Patients will face delays in getting diagnostic scans due to severe shortage of imaging agents

A global shortage of medical isotopes* used in over 80% of routine diagnostic nuclear imaging procedures such as heart imaging, bone scans and some cancer detection procedures, will cause delays and cancellations to diagnostic examinations across the UK and Europe in the next few weeks, predict experts on bmj.com today. UK hospitals are receiving less than 50% of expected supplies and rations are expected to drop still further in the coming weeks, write Alan Perkins and colleagues from the British Nuclear Medicine Society.

According to the European Association of Nuclear Medicine European hospitals are already limited to only 20��% of normal nuclear medical activities.

The authors warn that if NHS managers in the UK aim to meet the six-week target for diagnostic waiting times by altering bookings on the basis of waiting times rather than clinical priority, some patients may receive sub-optimal treatment.

Currently Europe's three isotope production reactors are all shut down because of maintenance issues and European producers only have enough radioisotopes to last until September 8.

In addition, other reactors in Canada and South Africa have also been temporarily closed, leaving just the Australian reactor which, according to the authors, does not have enough potential to significantly increase supply to the world market.

The closure of the Canadian reactor for two months in 2007 for safety reasons affected over 50 000 patient examinations in the US.

The authors point out that this is not just a short term emergency. Most of the commercial reactors are around 40 years old and new production capacity is urgently needed to meet the increasing demands of isotopes for research, diagnosis and treatment.

They warn that urgent global investment in new reactor facilities is essential or these problems will continue and it will be the patients that suffer.