The Reliable Supply of Mo-99 - A Decaying Ideal? (World Council on Isotopes, Don Robertson)

1. R e l i a b l e S u p p l y o f M o - 9 9 – A Decaying Ideal?

2015 March

Reported by Don Robertson Consultant of NTP Radioisotopes SOC Ltd, International Coordinator of WCI

01 Reliable Supply of Mo99 – A Decaying Ideal?

02 A View on the Fourth Anniversary of Fukushima Nuclear Accident 5p 03 Sketches from WCI Secretariat 8p 04 Introduction to New Organization Members 10p 05 Future Conferences 12p 06

Isotope Related News 19p

THE 2009 SUPPLY CRISIS

R D H S T

eliability of supply of Mo-99 and Tc-99m declined significantly since 2009, with supply shortages resulting in disruptions in the

availability of critical SPECT diagnostic services. This major impact on Nuclear Medicine led the OECD’s Nuclear Energy Agency (NEA), at the request of its member countries, to establish the High Level Group on Security of Supply of Medical Radioisotopes (HLG-MR). The Group was entrusted with (i) examining the underlying reasons for the global Mo99 supply shortages and (ii) developing a strategy to ensure long term security of supply.

A critically important finding of the Group was that the existing supply

chain pricing structure did not cover the actual costs of the reactors and processors. More importantly, it did not encourage the investment required to renew aging infrastructure. It was clear that changes were required in the market structure and that the economics of the supply chain would have to be reset according to sound financial and economic principles, specifically excluding inherent Government subsidisations.

As a result, one of the key principles put forward by the HLG-MR states that “All Tc-99m supply chain participants should implement full cost recovery, including costs related to capital replacement”.

2 CREATION OF THE PROBLEM

H S T

istorically, reactors that were used for Mo-99 target irradiation had been built with 100% government funding; the underlying reason was they were mainly used for materials testing and

research applications. The advent of isotope production programs, particularly that of Mo-99, provided reactors with a “by-product” in the form of target irradiations. Additional revenue generated by this by-product would, in turn, support research activities which remained the main focus and purpose of the reactor. Typically, irradiation of targets were priced at a level allowing reactor operators to only recover some direct marginal costs associated with the activity. As a consequence, initial Mo-99 market prices made no provision for recouping operational and maintenance costs of the reactor, let alone capital and refurbishment costs.

Furthermore, Mo-99 processing facilities were in most instances also funded by governments. Hence, in addition to not covering the above-mentioned costs, Mo-99 market prices did not even cover adequately isotope extraction costs.

This largely subsidised price for Mo-99 set the basis for Mo-99/Tc-99m generators to be priced at unrealistically low levels. The generator manufacturers, typically commercial radiopharmaceutical companies, would accept lower margins on the sale of generators as they would focus on the marketing and sale of their high margin cold kits.

The overall result was that Tc-99m became a trivially-priced low-value commodity. Illustrating the low value is the fact that, to this day, it is generally not itemized in diagnostic procedures and is reimbursed as part of the total procedure cost.

THE SPECT INDUSTRY

O H S T

ver the years SPECT diagnostic imaging has grown to a level where some 100 000 Tc-99m based scans are performed per day with an installed global infrastructure of some 22 000 SPECT

cameras. Tc-99m is, by some considerable margin, the most widely used isotope in nuclear medicine diagnostic imaging due its low price, its convenient availability (in the form of generators or unit doses), and its useful decay properties. Some reports go so far as to state that Tc-99m is the “the cheapest medical isotope available”. This is, of course, the crux of the problem that the industry now has to deal with.

This industry and the general well-being of patients are dependent on the reliable supply of the

isotope Tc-99m. Unfortunately, however, the entrenched price point of this isotope is, for the historical reasons outlined above, pitched at a level too low to allow for a viable, commercially-based upstream supply chain.

Soon after its inception, the HLG-MR identified and publicised that the unreliable supply of Mo-99 and Tc-99m could be directly attributed to the inappropriate economic structure of the supply chain. It was emphasised that, unless this was urgently addressed, supply disruptions would continue, jeopardising the future of SPECT diagnostic imaging.

3 Unfortunately, despite this warning, little progress has been made in the rectification of the situation.

To this day, the SPECT industry remains extremely vulnerable despite its substantial market value ($13 billion) and its significant contribution to the general well-being of the global population.

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SUPPLY AND DEMAND

D R D H S T T R D H S T

uring periods of stability of Mo-99 supply, there is a generator production overcapacity. All major generator manufacturers deliver generators of appropriate quality and are able to satisfy the

just-in-time requirements of the customer base. As a result, generator manufacturers are generally obliged to compete on price; simultaneously, the tender procurement system increasingly used by the public sector also tends to decrease the market price of the generator and thereby, the unit dose price of Tc-99m.

