You may never have heard of technetium-99m, but if you’ve had a cardiac stress test lately, odds are you’ve had a dose of the radioactive substance coursing through your veins.
The artificial element is widely used in medical imaging these days, from diagnostic procedures for heart disease to brain scans, bone scans and a variety of other tests. But a looming supply shortage is creating jitters among medical professionals — and a business opportunity for a Corvallis startup company.
Northwest Medical Isotopes hopes to become a leading supplier of technetium using a new technology developed at Oregon State University to produce technetium’s precursor, another radioactive isotope called molybdenum-99.
At present, molybdenum-99 is produced by a handful of large research nuclear reactors around the world, none of them in the United States. Two of those suppliers — including the sole North American producer, an aging Canadian reactor — are slated to cease production in the next two years.
That’s expected to create a major bottleneck in the moly-99 supply, which is already subject to disruption because of the small number of production sources and the isotope’s short half-life, which makes stockpiling impossible.
“There could easily be a day when somebody goes into the emergency room with chest pains and the doctor wants to do a technetium scan but can’t because there is no technetium,” said Northwest Medical Isotopes CEO Nick Fowler.
But researchers at Oregon State say they have come up with a way to produce the stuff in the kinds of small research reactors found on some college campuses, including OSU, creating the potential for a new, distributed production source.
“We’re taking the reactor out of the bottleneck,” said Steve Reese, director of the OSU Radiation Center and one of four researchers with the university listed on the patent application for the new technology. “It allows you to use a much broader number of reactors.”
Fowler said his company has licensed the technology from OSU and is negotiating agreements with several U.S. universities to rent reactor time for molybdenum-99 production.
“We’ll be able to cycle through a network of research reactors so we always have a reliable supply,” he said. “It’s a domestic, a secure and a reliable source of moly.”
While Northwest Medical Isotopes will continue to operate out of headquarters in Corvallis, the company’s main production facility will be elsewhere. Last week the firm announced plans to build a $50 million technetium processing plant in Columbia, Missouri.
Fowler said the central location was important because both molybdenum-99 and technetium-99m break down so quickly, leaving a short time window in which to get the moly from the reactors to the processing plant and get the technetium from there to hospitals around the country.
The company needs approval from the Nuclear Regulatory Commission to build the processing facility, but the review is expected to happen fairly quickly. Concerned about the potential supply crunch, Congress has directed the commission to expedite the application process for companies proposing to produce molybdenum-99.
Fowler said he hopes to break ground next year and begin production by late 2016 at the Missouri plant, which will employ 68 people.
“We’re shooting to be in operation as the nation’s supply becomes compromised,” he said.
At capacity, Fowler said, the plant could supply up to half the U.S. market for molybdenum-99, worth about $74 million a year at current prices.
Northwest Medical Isotopes is not the only firm looking to get in the game. Others are pursuing new production technologies, including established suppliers such as Mallinckrodt Pharmaceuticals, a $2 billion global company with U.S. headquarters in St. Louis.
Fowler won’t say how much capital his company has to work with, but he did identify a number of investors in the venture, including Corvallis-based Samaritan Health Services, Cheever Capital Management of Albany and Dignity Health, a California-based health system with hospitals and other operations in 21 states.
Samaritan President and CEO Larry Mullins said investing in Northwest Medical Isotopes could provide another revenue stream for the mid-valley health care network. But he also said it could help to prevent a recurrence of the technetium shortages that have troubled Samaritan and other health care providers in recent years.
“Maybe there is a possibility for a local solution to an internationally critical problem,” he said.
Molybdenum-99 generally is created by bombarding a target containing uranium-235 with neutrons, then using a chemical process to separate the moly from other isotopes created during this process.
Until now, university reactors have been considered too small for this purpose, both physically and in terms of the amount of radiation they can generate. But the OSU researchers came up with a compatible target design as well as a process for using available neutrons more efficiently, enabling campus reactors to produce moly-99 for the first time.
For Reese and his colleagues, it’s a satisfying achievement.
“This will do good,” Reese said. “To put it bluntly, this will save lives.”