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MEDICAL RADIOISOTOPES

The debates about radioisotope production and supply during the RRR were very similar to those that had surfaced o n several occasions from the late 1970s. T o give just one example, A S T E C (1985, p.4) put forward a set of arguments in 1985 that were just the s a m e as arguments put to the R R R by advocates of a n e w reactor:

A range of radioisotopes currently produced at HIFAR is used in medicine, industry and applied research in many fields. ASTEC believes that the domestic production of radioisotopes should continue so that Australian

patients can benefit fully from the diagnostic techniques of nuclear medicine.

If domestic production were to cease, patients would be vulnerable to the interruption of the supply of radioisotopes from overseas and also would be deprived of diagnostic techniques which utilise short-lived radioisotopes which cannot be imported. A nuclear reactor cannot be replaced by a

cyclotron for radioisotope production because some of the radioisotopes which are made by a nuclear reactor cannot be made by a cyclotron, and others can be made by a cyclotron only with great difficulty.

While on the surface these debates have changed little over the years, at a broader level there has been a significant shift. Radioisotope production has b e c o m e m o r e

important in the scope of the A A E C / A N S T O ' s activities and m o r e central as a justification for the existence of a nuclear agency and the operation of a research reactor. In other words, the debates about radioisotope production have not changed m u c h but they have b e c o m e m o r e important components of the overall controversy as to whether a domestic reactor is necessary.

The Review (ch.8) took up the issue of radioisotope production and supply in considerable detail. The focus w a s on medical radioisotopes since the vast

majority of radioisotopes produced using H I F A R are for nuclear medicine as opposed to industrial or research uses. Radioisotope production and supply w a s clearly an important debate: for example one of the three main reasons the

Review argued that the decision on the replacement of H I F A R be deferred w a s the possibility that cyclotron technology might develop rapidly in the following years, in which case there m a y not be a case for a reactor for radioisotope production, in which case the overall balance might swing towards the non-replacement of HIFAR. O f course m a n y other issues were also important: for example the issue of waste disposal w a s crucial, and debates over scientific research were very

important given that research would be the major use of a n e w reactor. Suffice it to assert that the radioisotope issue w a s given m u c h attention by the Review, and it also featured prominently in written and verbal submissions to the Review.

The Review considered various options for future procurement of medical radioisotopes. O n e w a s a greater reliance o n imports. It discussed issues such as reliability of supply and the relative costs of imported versus domestic

radioisotopes. The Review's conclusions (p.95) on this issue were vague and somewhat contradictory. It noted that m a n y countries have either overcome the problems associated with reliance o n imported medical radioisotopes, or found them not to be a problem, but then the Review goes on to say that "The Review is persuaded that the presence of a domestic source of supply is an important feature of the current high standard of services in nuclear medicine."

The emphasis in most submissions to the Review, for or against a new reactor, w a s on cyclotron versus reactor radioisotope production; the possibility of greater reliance o n imported radioisotopes received considerably less attention. This

emphasis o n cyclotrons versus reactors w a s reflected in the Review's findings.

The Review (p.xvii) w a s non-committal about the prospects for cyclotron

production of radioisotopes as a n alternative to reactor production. It focused o n the possibility of cyclotron production of technetium-99m, which is used in 80-90% of nuclear medicine procedures:

Cyclotron technology is evolving quickly, but the debate about whether

technetium can be produced successfully in cyclotrons is not resolvable at this time. There are no current cyclotrons producing technetium and no

plans anywhere to construct a large enough cyclotron for this purpose.

The Review (p.88), comparing reactors and cyclotrons for medical radioisotope production, said:

The Review neither could, nor would want to, pronounce one source better

than the other. It does, however, need to reiterate the conclusion it must draw on the evidence to this point, that a reactor-based source will continue to be essential as far ahead as can be foreseen, if Australia's need for medical isotopes is to be met domestically.

Henderson-Sellers (1993, p.810), during verbal submissions, said:

7 think the thing that has impressed me most as we have read through all of the submissions and have travelled around the country is not only the

fluency and the highly articulate nature of the submissions from the medical fraternity but also I think their almost complete internal consistency -and

that is very right and proper; they are all telling the same story I believe and I have no reason to believe it is not the truth.

However Henderson-Sellers (p.811) then went on to ask whether the medicos were perhaps well-briefed enthusiasts. Certainly A N S T O solicited submissions from medical institutions, as did the public relations firm it hired. Indeed t w o submissions from independent medical institutions in different countries were identical; whether they briefed each other, or whether both institutions (and perhaps others besides) were given a helping h a n d b y A N S T O , or the public relations firm hired b y A N S T O , is o p e n to speculation.56

56 The two institutions are the Isotope Department, Nuclear Energy Unit, Malaysia; and Eastern

Nuclear medicine practitioners were keen to support a n e w reactor because their careers are dependent o n security of supply of radioisotopes. So too they have a financial stake in the matter: they are concerned that in the absence of a domestic reactor, radioisotope prices might increase but Medicare Schedule fees would not reflect the increased costs. T h o u g h supply might be equally secure and inexpen-sive in the absence of a domestic reactor, there seems to be a genuine belief a m o n g nuclear medicine practitioners that it is very m u c h in their interests for there to be a domestic reactor source. A N S T O has played a major role in cultivating that

belief.