The downward pressure on the price of Tc-99m, as described above, prevents the successful

implementation of full cost recovery that is required to restore sound economic principles in the supply chain and, ultimately, security of supply.

Such market realities seem to indicate that the downstream consumers and users of Tc-99m might

not fully appreciate the vulnerability of the supply chain and the associated risk to their own industry.

PRICE IMPACT here appears to be uneasiness in the market regarding the potential impact of full cost recovery on the cost of the downstream diagnostic procedure. With a view to quantifying the impact, the

value addition for each of the stages of the value chain has been examined by the HLG-MR. For this exercise the value chain has been divided into four key stages namely, Mo-99, Tc-99m unit dose, labelled Tc-99m unit dose and the diagnostic procedure. Data derived from various sources provided an estimate of the percentage value addition for each of these stages; this value structure is summarised in Figure 1 hereunder.

2% Mo-99

3% Tc-99m Unit Dose

15 % Labelled Tc-99m Unit Dose

80 % Diagnostic Procedure

Figure 1: Mo-99 Value Chain On the basis of the above structure, a sensitivity analysis of the cost of the final procedure to the

price of Mo-99 would demonstrate that if the price of Mo-99 were to double, the final cost of the diagnostic procedure would increase by 2%.

4 CONCLUSION

T R D H S T

he sustainability of the SPECT industry requires that all participants in the Mo-99/Tc-99m supply chain, including the downstream customers, understand the reasons for full cost recovery and

support the initiative to achieve this. Unfortunately the tendency remains to exert downward pressure on the price of Tc-99m, which, as demonstrated above, is a major impediment to the successful realisation of full cost recovery.

One should further note that this comes at a time when there is a strong focus on reducing the

overall cost of healthcare service provision. It is generally accepted that nuclear medicine diagnostics, albeit a relatively small component of the healthcare system, have an important role to play in ensuring the well-being of the global population. This is well articulated in the Joint Declaration on the Security of Supply of Medical Isotopes (WCI Newsletter February 2015) in which Ministers and Representatives of 13 Countries declared their common interest “In ensuring the security of supply of the most widely used medical radioisotope, Molybdenum-99, and its decay product, Technetium-99m, which is used in approximately 40 million medical diagnostic imaging procedures per year worldwide enabling precise and accurate, early detection and management of diseases such as heart conditions and cancer, in a non-invasive manner�.

Because of historical events described above, the costs associated with producing isotopes in general and Mo-99/Tc-99m in particular, have been trivialized. This perception remains entrenched in the industry and the myth of cheap isotopes must be dispelled once and for all: it is time that all participants understand and accept the true value of medical isotopes which, in any event, will not have a significant impact on the overall cost of the procedure.

In 2013 the Centre for Medicare and Medicaid Services (CMS) in the USA announced an additional reimbursement of $10 per unit dose of LEU based Tc-99m. In making this additional reimbursement available CMS stated that they wished to address two issues, namely full cost recovery and the cost of conversion of production from HEU to LEU, these being two critically important cost drivers experienced by reactor operators and Mo-99 processors. This $10 per dose additional reimbursement, as proposed by CMS, should indeed cover the implementation of full cost recovery at reactor and Mo99 processor level and would in turn have a minimal impact on the cost of a diagnostic procedure. It is time for the industry to make a paradigm shift and accept the need to pay an appropriate price for the isotope which supports this multi-billion dollar SPECT industry.

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2. A view on the fourth anniversary of Fukushima nuclear accident

Reported by Toshikazu Hosoda CEO of Chiyoda Technol Corporation

T

he groundwater that flows from the Abukuma mountains, which run north to south in the

Fukushima prefecture, to the Fukushima Daiichi Nuclear Power Station (FDNPS) reaches 400 tons

per day.

Though the volume of the water decreased to 300 tons a day as a result of the construction of a groundwater by-pass in 2014, dealing with the contaminated water originating from this groundwater has becomes a great challenge to the Tokyo Electric Power Company (TEPCO).

It is understood that all nuclear fuels of Unit 1 and part of the nuclear fuels of Units 2 and 3 were melted down and dropped to the bottom of the Reactor Pressure Vessel (RPV) and the pedestal of the Primary Containment Vessel (PCV). These are cooled by the circulation cooling system from the outside, and the water temperature is kept at 40-50℃. As the air dose rate near the pedestal is between 30 to 80 Sv/h, no one can access the area. Groundwater under the reactor and turbine buildings mixes with this circulating cooling water. As a result, approximately 670 tons of contaminated water must be processed daily. The purification equipment set up in the circulation cooling system is composed of (i) oil removing equipment for oils leaked from the damaged hydraulic system, (ii) cesium adsorption equipment and (iii) desalination equipment using reverse osmosis.

