Advancing Health Care: An Inside View

By John Stewart
Director, Policy and Research
Canadian Nuclear Association

CNA is reaching out this fall to users of nuclear technology across Canada’s health care sector. It’s part of the Nuclear Leadership Forum’s work toward a Nuclear Innovation Agenda – making sure Canada retains its world leadership in nuclear in decades to come.

The Ottawa Hospital’s Chair of Nuclear Medicine, Dr. Lionel Zuckier, invited CNA to visit this large hospital’s radiochemical laboratory on October 29.

Dr. Lionel Zuckier (right) illustrates the value of PET imaging to CNA’s Dr. John Barrett.

Dr. Zuckier and his colleagues explained how advances in molecular imaging are constantly making treatments more personalized and accurate. This has greatly reduced each patient’s radiation exposure while making treatments faster, less intrusive, and more effective.

Yanick Lee (right) and Ran Klein (centre) show off the Ottawa Hospital’s cyclotron.

The Ottawa Hospital hosts impressive molecular medicine facilities: a cyclotron, hot cells, chemistry modules, a dose preparation “clean room,” and many imaging and treatment machines.

Like others in the health community, Ottawa Hospital leaders express concern about the supply-demand picture for medical isotopes around 2016. Many say that immediately following the end of the National Research Universal (NRU) reactor’s molybdenum production, alternative supplies will not be sufficient to cover patient needs.

Yanick Lee demonstrates a small hot cell, where freshly produced isotopes are received from the cyclotron.

Canadian Association of Medical Radiation Technologists (CAMRT) President Francois Couillard blogged about this issue in September.

Yanick opens up a chemistry module, where isotopes are processed before going to the dose preparation room.

According to the hospital’s Ran Klein, Cardiac Imaging Core Lab Manager at the National Cardiac PET Centre, “More than 100,000 Canadian patients each year get technetium scans that are crucial to their diagnostic and prognostic accuracy – especially for cardiac patients (40% of all nuclear imaging is cardiac imaging). What are we going to do in 2016? We are not ramping up to deal with that.”

Dr. Klein continued that even in the longer term, there are serious supply issues. “I have nothing against India, South Africa, or Pakistan (some of the alternative supplying countries) but you are losing control of the supply chain, and you are losing control of the regulatory structure around it.”