{"entity":{"id":"f-isotope-supply","kind":"section","name":"Isotope supply","aka":[],"tldr":"The radioactive ingredients in these medicines are made in a small number of ageing reactors and accelerators worldwide, and demand is now growing faster than that supply.","summary":"Every radiopharmaceutical begins as an isotope made in a reactor or accelerator, and the whole field sits on a genuinely fragile production base. Roughly 95% of the world's molybdenum-99 (the parent of technetium-99m, used in about 30 million SPECT scans a year, 80% of all nuclear medicine imaging) comes from a handful of research reactors in South Africa, the Netherlands, Belgium and Australia; because Mo-99's half-life is 66 hours it cannot be stockpiled, so a reactor outage cancels scans within days (OECD-NEA, 2025 review of medical radioisotope supply).\n\nLutetium-177 demand rose sharply after Pluvicto's approval, and the OECD-NEA and IAEA both project that non-carrier-added Lu-177 production capacity will not keep pace with clinical demand; a key bottleneck is enriched ytterbium-176 target material, historically sourced mainly from Russia. New capacity is being built to close the gap: Canada's Darlington reactor began isotope production runs (Mo-99, Lu-177, Y-90) from 2025; India's Dhruva reactor supplies domestic Lu-177 and imports the shortfall from Russia; SHINE Technologies (Chrysalis facility, Wisconsin) is targeting over 75% of US Mo-99 demand with a $263 million DOE conditional loan commitment, and is already producing Lu-177; and Eden Radioisotopes has filed a US NRC construction permit for a new Mo-99/Lu-177 facility aiming to supply up to 50% of global Mo-99 demand.\n\nActinium-225 has its own, much tighter, constraint (see the alpha-therapy front): global supply of roughly 63 GBq/year against rising clinical trial demand. Ideas circulating to fix the underlying fragility include a coordinated international reserve and shared production schedule across the world's medical isotope reactors, Western enrichment capacity for ytterbium-176 so Lu-177 has more than one supplier, and a global isotope supply observatory that forecasts shortages before they hit clinics.","asOf":"2026-09-22","links":[{"label":"OECD-NEA: Current trends in the supply and utilisation of medical radioisotopes (2025)","url":"https://www.oecd-nea.org/upload/docs/application/pdf/2025-10/7743_medical_radioisotopes_supply_rev.pdf"},{"label":"Eden Radioisotopes files NRC construction permit for Mo-99/Lu-177 facility (ANS, May 2026)","url":"https://www.ans.org/news/2026-05-08/article-8016/eden-targets-domestic-medical-radioisotope-production/"},{"label":"IAEA/OECD-NEA: Towards a robust supply chain for medical radioisotopes","url":"https://inis.iaea.org/records/06vmc-y0w54"}],"tags":[],"related":["f-alpha-therapy","f-radiochemistry","f-radioligand-therapy","tc-99m","mo-99","lu-177","ac-225","y-90"],"indications":[],"sections":[],"technologies":["therapy-isotope-supply-chain","research-reactor-isotope-production","cyclotron-isotope-production","actinium-225-supply","radiopharmacy-network"],"targets":[],"drugs":[],"companies":["ansto","ire","nordion","northstar-medical-radioisotopes","shine-technologies","terrapower-isotopes","isotopia","curium"],"institutions":["iaea"],"pathways":[],"terms":[],"trials":[],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":["Mo-99's 66-hour half-life means it cannot be stockpiled; the physics of decay, not inventory management, sets the logistics of the whole Tc-99m supply chain.","Enriched ytterbium-176, the target material for non-carrier-added Lu-177, has historically depended heavily on Russian supply; Western enrichment capacity is only now being built out.","PALLAS/OECD-NEA modelling projects Lu-177 demand outpacing available capacity from around 2025 onward without new reactor investment."],"order":4},"route":"/fronts/f-isotope-supply/","neighbours":{"section":[{"id":"f-radiochemistry","kind":"section","name":"Radiochemistry & manufacturing","route":"/fronts/f-radiochemistry/"},{"id":"f-radioligand-therapy","kind":"section","name":"Radioligand therapy","route":"/fronts/f-radioligand-therapy/"},{"id":"f-regulation-reimbursement","kind":"section","name":"Regulation & reimbursement","route":"/fronts/f-regulation-reimbursement/"},{"id":"f-alpha-therapy","kind":"section","name":"Targeted alpha therapy","route":"/fronts/f-alpha-therapy/"}],"isotope":[{"id":"ac-225","kind":"isotope","name":"Actinium-225","route":"/isotopes/ac-225/"},{"id":"lu-177","kind":"isotope","name":"Lutetium-177","route":"/isotopes/lu-177/"},{"id":"mo-99","kind":"isotope","name":"Molybdenum-99","route":"/isotopes/mo-99/"},{"id":"tc-99m","kind":"isotope","name":"Technetium-99m","route":"/isotopes/tc-99m/"},{"id":"y-90","kind":"isotope","name":"Yttrium-90","route":"/isotopes/y-90/"}],"technology":[{"id":"actinium-225-supply","kind":"technology","name":"Actinium-225 supply: thorium stocks, accelerators and radium targets","route":"/technologies/actinium-225-supply/"},{"id":"cyclotron-isotope-production","kind":"technology","name":"Cyclotron isotope production (F-18, Ga-68, Cu-64, Zr-89, At-211)","route":"/technologies/cyclotron-isotope-production/"},{"id":"radiopharmacy-network","kind":"technology","name":"Radiopharmacy and cyclotron networks","route":"/technologies/radiopharmacy-network/"},{"id":"research-reactor-isotope-production","kind":"technology","name":"Research reactors for medical isotopes (Mo-99, Lu-177, I-131)","route":"/technologies/research-reactor-isotope-production/"},{"id":"therapy-isotope-supply-chain","kind":"technology","name":"Therapeutic isotope supply chain (Mo-99, Lu-177, Ac-225)","route":"/technologies/therapy-isotope-supply-chain/"}],"company":[{"id":"ansto","kind":"company","name":"ANSTO (Australian Nuclear Science and Technology Organisation)","route":"/companies/ansto/"},{"id":"curium","kind":"company","name":"Curium","route":"/companies/curium/"},{"id":"ire","kind":"company","name":"IRE (Institut national des Radioéléments)","route":"/companies/ire/"},{"id":"isotopia","kind":"company","name":"Isotopia Molecular Imaging","route":"/companies/isotopia/"},{"id":"nordion","kind":"company","name":"Nordion (Sotera Health)","route":"/companies/nordion/"},{"id":"northstar-medical-radioisotopes","kind":"company","name":"NorthStar Medical Radioisotopes","route":"/companies/northstar-medical-radioisotopes/"},{"id":"shine-technologies","kind":"company","name":"SHINE Technologies","route":"/companies/shine-technologies/"},{"id":"terrapower-isotopes","kind":"company","name":"TerraPower Isotopes","route":"/companies/terrapower-isotopes/"}],"institution":[{"id":"iaea","kind":"institution","name":"International Atomic Energy Agency: Rays of Hope","route":"/institutions/iaea/"}]}}