Contaminated water processed by this purification system is kept in dedicated storage tanks; the number of those tanks already exceeds 1000 units, storing almost 620,000 tons. The ALPS (Advanced Liquid Processing System), also known as Multi-nuclide Removal System, is used to remove 62 nuclides including 90Sr-90Y from this contaminated water. Completion of purification of the contaminated water is expected to take another year.

As no suitable technology for tritium removal from this water is available, there is a scientific rationale to dilute the tritium by discharging the water to the sea. However, the local fishing cooperative has expressed concerns about possible harmful effects, meaning that no decision has yet been taken on the processing method.

The main initial countermeasures to reduce the amount of contaminated water is to control the groundwater inflow. Plans include the construction of the “frozen ground wall” 1.5km around the nuclear reactor facilities. This wall would involve the positioning of 1709 cooling pipes 30m underground as a prevention measure. Before the accident there were 57 large pumps to extract water from a deep well in order to lower the groundwater level around the reactor facilities. However,

6 such operations became impossible because of the loss of the power supply after the tsunami, which in turn caused the inflow of groundwater. The second possible countermeasure to the contaminated water is release into the ocean, as mentioned above, after initial purification. In this regard a wall of steel pipes in the bay is already 99% complete and a system is under construction to prevent marine pollution by contaminated water.

As far as radiation doses at FDNPS are concerned, the current dose rate at the supervised area boundary is 1 to 4 μSv/h, but in some areas on the site, the dose rate is still high. For example, 1m from the surface of the Unit 2 reactor building it reaches 500 μSv/h, and at the surrounding of the contaminated water storage tank it shows around 50 μSv/h by the effect of bremsstrahlung as a result of the beta-rays originating from

90

Sr-90Y in the tank.

The number of radiation workers registered in January 2015 was 10,651. The maximum external exposure was 12.2 mSv and the average was 0.5mSv. All radiation workers were below the detection limit for internal exposure in the same month. The accumulated dose in 40,394 (99.6%) of 40,569 workers engaged in the radiation work at the FDNPS between 11 March 2011 and 31 December 2014 was below 100mSv and 38,349 (94.5%) workers were below 50mSv. The dose limit of 250mSv was exceeded only for 6 workers in the early stage of the accident. All of them were working in the central control room, and the maximum recorded exposure was 679 mSv. On the other hand, for the 6 Self-Defense Force personnel who had been in the way of the blast of the hydrogen explosion in front of Unit 3, external exposure was moderated to 20 mSv by appropriate radiation emergency medicine and the maximum internal exposure was suppressed to 4.2 mSv by the administration of stable iodine, 90 minutes before the blast and wearing an overall mask with the charcoal filter (photo 1).

7131I discharged into the environment due to the Fukushima accident is 1/10 of that from the Chernobyl accident and

137

Cs is 1/5 of the Chernobyl release,

according to a report by UNSCEAR in 2013. The citizens’ health investigation performed by the Fukushima prefecture with the National Institute of Radiological Sciences determined that, in terms of external exposure, among 421 394 inhabitants during the first four months after the accident: - (i) 99.8% of the population was below 5 mSv, Photo1: Battle suits of the commander rolled in the hydrogen explosion

- (ii) the maximum was 25 mSv - (iii) the average was 0.8 mSv. By wearing personal dosimeters some inhabitants could measure their external exposure directly; the recorded maximum was 1.7 mSv in 2011 and 1.4 mSv

in 2012. 15,000 people for whom acute intake was assumed were measured by whole-body count between June 2011 and January 2012; it was evaluated that 99.8% of their internal exposure was below 1 mSv. As for 212,000 people to whom chronic intake was assumed from February 2012 to October 2014, it was determined that the internal exposure was below 1 mSv for 99.9% and the maximum was 1 mSv.

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Thyroid dose equivalent caused by

131

I was 30 mGy in the 90th percentile dose for one-year old

infants by the evaluation of National Institute of Radiological Sciences and the estimated maximum dose in the UNSCEAR report was 83 mGy. Whilst an increase in infant thyroid cancer had been reported after the Chernobyl accident, thyroid examination of 296,026 children between the ages of 0 and 18 was performed by Fukushima Prefecture in June 2014. The result was a definite cancer diagnosis in 57 people, but carcinogenesis is not deemed to be caused by the accident, considering the incubation period of thyroid cancer, the internal dose, the fact that thyroid cancer was not recorded in infants and because there is no noticeable difference with the trend in other prefectures unaffected by the radioactive plume.

No radiation damage as a result of the Fukushima Daiichi accident has been reported. However, the socio-psychological effects of nuclear accidents are extensive. The number of evacuees stands at 130,000 people, and many relocated inhabitants suffer from stress, depression and physical symptoms that are not explainable on medical grounds (photo 2).

