Isotope supply tracker
Radiopharmaceuticals are only as available as their isotopes. Actinium-225 gates the entire alpha-therapy pipeline; lutetium-177 supply dictated Pluvicto's launch. This page tracks each medical radionuclide, how it is made, who makes it, and how tight supply is.
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¹⁷⁷Lu Lutetium-177
t½ 6.65 days · therapy
- Emission
- β⁻ (0.5 MeV, ~2 mm range) + γ (208 keV, imageable)
- Production
- Reactor: indirect route via ¹⁷⁶Yb(n,γ)¹⁷⁷Yb→¹⁷⁷Lu (non-carrier-added, n.c.a.) or direct ¹⁷⁶Lu(n,γ) (carrier-added, contains long-lived ¹⁷⁷ᵐLu).
- Suppliers
- ITM (n.c.a., largest), Novartis (in-house for Pluvicto, Millburn NJ and Indianapolis), SHINE (n.c.a.), Eckert & Ziegler, NorthStar, Curium, IRE/Isotope Technologies.
- Supply
- Demand grew sharply with Pluvicto. Reactor capacity (BR2, HFR, MARIA, SAFARI-1, Russian reactors) and enriched ¹⁷⁶Yb availability are the constraints; accelerator-based routes (SHINE) are scaling. Shortages in 2022–23 delayed Pluvicto doses; supply improved by 2025.
²²⁵Ac Actinium-225
t½ 9.9 days · therapy
- Emission
- 4 α particles over its decay chain (via ²²¹Fr, ²¹⁷At, ²¹³Bi); ~28 MeV total
- Production
- Legacy: decay of ²²⁹Th from US ²³³U stockpile (DOE/ORNL, TerraPower). Accelerator: ²²⁶Ra(p,2n)²²⁵Ac on cyclotrons (Eckert & Ziegler, Bayer/Nusano route), photonuclear ²²⁶Ra(γ,n)²²⁵Ra→²²⁵Ac (NorthStar), high-energy spallation of ²³²Th (DOE Tri-Lab, contains ²²⁷Ac impurity).
- Suppliers
- DOE Isotope Program, TerraPower Isotopes (Philadelphia plant under construction, ~20× capacity), Eckert & Ziegler, NorthStar Medical Radioisotopes, Nusano, Ionetix, Bayer (in-house), RayzeBio/BMS (in-house), Niowave.
- Supply
- The binding constraint on targeted alpha therapy. Global supply in the mid-2020s was roughly enough for low thousands of patient doses per year; multiple phase 3 programmes (Novartis, Bayer, BMS, AstraZeneca) need far more. Commercial-scale expansion is described as a 3–5 year effort.
²¹²Pb Lead-212
t½ 10.6 hours · therapy
- Emission
- β⁻ to ²¹²Bi, then α (via ²¹²Bi/²¹²Po); effectively an in-vivo α generator
- Production
- ²²⁴Ra/²¹²Pb generators from ²²⁸Th (Orano Med's Plano, Texas and Brownsburg, Indiana plants); Perspective Therapeutics VMT platform.
- Suppliers
- Orano Med (dominant), Perspective Therapeutics (in-house), AdvanCell (²¹²Pb from ²²⁴Ra generator, Australia).
- Supply
- Short half-life forces same-day logistics but avoids Ac-225's daughter-redistribution problem. Orano Med's industrial-scale ²¹²Pb production came online 2024–25; AlphaMedix (²¹²Pb-DOTAMTATE) is in registrational development.
²²³Ra Radium-223
t½ 11.4 days · therapy
- Emission
- 4 α particles over decay chain
- Production
- ²²⁷Ac/²²⁷Th generator (from ²²⁶Ra neutron irradiation).
- Supply
- Established since 2013; demand has declined as PSMA radioligands took share.
⁶⁸Ga Gallium-68
t½ 68 minutes · imaging
- Emission
- β⁺ (PET)
- Production
- ⁶⁸Ge/⁶⁸Ga generators (270-day parent) or cyclotron ⁶⁸Zn(p,n)⁶⁸Ga (liquid or solid target).
- Suppliers
- Eckert & Ziegler and IRE (generators), Telix/Illuccix and Novartis/Locametz kits, cyclotron production at large centres.
- Supply
- Generator shortages in 2020–21 during PSMA PET launch; cyclotron routes and ¹⁸F-labelled alternatives (Pylarify) relieved pressure.
¹⁸F Fluorine-18
t½ 110 minutes · imaging
- Emission
- β⁺ (PET)
- Production
- Medical cyclotrons: ¹⁸O(p,n)¹⁸F in enriched water; distributed daily from regional radiopharmacies.
- Suppliers
- Cardinal Health, PETNET (Siemens), SOFIE, Jubilant, Curium, GE HealthCare; hundreds of cyclotron sites worldwide.
- Supply
- The most robust radionuclide supply chain in medicine; FDG, PSMA (Pylarify, Posluma), FES, and FAPI-74 all ride on it.
⁸⁹Zr Zirconium-89
t½ 78.4 hours · imaging
- Emission
- β⁺ (PET), γ (909 keV)
- Production
- Cyclotron ⁸⁹Y(p,n)⁸⁹Zr on yttrium foil; chelated via desferrioxamine (DFO) to antibodies.
- Suppliers
- 3D Imaging, PerkinElmer/Revvity, IBA and academic cyclotrons; Telix (TLX250-CDx girentuximab).
- Supply
- Half-life matched to antibody kinetics (imaging at 3–7 days); higher patient dose than ¹⁸F. Supply scales with immuno-PET demand.
⁶⁴Cu Copper-64
t½ 12.7 hours · both
- Emission
- β⁺ (PET), β⁻, Auger electrons
- Production
- Cyclotron ⁶⁴Ni(p,n)⁶⁴Cu; theranostic pair with ⁶⁷Cu (therapy).
- Suppliers
- Curium (Detectnet ⁶⁴Cu-DOTATATE), Clarity Pharmaceuticals (SAR-bisPSMA), Washington University and other academic cyclotrons.
- Supply
- Longer half-life than ⁶⁸Ga allows central production and next-day imaging; Clarity's ⁶⁴Cu/⁶⁷Cu PSMA pair is in phase 3.
¹³¹I Iodine-131
t½ 8.0 days · both
- Emission
- β⁻ + γ (364 keV)
- Production
- Reactor fission product or ¹³⁰Te(n,γ)¹³¹Te→¹³¹I.
- Suppliers
- Curium, Jubilant, IRE, NTP; widely available.
- Supply
- The original theranostic (thyroid cancer since 1946); also ¹³¹I-MIBG in neuroblastoma and ¹³¹I-apamistamab (Iomab-B) conditioning.
⁹⁰Y Yttrium-90
t½ 64 hours · therapy
- Emission
- β⁻ (2.3 MeV, ~11 mm range), no useful γ
- Production
- ⁹⁰Sr/⁹⁰Y generators (fission-product parent) or ⁸⁹Y(n,γ).
- Suppliers
- Boston Scientific (TheraSphere glass microspheres), Sirtex (SIR-Spheres resin), Eckert & Ziegler.
- Supply
- Mainstay of hepatic radioembolisation (SIRT); Zevalin (⁹⁰Y-ibritumomab) proved radioimmunotherapy in lymphoma but was commercially abandoned.