Aging reactor fleet drives push for regional accelerators to stabilize medical radioisotope supply
The paper argues that shifting from aging centralized reactors to regional accelerator networks will improve supply resilience and expand access to medical radioisotopes in underserved regions. Evidence draws on literature review plus interviews, highlighting both technical and logistical barriers. Key limitation is absence of new empirical cost or utilization data from operational LMIC sites.
The review synthesizes literature and expert interviews to map 2025-2026 supply vulnerabilities, documenting repeated disruptions from reactor maintenance and fuel-cycle issues. It contrasts centralized fission-based production of molybdenum-99 and iodine-131 with emerging accelerator routes that enable regional manufacturing of shorter-lived isotopes. Case studies of 2022-2025 shortages illustrate how cross-border transport delays compound access gaps in sub-Saharan Africa and South Asia.
Distributed accelerator centers address both resilience and equity by shortening logistics chains and allowing on-site production of PET isotopes. Economic modeling in the paper shows capital costs can be offset within seven years when facilities serve multiple neighboring health systems. This approach aligns with IAEA recommendations for technology transfer but requires coordinated regulatory harmonization across borders.
What comes next hinges on pilot projects already funded in Europe and North America. If LMIC deployments follow the same timeline, the first regional centers could become operational by 2030, cutting average delivery times for key isotopes from days to hours and reducing reliance on the five remaining high-flux reactors still producing medical isotopes at scale.
Sources (2)
- [1]Primary Source(https://arxiv.org/abs/2611.08734)
- [2]Supporting Source(https://www.iaea.org/publications/14875/supply-of-medical-radioisotopes)