The number of “deaths related to the earthquake” totaled 1704 victims by March 2014, solely in the Fukushima prefecture; this “relation to the earthquake” is resulting from health disorders associated with refugees.

The accident also had a major impact on the economic situation, as demonstrated by Japan’s first trade deficit in fiscal year 2011, after 31

Photo 2: The cherry blossom in front of abandoned Fukushima field command post（March 2011）

years of trade surpluses.

All nuclear power plants are still not in operation, and the increase of fossil fuel imports over the last in three years reaches 10 trillion yen (83.85 billion USD). As a result, nuclear fuel producing companies are facing imminent dangers and the future of nuclear power generating companies is bleak.

All electric power companies are experiencing hardship, resulting in the reduction of wages to a level around 60~70% of that prior to the accident.

At the fourth anniversary of the accident, the Fukushima accident has not yet been settled despite the fact that reactors are kept in cold shutdown and that the environmental discharge of radioactivity is controlled. The toughest challenges might consist of recovering the collapsed regional economy, and finding alternative solutions to waiting for the decay of

137

Cs in contaminated land. Although

decontamination and decommissioning work, using the huge capital and talent available, will allow for some reconstruction, true restoration will only be realized when residents feel a sense of well-being.

An important number of disasters has affected Japan over its long history. The experience to overcome these difficulties has built the Japanese culture and, each time, a sense of restoration was achieved in a gradual manner: People try to accept the situation and stand up, leading by example among the scared, angry, and disappointed. In our own way, we would like to contribute by supporting such people on a long-term basis.

※ This article is co-authored by Toshikazu Suzuki, the scientific advisor of Chiyoda Technol Corp.

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3. Sketches from the WCI Secretariat

VISIT TO MONGOLIA

M D H S T

r. Nam Ho, International Coordinator of WCI, visited Mongolia on 9~10 March 2015 to discuss

the preliminary program for the upcoming “Conference on Nuclear Energy and Radiation Safety”

with Dr. Tseren Davaadorj (Director of Information and Analysis Service, National Security Council of Mongolia) and Mrs. Nyamsuren Sandag-Ochir (CEO of Radiation Safety and Nuclear Association RS&NTA). This conference which will be held in Ulaanbatar, Mongolia from 6-9 July 2015, is jointly organized by RS&NTA and the Korean Nuclear Society (KNS).

Mr. Nam Ho took advantage of his stay in Ulaanbaatar to deliver the “Certificate of Membership” to

the President of RS&NTA, Dr. Namsraigar ALTANGEREL. The same “Certificate of Membership” could not be delivered to the Nuclear Energy Agency of the

Mongolian Government as this body is no longer effective since 15 Feb 2015; it has been divided into three organizations: (i) Mining, (ii) General Agency for Specialized Inspections (Nuclear Regulatory Body) and (iii) Nuclear Energy Commission (NEC). This latter body will maintain the WCI membership and Mr. Nam Ho met with the contact point for NEC, Mr. Chadraabal Mavag, who will deliver the Certificate to the Secretary-General of NEC who is yet to be appointed.

Finally, Mrs. Nyamsuren Sandag-Ochir (CEO of RS&NTA) presented to Mr Nam Ho Professor Suren Davaa (Director of the Nuclear Research Center of National University of Mongolia) and Dr. Orlohk Dorjkhaidar (Director of Institute of Physics). They introduced their facilities and research program which were very impressive.

From the Left <Prof. Namsraijav ALTANGEREL, President of RS&NTA>, <Mr. Nam Ho, WCI>

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From the Left <Prof. Namsraijav ALTANGEREL, President of RS&NTA>, <Mr. Nam Ho, WCI>, <Mr. ORLOKH Dorjkhaidav, Director of IPTMAS>, <Mrs. Nyamsuren Sandag-Ochir, CEO of RS&NTA>

9 MEMBERSHIP PROMOTION

D H S T

r. Tatsuo Ido, Chairman of IE&CC of WCI informed the Secretariat that five Cuban institutes are interested to join the WCI membership.

The five Institutes are: Agency for Nuclear Energy and Applied Technologies (http://www.aenta.cu/) Centre for Applied Technologies and Nuclear Development (http://www.ceaden.cu) Centre for Radiation Proection (http://www.cphr.edu.cu/index.htm) Cuba National Centre for Nuclear Safety (http://www.medioambiente.cu/oregulatoria/cnsn/index.htm) Isotope Centre. (http://www.centis.edu.cu/)

WCI Secretariat provided them with the information on WCI membership application process.

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Communication with 9ICI

D H S T

r. Ilham Y. Al-Qaradawi reported to WCI Secretariat on the following items related to 9ICI :

The 9ICI Banner will be placed on the WCI webpage in April.

