Therapeutic isotope supply chain (Mo-99, Lu-177, Ac-225)
Where the radioactive atoms for imaging and therapy actually come from: ageing reactors, new accelerators, and a scramble for actinium.
Mo-99/Tc-99m for SPECT still depends on a few research reactors (BR2, HFR Petten, OPAL, SAFARI) with accelerator alternatives from NorthStar and SHINE. Lu-177 (non-carrier-added) is supplied by ITM, SHINE, Eckert & Ziegler, Curium and NorthStar; Ac-225 supply is the binding constraint for alpha therapy, with US DOE, TerraPower Isotopes, Orano Med (Pb-212), NorthStar, Niowave, and ITM expanding. Supply agreements are now a competitive asset for radiopharma companies.
How it works
Reactor neutron capture (Lu-176→Lu-177), Th-229 decay chains and accelerator spallation (Ac-225), and electron-accelerator photonuclear routes (Mo-99) produce isotopes that are purified, calibrated, and shipped against decay.
- Multiple new non-reactor routes since 2020
- Ac-225 shortage until late 2020s
- Reactor outages cause global shortages
- Regulatory licensing of new production sites is slow
Latest papers
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