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Accelerator Driven Production of Medical Isotopes
World Market Usage and Industrial Production
Presentation at The Cockcroft Institute 8th and 9th Dec 2011
Dewi M. Lewis CERN, and AIPES
Radioisotope Markets Approx World Market 99Mo 6000 Ci/wk at 6 day Ref >150 M$US Assumes no generators, kits etc 18F as FDG around 2x106/yr ~400 MUS Assumes supply of radiopharmaceutical grade FDG 60Co as Low Spec Ac (LSA) ~120 MUS Assumes selling price of isotope only
Radionuclides for labelling
99mTc 18F 123I
Nuclear Medicine Imaging
SPECT PET
Nuclear Medicine Imaging Procedures
NUCLEAR MEDICINE PROCEDURES
USA 2008 TOTAL 17.3 million
9%
54%
15%
7%
4%
3%
2%
2%
2%
2%
PET All
SPECT cardiac
SPECT bone
SPECT liver
SPECT respiratory
SPECT thyroid
SPECT reanl
SPECT infection
SPECT tumour location
SPECT other
NUCLEAR MEDICINE PROCEDURES
USA 2008
0
5
10
15
20
1
Mill
ions
per
year
Total procedures
Total Tc-99m
TOTAL PET procedures
Total Other radionuclides
Tc-99m PROCEDURES
Tc-99m Cardiolite
Tc-99m MyoView
Tc-99m bone
Tc-99m others
Global markets M$ US
1.E+00
1.E+01
1.E+02
1.E+03
1.E+04
1.E+05
1.E+06
1.E+07
Total h
ealth
care
phar
mac
eutic
als
med
ical diagn
ostic
s an
d de
vice
s
diag
nostic im
aging
nuclea
r med
icine
Rad
ioph
arm
aceu
ticals
Tc-99
m b
ased
age
nts
Mo-
99 G
ener
ator
s
Mo-
99 cos
tsB
$ U
S
22% 1% 0.1% 0.004%
NUCLEAR MEDICINE PROCEDURES
USA 2008 TOTAL 17.3 million
9%
54%
15%
7%
4%
3%
2%
2%
2%
2%
PET All
SPECT cardiac
SPECT bone
SPECT liver
SPECT respiratory
SPECT thyroid
SPECT reanl
SPECT infection
SPECT tumour location
SPECT other
Market Models 2009 USA Imaging Procedures World Consumption of 99mTc
PET
Other nuclides
Tc-99m
Cardiology
Tc-99m Bone
Tc-99m Other
procedures
Structure of the 99Mo Industry
Research Reactor
Operators
Suppliers of Radiopharmaceutical
grade 99Mo
Manufacturers of 99mTc/99Mo Generators
Supplier Dynamics of 99Mo Industry
Australia OPAL ANSTO
STRUCTURAL INDUSTRY ISSUES FOR 99Mo
1. HEU to LEU conversion requirement
2. Cost recovery problem for irradiations
3. General re-imbursement
4. Additional European reactor capacity – EU
5. Incentives to invest in R&D
Future Trends for SPECT imaging
1. Large infrastructure of SPECT cameras
2. Forecast increasing demand
3. Increasing use of SPECT/CT cameras
4. Emergence of new detectors with CZT
NUCLEAR MEDECINE CAMERAS IN EUROPE
2009
Courtesy of EANM survey
0
1000
2000
3000
4000
SPECT SPECT/CT PET PET/CT
Scanner Placements in Europe market estimates
Courtesy of the Petten future Project Group, Holland
Applications of Accelerators
Accelerators for medical isotope production
Energy (MeV)
Industry Vendors Cyclotrons for SPECT radioisotope production
FDG Procedure Volume
0
150
300
450
600
2002 2003 2004 2005 2006 2007 2008
Total Examinations
25+% per year
0
125
250
375
500
2002 2003 2004 2005 2006 2007 2008
PET PET/CT
15+% per year
PET Scanners Installed
0
300
600
900
1200
1500
2002 2003 2004 2005 2006 2007 2008
Avg procedures per scanner
European PET Imaging Industry
0
40
80
120
160
2002 2003 2004 2005 2006 2007 2008
COMPANY INSTITUTION
PET Cyclotrons Installed
9+% per year
PET Cyclotron Installed Base
• Historically, commercial supply were taken from existing cyclotrons in partnership with a host institution
• Number of PET commercial suppliers have relocated away from hospitals or universities to focus on production
Europe Cyclotron coverage
= 2 hour drive times Academic
Commercial
63
74
Academic Commercial
European PET Cyclotron Market 2009
WORLD CYCLOTRONS IN 2009
0
50
100
150
200
250
300
GE Siemens IBA ACSI
Data supplied by Dave Schlyer, Brookhaven
PET Cyclotron Technology
TargetsAndBeamLineStart.JPGTargetsAndBeamLineStart.JPG
Cyclotron Targets
Manufacturing of PET agents Automated PET synthesis - FastLAb - GMP
•Reproducibilty & robustness,
•Ease of use & safety,
•Flexible & multi tracers
•GMP compliant processes
RadioPharmaceutical Industry SPECT Isotope Production
Company No of Cyclotrons
Europe USA Japan Total
Amersham 5 5 4 14
Tyco/Mallinckrodt 2 3 5
Dupont 6 6
MDS/Nordion 1 2 3
Schering/CIS 2 2
Daiichii 2 2
Theragenics 14 14
Total 46
COMPANY NO OF
CYCLOTRONS
Europe North America Japan Total World
General Electric 3 4 4 11
Covidien 2 3 5
Lantheus 5 5
BEST 1 1
Nordion 2 2
IBA 2 2
FujiFilm 2 2
Theragenics 10 10
TOTALS 8 24 6 38
CYCLOTRON PRODUCTION
TYPICAL INDUSTRIAL CYCLOTRON LAYOUT
KIPROS 120 - 123I Production system Side View (left and right)
Courtesy of Hermann Schweikert, Zyklotron AG
Radiochemistry, Hot cells, Finishing ops, GMP
DISTRIBUTION Canadian national strategy for 99mTc
Stable Isotope Enrichment Some Issues
1. 235U enrichment - the HEU problem
2. 18O enrichment - increasing use for 18F
3. 100Mo production - quantities/quality for 99mTc
4. Metal elements - 201Tl, 68Zn, 112Cd etc
CURRENT METHODS OF ISOTOPE ENRICHMENT Gaseous Diffusion Electromagnetic Separation
Centrifuge Methods Laser separation
General Conclusions
Mature industry Advantages for cross disciplinary scientific approaches Longitudinal integration of technology needed Opportunities remain - accelerator lab collaborations Probable requirement for constructing demonstrators No strategic involvement by UK government Increased funding now available by the EU Scope remains for scientific innovation
Industry Trends
1. Development of PET imaging with 18F
2. Global crisis of 99Mo Production for SPECT imaging a) Potential use of cyclotrons for 99mTc b) alternative accelerator-driven methods
3. Increasing use of 123I for SPECT imaging
4. Development of very small cyclotrons
THANK YOU
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