Scott and colleagues received responses from key society contacts in the International Atomic Energy Agency database. For North America, Latin America and Australia the data represented 91.3% to 100.0% of nuclear medicine camera sites. Half of locations in Africa were represented, but European responses were low, which likely affected the survey results.

In addition to Mo-99/Tc-99 supply issues, respondents noted problems reliably obtaining cold kits, which are used to simplify radiopharmaceutical production and enable consistency across varying sites. More than half of the 33 radiopharmaceutical kit manufacturers provide to only a single country and eight provide kits to two countries.

Additionally, all countries said they lack trained and qualified staff, including clinicians, radiochemists and physicists, to perform tasks such as quality assurance and proper labeling. This also hampered their ability to offer complex procedures, Scott et al. noted.

Issues also extended into specific radiopharmaceuticals, with only 28 countries indicating they offered PET services. Low and low-middle income countries had the fewest number of sites. The most widely used agent is 18F-FDG, but non-FDG tracers were limited in most countries due to high cost, no access to a cyclotron, and regulatory restrictions, among other reasons.

Most respondents also do not have access to therapeutic tracers, such as 123I, 123I-MIBG and 131I-MIBG, because of costs and supply or distributor issues.

The data obtained in this survey project clearly shows that all countries have issues of radiopharmaceutical access and availability, although the capability to address these issues varies according to the size of the country, funding and nuclear medicine infrastructure, the group noted.

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Most countries face nuclear imaging supply issues, and COVID-19 has only exacerbated the problem - Health Imaging