An exhibition hall will be chosen and reserved.

The Local Organizing Committee and WCI Organizing Committee will be established by May Activities celebrating the 150th Anniversary of Marie Curieâ&#x20AC;&#x2122;s birthday will take place during 9ICI.

New Staff Announcement

W D H S T

CI Secretariat is delighted to announce the appointment, as

of March 16, of Ms. Amy Lee who joined WCI from the

Department of Nuclear Medicine of the Seoul National University Hospital where she served as the International Coordinator.

Ms. Amy Lee was born in Korea and moved to New Zealand at the age of 14 and graduated from Auckland University of Technology in New Zealand.

She is responsible for providing administrative and general services

Ms. Amy Lee and Mr. Nam Ho

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geared to meet the needs of the WCI Secretariat.

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4. Introduction to New Organization Members National Atomic Energy Commission

http://www.cnea.gov.ar/

T

he Argentine National Atomic Energy Commission (in Spanish: Comisi贸n Nacional de Energ铆a

At贸 mica, CNEA) is a governmental agency created on May 1950, devoted to research anddevelopment of peaceful uses of nuclear energy.

CNEA activities are spread in three Atomic Centers: Bariloche Atomic Center (in San Carlos de Bariloche city, Province of Rio Negro), Constituyentes Atomic Center (San Martin district, Province of Buenos Aires), and Ezeiza Atomic Center (Ezeiza district, Province of Buenos Aires). Several facilities associated with the nuclear fuel cycle, such as research and testing reactors, are located in these atomic centers.

In Bariloche Atomic Center is located the Balseiro Institute, created in association between CNEA and the National University of Cuyo. Since its creation in 1955, this institute has trained a couple of hundred physicists and nuclear engineers and produced hundreds of peer-reviewed scientific papers, as well as other important contributions to applied and basic science.

At the Constituyentes Atomic Center, CNEA constructed the first research reactor in Argentina, also in Latin America. This Atomic Center is devoted to research and development activities regarding metallurgy, physics and chemistry. It is also equipped with an Accelerator, the TANDAR Accelerator, a large tandem Van de Graaff type facility dedicated to nuclear physics, condensed matter physics and medical research. Additionally, CNEA runs an academic unit, the Sabato Institute, created in association with the National University of San Martin, that grants Masters and PhDs in Materials Science.

The Ezeiza Atomic Center produces radioisotopes for nuclear medicine in its RA-3 research/ production nuclear reactor. This Atomic Center is mainly devoted to applications of nuclear technology covering a wide range of activities such as agricultural applications, food irradiation, nuclear analytical techniques, radiopharmacy, nuclear fuels and waste management. Additionally, the RA-10 -the brand new argentine research reactor under construction- will be located in this atomic center along with the new facilities for nuclear fuels and fission radioisotopes production. Regarding its academic unit, the Dan Beninson Institute -created in 2006 between an association among CNEA and the National University of San Martin- offers education and training activities, careers and courses in the field of applications of nuclear technology.

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NTP Radioisotopes SOC Ltd

http://www.ntp.co.za/ A GLOBAL NUCLEAR TECHNOLOGY INNOVATION LEADER

N T

TP Radioisotopes SOC Ltd (NTP) of South Africa - a subsidiary of Necsa, the South African Nuclear Energy Corporation - occupies a pre-eminent position on the global radiochemical and complementary isotope production and marketing stage.

NTP Radioisotopes, is - and has for some considerable time been - amongst the world’s largest and most reliable producers of high quality critical medical isotopes, Mo-99 and I-131. These products are supplied to a large number of international and domestic users.

NTP’s Mo-99, used in the production of Tc-99m generators, is estimated to account for 8 to 10 million of the 40 million Tc-99m based medical diagnostic imaging scans performed annually throughout the world.

In the field of modern medical isotope production, NTP has invested in the establishment of a Lu-177 n.c.a. cGMP-ready facility at its Pelindaba site near Pretoria from which this isotope will be routinely distributed to both South African and international oncology treatment centres. NTP aims to assist in providing opportunities for the expanded use of Lu-177 to include treatment of a range of indications besides neuroendocrine tumours.

NTP makes use of irradiation services provided by this 20 MW SAFARI-1 research reactor, which celebrated its 50th birthday on 18 March 2015, on a full cost recovery basis and in compliance with OECD-NEA policy guidelines.

SAFARI-1 has an impeccable, world-class safety and operational performance record and is located adjacent to NTP’s radiochemical and radiopharmaceutical processing plants. By 2010 it had been fully converted to the use of proliferation-resistant LEU for both fuel and targets. As such, NTP was able to be the first supplier of commercial-scale fully LEU-based Mo-99 to a major Tc-99m generator manufacturer in the USA in 2010. Together with co-supplier ANSTO (Australian Nuclear Science and Technology Organisation), it continues to do so at ever-increasing volumes.

