Much of nuclear medicine depends on a steady supply of an isotope called molybdenum-99—“Mo-99” for short. A byproduct of nuclear fission, Mo-99 is used to produce another radioactive substance, technetium-99m, which is employed in more than 16 million nuclear imaging procedures every year in the US alone. These include sentinel node biopsies in cancer surgery, bone scans, and cardiac stress tests, to name a few.

But the supply of Mo-99 and other radioisotopes has been unreliable at best. All of the Mo-99 used in the US is imported, with the main source being the National Research Universal (NRU) reactor at Chalk River, Ontario. A shutdown for repairs in May 2009 contributed to a global radioisotopes shortage. Although the reactor has been back in operation since August 2010, it is scheduled for closure by 2016.

The shortage showcases a critical gap in the supply chain. The United States has no domestic reactor that can make the radioisotopes, so new production strategies are desperately needed. For some procedures, there’s simply no alternative, and without a reliable domestic supply of isotopes, nuclear medicine would halt, severely limiting doctors’ ability to diagnose and treat many diseases.

Already, some clinicians have switched to using a radioactive variant of thallium, which went out of favor about 15 years because Mo-99/technetium-99m has better imaging characteristics. Additionally, physicians are finding it harder to get their hands on iodine-131, another radioisotope that is used to treat thyroid cancer, Graves’ disease, and hyperthyroidism. There are alternatives for many procedures, including CT and PET scanning using radioisotopes not made in nuclear reactors, but these have drawbacks such as increased cost, greater radiation burden, and low image quality.

The directive is clear. Manufacturers must build strategies to bring radioisotope production back to the US. Currently, my company is developing a way to produce Mo-99 and other radioisotopes without needing a nuclear reactor, instead using a device the size of a commercial cyclotron.

We have a moral imperative to produce isotopes on our soil for our people. Doing so would save tens of millions of dollars for the healthcare market, which already spends about $120 billion per year on cancer. The lives we might ultimately save make this a worthy endeavor indeed.

Jim Katzaroff is chairman and CEO Advanced Medical Isotope Corp., a company engaged in the production and distribution of medical isotopes.