NEA Director-General William D. Magwood, IV visiting nuclear medicine facilities at Osaka Hospital during the mission to Japan in July 2025
Nuclear medicine stands at the threshold of a new era of advanced therapeutic treatments, applying new technologies that bring us closer to reducing or even eliminating the fear that patients feel when they hear the word “cancer”. The cornerstone of nuclear medicine is medical radioisotopes. Since their discovery, their unique properties have been harnessed to analyse body functions and deliver life-saving insights. These radioisotopes enable the production of early, precise and detailed 2D or 3D internal images, helping physicians plan treatments effectively.
While essential for diagnostics and cancer treatment, their supply chains remain fragile - particularly because different isotopes rely on distinct production methods, and their short half-lives make stockpiling impractical. Maintaining this supply chain has, at times, required direct governmental intervention. Despite these efforts, challenges remain - including the ageing of the reactor infrastructure used to produce technetium-99m (Tc-99m) from molybdenum-99 (Mo-99).
The Nuclear Energy Agency (NEA) has made forecasting the supply and demand of medical radioisotopes one of the points of focus of its activities in this area since 2009, when there were significant shortages of Mo-99 and Tc-99m. The second International Workshop on the Security of Supply of Medical Radioisotopes in October 2024, which gathered over 130 decision-makers in the field, joined by hundreds more participants online, showcased significant leaps forward in cancer treatment using novel medical radioisotopes such as Lutetium-177 (Lu-177) and Actinium-225 (Ac-225).
However, the adoption of novel radioisotopes and ensuring their stable supply will require governments to address ongoing challenges.
The recent NEA publication Current Trends in the Supply and Utilisation of Medical Radioisotopes describes these challenges and outlines a set of recommendations to guarantee long-term sustainable access to established and new radioisotopes for all stakeholders:
- Modernising infrastructure and diversifying production methods;
- Supporting technological innovations in accelerator-driven and cyclotron-based production;
- Addressing infrastructure gaps, the insufficient numbers of trained health care professionals, and inconsistent regulatory frameworks - especially for novel radioisotopes; and
- Expanding training programmes for nuclear medicine professionals and fostering international collaboration on regulatory alignment.
By addressing these challenges and taking these opportunities, governments can harness the potential of nuclear medicine and help millions of cancer patients in their countries and around the world.
