Lives lost without nuclear medicine

The utility and benefit to society from modern forms of radiology and nuclear medicine might not be widely recognized but hopefully are generally accepted.   The contribution of this technology to our standard of living includes not only the ability to see broken or fractured bones but also the ability to avoid exploratory or unnecessary surgeries.  Computed tomography (CT) scans can create images of internal organs and body parts as can nuclear medicine.  These can identify disease early on, prior to the need for other more invasive diagnostic means. In addition, nuclear medicine can make images of actual blood flow through the heart, it can identify internal infections and compliment other radiology applications in a number of ways.

Many tens of thousands of hospitals use nuclear medicine with the vast majority of these being for diagnosis.  This is often done by injecting patients with or having them swallow radioactivity in special chemical forms to allow the body to move the material through natural means to locations of interest.  This in turn allows unique and special imaging with the single intake followed by characterization with radiation detectors.  The majority of the procedures use Technitium-99 (Tc⁹⁹) as the isotope of choice due to its availability to be safely shipped, to maintain a reasonable shelf life and have multiple oxidation states that allow many chemical bonding structures.  As a result of this, Tc⁹⁹ is used in tens of millions of clinical procedures each year.

A rather long list of treatments and diagnostic applications with ionizing radiation is very widely used in medicine today to help maintain the highest quality of health care available.  The use does not only apply to diagnosis and assessment but also direct treatment and so not only plays a very important role in improving overall health care but in saving lives as well. 

Another common use of nuclear medicine is the use of radioactive iodine as this element is concentrated in the thyroid so that imaging or treatment of polyps and tumors there can occur.  All of this with medically acceptable radiation exposures to minimize physical insult to patients.

The radio-pharmaceuticals used in nuclear medicine are only produced in nuclear reactors or high powered accelerators.  In either case, special or unique isotopes have to be created to carry out this work.  The nuclear reactors generating the bulk of the Tc⁹⁹ are foreign and are all over 40 years old.  New production facilities are very much in need to eventually fill the supply chain to meet the growing demand for health care here and around the world.

Other less common forms of nuclear medicine include positron emission tomography which involves using radionuclides decaying through emission of antimatter.  Specifically an anti-electron also known as a positron is emitted inside the body which will very quickly will interact with a normal electron and convert them both into a pair of high energy gamma rays.  These gamma rays are very specific and localized allowing much more precise imaging.  These positron emitters are readily produced in high powered particle accelerators where electrons can be accelerated to phenomenally high speeds so that when they hit their designed targets, they can knock protons and neutrons out of the nuclei of the atoms leaving them radioactive.

Still, the vast majority of nuclear medicine requires Tc⁹⁹ which in turn requires nuclear reactors as Technetium is the lowest weight element which is not naturally occurring.  As Technetium is not naturally occurring, neither is the isotope Tc⁹⁹ and so we require the use of nuclear reactors to produce this material.