September 6, 2008
Hundreds of Patients Face Delays on Scans
A global shortage of medical isotopes used in scans of hearts, bones, kidneys and some cancers will cause delays and cancellations across the UK in the coming weeks.British hospitals were receiving less than 50 per cent of expected supplies and rations were expected to drop even further, the experts warned.The isotopes are used in more than 80 per cent of routine diagnostic nuclear imaging procedures.Professor Alan Perkins, honorary secretary at the British Nuclear Medicine Society, said: "The expected number of people who will be affected is quite difficult to determine at the moment."But we are certainly talking about hundreds of patients here."The procedures include cardiac blood flow imaging, bone scanning looking for secondary tumours, lymph node detection in breast cancer and renal function, which is commonly done in children."These patients are going to be facing delays. Clinicians will be addressing the issue on the basis of clinical need."Prof Perkins also warned that a Government target to scan patients within six weeks could mean some doctors give patients inappropriate tests.Patients might be given other tests to ensure they did not fall outside the six-week target but it could mean they were not receiving best care, he said."Patients may be put through inappropriate tests to make sure patients do not breach the six-week pathway."Prof Perkins said professionals should not alter bookings on the basis of waiting times rather than clinical priority.Three of the five global nuclear reactors supplying medical isotopes are currently shut down.Prof Perkins said doctors would have the option to use alternative tracers or alternative imaging methods, such as magnetic resonance tomography, in some non-urgent cases."But some patients will receive suboptimal diagnostic observation," he said as part of an article on bmj.com, the online website for the British Medical Journal. "It will slow up the system."Wolfram Knapp, president elect of the European Association of Nuclear Medicine, warned this week of a global shortage.The High Flux reactor at Petten in the Netherlands was shut down unexpectedly in late August after gas bubbles were discovered escaping from a pipe.The Petten reactor accounted for over 25 per cent of global demand and more than half of Europe's demand. A reactor in France and one in Belgium are closed for regular maintenance. This leaves only two reactors operating one in Canada and the other in South Africa.Dr Knapp warned that although 80 per cent of molecular imaging investigations were not urgent and could be postponed for one to three weeks others must be done within days.According to the European Association of Nuclear Medicine, European hospitals are already limited to 20 per cent to 40 per cent of normal nuclear medical activities. Prof Perkins and colleagues in the British Nuclear Medicine Society said most commercial reactors were about 40 years old and new production capacity was urgently needed.
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