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5. Future Conferences Position Emission Tomography (PET) Technology & Application  Date: April 20-22 2015  Venue: London, UK  Website: https://www.kcl.ac.uk/prospectus/shortcourses/index/name/pet2015/keyword/medicine This three-day course is delivered by leading international experts from a range of academic, research and industrial institutions in the UK, Europe and North America. It is designed for researchers in the radiopharmaceutical and drug development industries, academic researchers, and scientists already working in commercial, clinical or academic PET centers.

The principal objectives of this program are to review the basic principles of PET imaging and to convey an understanding of the modern application of PET technology.

German Society of Nuclear Medicine Annual Congress 2015 (DGN 2015)  Date: April 22-25, 2015  Venue: Hannover, Germany  Website: http://www.nuklearmedizin2015.de/ The German Society of Nuclear Medicine will be hosting its 2015 Annual Congress at the Hannover Conference Centre. The congress theme will be “Moderne Bildgebung fü r moderne Therapien” (“Modern imaging for modern therapies”). The language of the congress is German.

British Nuclear Medicine Society Spring Meeting 2015 (BNMS 2015)  Date: April 26-29, 2015  Venue: Brighton, UK  Website: http://www.bnms.org.uk/all-events/viewevent.html?eventid=486 The British Nuclear Medicine Society will be hosting their Annual Spring Meeting on the 26-29th April 2015.

Meeting Theme is “Fusion of Emerging Technologies: Molecular Imaging & Therapy”. Bootcamp Focus “Conventional Nuclear Medicine & PET/CT: Best Practice & How the Experts do it”

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15ICNC12 – Nuclear Cardiology and Cardiac CT  Date: May 3-5, 2015  Venue: Madrid, Spain  Website: http://www.escardio.org/congresses/icnc12/Pages/welcome.aspx

T N T

he ICNC meeting has been a key international scientific event for nuclear cardiology and cardiac CT imaging for more than 20 years. It provides the opportunity for clinicians and scientists from all over

the world to gather to learn about new advances and to exchange scientific ideas and experiences in a distinctive environment. The upcoming meeting provides an exciting and diversified scientific program which offers a full spectrum of opportunities ranging from continuing education to cutting-edge presentations of new and original scientific research.

10th International Conference on Radiopharmaceutical Therapy 2015 (ICRT 2015)  Date: May 4-8, 2015  Venue: Innsbruck, Tyrol, Austria  Website: https://warmth.org/icrt The ICRT meeting at Innsbruck is to be a highlight for the theranostic soul of nuclear medicine. There will be plenary lectures devoted to nuclear medicine therapy as well as therapy-related diagnosis and follow-up.

The distinguished speakers will address the state of the art and new developments.

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15th International Congress of Radiation Research (ICRR 2015) • Date: May 25-29, 2015 • Venue: Kyoto, Japan • Website: http://www.congre.co.jp/icrr2015/

T N T

he theme of ICRR2015 is “Radiation Science Shaping the Future of the Earth and Mankind”. The programs will focus on nine key fields of radiation science: radiation biology, therapeutic

radiation biology, life science, non-ionizing radiation, radiation protection science, radiation chemistry, radiation oncology, radiation medicine, and multidisciplinary fields. A number of joint symposia will be held in cooperation with other organizations. As shown by the list of invited speakers now available on the congress webpage, this congress provides a rare opportunity to meet many famous researchers in your field of speciality. Note that the nine fields are closely linked with each other, for example, a renowned researcher in life science will talk at the therapeutic radiation biology symposium. Therefore, you are encouraged to not only identify programs of direct relevance to your field, but also to look at other fields, which may yield an unexpected fusion of distinct research fields.

While ICRR2015 will naturally feature the highest levels of expertise and the latest technology in these fields of radiation science, the overriding objective is to shape the future of the Earth and mankind. It is also important to consider how our daily research can contribute to the development of human society and protection of the global environment. At the beginning of the congress, Dr. Shinya Yamanaka, a Nobel Laureate for his work with iPS cells, and Dr. Akito Arima, a physicist and one-time Minister of Education, Science and Culture of Japan, will give plenary lectures. Other programs include a variety of award lectures, a gala dinner where you can deepen friendships with other participants while enjoying Japanese cultural performances, and a program for international exchange for young researchers beyond the boundaries of research areas. An attractive point of this congress is that the diverse programs will help increase attendees’ research insights and will examine the future of the Earth and mankind. In this contemporary society where great specialization is the norm, there are few opportunities to meet with people from around the world to discuss our life on this planet. No multidisciplinary congress like ICRR is held in other academic fields. This congress, which is held only once every four years, is unlikely to be held again in Japan in the near future. We look forward to welcoming you to this unique opportunity to broaden horizons, deepen understanding, and discuss the future of the Earth and human society.

