in the heart. In the liver, it’s taken out by the liver cells and excreted into the bile until we can see how the biliary system is working. In the kidney, it’s taken out by the kidneys and excreted into the urine and we can see how the urinary system is working. In general, our tests are physiologic tests to see how the different organ system is working—or not working.
How are radioactive substances used in testing?
The various materials are labeled, usually with technetium 99M—the isotope that has been the problem. We image the distribution of the activity using a gamma camera—either images taken over a period of five minutes or so, or a dynamic sequence of images taken over as long as one hour.
On average, how many nuclear testing procedures does a facility like UI Hospitals and Clinics use in a typical day or week?
We typically do 20 to 30 of these studies every day. Throughout the United States, there are hundreds of thousands of these studies done every day. So it’s actually a very important part of the medical care of a large number of patients.
How many facilities are affected by this one nuclear reactor shutdown in Canada?
Virtually all nuclear medicine facilities throughout North America, that’s what’s so astounding about this shutdown, that it has such an enormous impact and was done with little forethought.
Is it common for one site, like this one based in Canada, to provide the entire supply of nuclear medical materials for so many medical facilities?
I wouldn’t like to call it common—it’s certainly not a good idea—but that is the situation that we’re in and this has arisen from a variety of political and economic considerations. We hope that this event will allow us to pressure Congress and the Department of Energy to ensure that we have a reactor or more than one reactor in the United States capable of this kind of production.
How long is the nuclear reactor in Canada expected to be shut down for repairs?
Initially, we were told it was going to be till the end of January some time, or even longer; but just two days ago the Canadian Parliament passed a bill forcing the reactor to restart and it actually restarted this morning. The reason it had been shut down was because of regulatory issues and it wasn’t clear that there was any real safety issue that would prevent it from operating, and indeed it’s now up and running.
What will facilities like UI Hospitals and Clinics do in the interim?
We had to reschedule some patients and we have changed our cardiac imaging from technetium 99M-based agents to thallium-201. The quality of the images is very similar and we’re able to provide almost all of the testing that we did previously. The one thing that we worry about, though, is next week. That’s the sort of last critical week in this whole sequence of events because restarting the reactor means that we will actually get material from that reactor on Dec. 24 and so that week—the week of Christmas—we’re going to be just fine.
If someone has a question or would like to learn more about this event or nuclear medicine in general, is there a Web site address, or phone number they could call?
For nuclear medicine in general, there is an excellent Web site at the Society of Nuclear Medicine. snm.org Locally, if they have any questions about our operation, they should call 319-356-1911. |
