Medical Isotopes in Canada

What is a medical isotope?

An isotope that emits radiation that is used to diagnose or treat disease

Isotopes are atoms that have the same number of protons as each other, but different numbers of neutrons. There are both stable and non-stable isotopes, of which the unstable forms exhibit characteristic radioactive decay via electromagnetic (gamma) or particulate (alpha, beta, Auger, etc.) emission.

WHAT IS HALF-LIFE?

Each isotope also has its own unique “half-life”: the time it takes for half of the atoms to undergo radioactive decay. A radioactive half-life (t½) can range in duration from nanoseconds to hundreds of thousands of years.

Isotopes can be produced by both reactors and cyclotrons. These methods are complementary.

Reactor produced
  • Technetium-99m
  • Iodine-125
  • Iodine-131
  • Lutetium-177
  • Radium-223
  • Yttrium-90
  • Holmium-166
Cyclotron produced
  • Fluorine-18
  • Iodine-123
  • Palladium-103
  • Copper-64
  • Zirconium-89
  • Indium-111
  • Technetium-99m
  • Carbon-11

MEDICAL ISOTOPE PRODUCTION CHAIN

Stable Isotopes are irradiated (neutron activation) at an irradiation source (cyclotron, accelerator or reactor) to create the radioactive material

The isotopes are then “harvested” and sent to an isotope processor

The isotope processor purifies the radioactive isotope according to good manufacturing practices to produce a pharmaceutical grade material

The pharmaceutical material is then delivered to a hospital where it is used to treat the patient.

CANADIAN ISOTOPE SUPPLY CHAIN

Nearly the complete supply chain for the production, processing and delivery of medical isotopes is represented in Canada

Applications of Isotopes

Sterilization
Diagnostic imaging
Cancer treatment
Insect sterilization
Food irradiation
Research & Development

Specific Medical Applications

Ac-225Metastatic cancers
Lu-177Neuroendocrine tumours (but many other promising applications for oncology because of its low energy/low penetration, allowing for more focused delivery to the tumor while preserving normal tissue)
Ga-68PET imaging scans
Co-60Brain disease (Gamma Knife)
I-131Prostate Cancer (permanent brachytherapy), thyroid
Ir-192Prostate Cancer/Gyne Cancer/Esophageal cancer/GI cancer (brachytherapy)
Ra-223Prostate Cancer (bone metastases)
Y-90Primary or metastatic disease to liver
F-18PET imaging scans

STRATEGIC PRIORITY FOR CANADA

A major driver for the market growth of isotopes is their use in accurate diagnosis, imaging and treatment solutions.

It is estimated that the nuclear medicine market will see 15% growth per year until 2026. By 2031, the market will reach between $14-$33 billion US (MEDraysintell, 2021)

In 2013, therapeutics represented just 6% of the nuclear medicine market but grew to 20% in 2019. Therapeutics are projected to represent 75% of the $33 billion market in 2031.