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21st International Symposium on Radiopharmaceutical Sciences (ISRS2015)  Date: May 26-31, 2015  Venue: Columbia, MO, USA  Website: http://isrs2015.org/

T N T

he 21st International Symposium on Radiopharmaceutical Sciences will be held on the University of Missouri Campus in Columbia, Missouri, USA from 26-31 May 2015.

Swiss Society of Radiology and the Swiss Society of Nuclear Medicine 2015 (SGR 2015)  Date: June 4-6, 2015  Venue: Basel, Swiss  Website: http://www.radiologiekongress.ch/cms/website.php?id=/2674/2673/de/welcome.htm

T N T

he Scientific Committee of all the involved societies and associations offers a program with plenary

sessions, workshops and dedicated scientific sessions. The opening session organized jointly by the three societies will be dedicated to the topic of incidental findings. The other two plenary sessions will

cover imaging aspects of the thyroid gland and the acute abdomen. The post-training course will be focused on musculoskeletal radiology.

Society for Nuclear Medicine and Molecular Imaging Annual Meeting 2015 (SNMMI 2015)  Date: June 6-10, 2015  Venue: Baltimore, Maryland, USA  Website: http://www.snmmi.org/am2015

T N T

he SNMMI 2015 Annual Meeting – the premier educational, scientific, research, and networking event

in nuclear medicine and molecular imaging – provides physicians, technologists, pharmacists,

laboratory professionals, and scientists with an in-depth view of the latest technologies and research in the field.

Attendees choose from more than 150 expert-led scientific and CE sessions – including up to 20 SAM

sessions – explore the scientific poster hall, educational exhibits, and one of the profession’s top exhibit halls. Also it provides an entertaining agenda of social events that provide opportunities to network with colleagues.

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The 12th International symposium on the Synthesis and applications of Isotopically labelled compounds

• Date: June 7-11, 2015 • Venue: Princeton, New Jersey, USA • Website http://www.cvent.com/events/12th-international-symposium-on-the-synthesis-andapplications-and-isotopically-labelled-compounds/event-summary20f3639385e34233bf5da2d4e6537927.aspx

T

he 12th International symposium on the Synthesis and applications of Isotopically labelled compounds will take place at Princeton University on June 7th-11th 2015. The symposium will attract scientists in many fields related to isotopes and isotopically labelled compounds. The scientific highlight of the conference will be 9 plenary lectures given by a number of renowned scientists in variety of field who are listed below:

< Plenary Speakers > •

Prof. Mohammad Movassahi (MIT)

•

Prof. Tobias Ritter (Harvard)

•

Prof. Véronique Gouverneur (University of Oxford, UK)

•

Prof. Ji-Quan Yu (Scripps Research Institute)

•

Prof. Abigail Doyle (Princeton University)

•

Prof. Mathew Thakur (Thomas Jefferson University)

•

Prof. Jeffrey Bode (ETH Zurich)

•

Dr. Jack Hoppin (inviCRO)

•

Prof. Angela Creager (Princeton University)

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There will be 11 themed scientific sessions and a poster session. The titles and session chairmen are listed below:

121 Scientific Sessions •

Session 01: Synthesis of Compounds Labelled with Long-Lived Isotopes Jens Atzrodt Ph.D. (Sanofi, Germany) Monday session Matt Donahue Ph.D.(USA) Monday session Richard Burrell Ph.D. (BMS, USA) Thursday session Thomas Moenius Ph.D. (Novartis, Switzerland) Thursday session

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Session 02 Handling of Isotopes: Safety, Political and Social Dimensions Bradly Keck, Ph.D. (Keck Consulting)

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Session 03 Preclinical and Clinical ADME studies supported by labelled compounds Joel Krauser Ph.D. (Novartis, Switzerland) Brad Maxwell Ph.D. (BMS, USA)

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Session 04 Whole Body Autoradiography (WBA)-New methods, applications and trends Eric Solon Ph.D. (QPS, USA) Alain Schweitzer Ph.D. (Switzerland)

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Session 05 New insights into metabolite identification applications and underlying strategies Mihaela Plesescu (Millenium, USA) Rhys Salter, Ph.D. (J&J, USA)

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Session 06 Accelerator Mass Spectrometry (AMS) a versatile tool in drug development Daniel Murnick Ph.D. (Rutgers Newark, USA) Mark Seymour Ph.D. (Xceleron, UK)

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Session 07 Analytical Challenges and formulation issues with labelled compounds David Schenk Ph.D. (Merck, USA) Martin Sandvoss Ph.D. (Sanofi, Germany)

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Session 08 Synthesis and application of labelled compounds with short lived isotopes Thomas Hartung Ph.D. (Roche, Switzerland) Sam Bonacorsi Ph.D. (BMS, USA)

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Session 09 Non pharmaceutical applications of labelled compounds Bruce McKillican Ph.D. (Syngenta, USA) Jon Bloom Ph.D., (Quotient Biosciences, UK)

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Session 10 Production of Isotopes Nigel Stevenson Ph.D. (Clear Vascular Inc, USA) Darren Brown Ph.D. (Trace Sciences, Canada)

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Session 11 New trends and technologies in isotope science.

