AuntMinnie.com Molecular Imaging Insider

Dear Molecular Imaging Insider,

Since the severe shortage of molybdenum-99 (Mo-99) in 2009 and 2010, nuclear medicine practitioners have been wary of a repeat of the crisis, which delayed clinical evaluations of patients around the world. Now, entrepreneurs are coming forward to offer their own strategies for manufacturing Mo-99 and ensuring that an adequate supply is always available.

One such effort comes from Shine Medical Technologies, which hopes to build a Mo-99 production plant in Wisconsin. With both altruistic and financial goals in mind, CEO and co-founder Gregory Piefer, PhD, and colleagues have found the path to completing the facility difficult to navigate at times. Read about their efforts in this issue's Insider Exclusive.

The tenuous supply of Mo-99 in recent years has resulted in a double-digit price increase at many nuclear medicine facilities across the U.S., as well as the canceling or rescheduling of appointments and fewer after-hours exams. Those findings come from a survey conducted this past summer by the Society of Nuclear Medicine and Molecular Imaging. Of the 522 respondents, 90% said their radiopharmaceutical prices have increased since December 2013, with a majority describing the hike as a "significant."

In other featured articles, a new study published in Annals of Internal Medicine concluded that overuse of cardiac stress testing with medical imaging has contributed to rising healthcare costs. Patients have also been exposed to unnecessary radiation due to stress imaging tests, according to the researchers, who analyzed data for 1993 through 2010.

Also, the convenience of pharmacologic stress agents and an increase in patient mobility issues may be contributing to a decades-long decline in the use of exercise stress for SPECT myocardial perfusion imaging. Researchers found that the use of exercise stress declined from 1996 to 2012, while pharmacologic stress tests increased during the same period. Interestingly, there was also a decrease in abnormal SPECT MPI results, despite a greater number of patients with cardiac risk factors and comorbidity.

Finally, German researchers have found promising evidence that PET/MRI is equivalent to PET/CT for lesion detection in pediatric cancer patients, while at the same time delivering just one-quarter of the radiation dose. Separately, MRI provided substantial additional clinical information, especially in soft-tissue lesions that were deemed negative with PET.

Be sure to stay in touch with the Molecular Imaging Community on a daily basis when AuntMinnie.com travels to Chicago for the 100th annual meeting of RSNA, which begins Sunday, November 30.

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