Chad Elmore Ph.D., (Astra Zeneca, Sweden) Ronghui Lin Ph.D. (J&J, USA)

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Session 12 Poster Session – All Subjects Dieter Muri Ph.D. (Roche, Switzerland)

On Monday afternoon, there will be an address from the recipient of the Melvin Calvin award and on Wednesday morning recipients of the J. Wiley student awards will present their research.

In addition to the scientific program, the social program will include an opening reception on the evening of Sunday June 7th, a barbecue in conjunction with the Monday evening poster session and the conference banquet on Wednesday.

RAD 2015 • Date: June 8-12, 2015 • Venue: Budva, Montenegro • Website: http://www.rad-conference.org/about_conference.php

R T N T

AD 2015 is organized by the RAD Association in cooperation with the Applied Physics Laboratory (APL), Faculty of Electronic Engineering, University of Niš, Niš, Serbia.

The aim of the Conference is to provide the forum for researchers and professionals involved with

radiation and its applications to exchange and discuss their findings and experiences. The fields covered by the Conference are biology, chemistry, physics, medicine, environmental protection, electronics, and other areas related to ionizing and non-ionizing radiation and their applications. The Conference program includes topical invited lectures, a limited number of oral presentations, and poster presentations. The official language of the Conference is English.

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6. Isotope Related News FIRST-IN-AFRICA ISOTOPE-LABELLED THERANOSTIC PROCEDURE ON PROSTATE CANCER PATIENTS

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hursday, 26 March 2015, Steve Biko Academic Hospital/University of Pretoria and NTP

Radioisotopes subsidiary of the South African Nuclear Energy Corporation in collaboration with

ITG in Germany and AEC-Amersham has made provision for Professor Mike Sathekge to perform the first-in-Africa isotope-labelled theranostics procedure for prostate cancer on two patients.

NTP Group Managing Director, Ms Tina Eboka, said this has come together with the dedication of many who worked behind the scenes. “NTP, its subsidiary company AEC-Amersham in association with ITG and Steve Biko Academic Hospital are proud of this milestone! AEC-Amersham played a major role in ensuring the isotopes, peptides and sundry reagents necessary for the procedures, supplied by ITG, were timeously delivered to Professor M Sathekge at the Steve Biko Nuclear Medicine Department. NTP performed the labelling of the Prostate Specific Membrane Antigen (PSMA) together with an ITG representative who especially flew in from Germany.”

Professor Sathekge explained that Lutetium-177 (Lu-177) labelled (PSMA, a peptide) is used a targeting tracer and is very effective in detecting, and treating resistant metastatic or recurrent prostate cancer. He said he believes that many prostate cancer patients will benefit from treatment with Lu-177 n.c.a added to carrier PSMA. “Most prostate cases are often diagnosed at a late stage of the disease, hence Lu-177 PSMA is able to deal with both local and distant cancer, which may have spread to other parts of the body.”

Nuclear medicine specialists are excited about the potential of theranostics, a combination of therapy and diagnostics in which the same type of targeting molecule is used to obtain images and to deliver the therapeutic isotope dose, selectively, to the tumour site and to destroy cancerous cells.

In this procedure, PSMA is used as the targeting (or tracer) medium and is very effective in detecting, staging and treating recurrent prostate cancer. After performing a scan with Ga68 labelled PSMA to select patients who will benefit from therapy, the Lu-177 labelled PSMA is administered and transports the radioisotope selectively to the tumour(s), irradiating and killing the cancer cells and leaving healthy tissue unharmed. The full treatment involves a series of four intravenous injections, which are administered a month apart.

Cancer of the prostate is the biggest carcinogenic killer, excluding skin cancers, of men in South Africa (16.3% of all cancer deaths and over 4 000 in number per year). Up to the age of 74, men have a 1 in 23 chance of developing prostate cancer and the rate is climbing as diagnosis improves and the population average age increases.

It is not yet known how many PSMA procedures will be in demand in South Africa but certainly it will be an appreciable number and will provide NTP with an additional weapon in the armoury that is 2 progressively being assembled for fighting the scourge of cancer therefore bringing hope to many patients inflicted with prostate cancer in their country.

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