This report originally appeared in the June 2009 issue of DOTmed Business News

The answer is neither. It was the radiopharmaceutical. If you're talking about nuclear medicine, it's true. Although nuclear medicine imaging has been around for 50 years or so and there's a Society of Nuclear Medicine meeting each June, it's still not main stream medical imaging. The reasons are numerous, but it's the use of radiopharmaceuticals that clearly distinguishes nuclear imaging from general radiology.

Nuclear medicine imaging, whether it is single photon, SPECT, dual photon or PET, relies on the development and FDA approval of novel compounds that are tagged with a radioactive tracer for diagnostic imaging and therapy management. Without the availability of several different radiopharmaceuticals, nuclear medicine scanning is quite limited.


Over the early course of nuclear medicine's history, companies were devoted to the development of novel radiopharmaceuticals which drove nuclear medicine's use. New England Nuclear, Amersham and Mallinckrodt led the way by introducing Techneticium-99m labeled compounds for use in neurology, oncology and cardiology. In the early 1980s, Thallium-201, a unique tracer became the gold standard for cardiac stress perfusion imaging.

In the past decade, the introduction of new radiopharmaceuticals hasn't kept pace, leaving many to say nuclear imaging hasn't met its potential. There were new scanners, but without new radiopharmaceuticals to expand clinical applications, nuclear medicine lags behind other imaging modalities.

What changed to cause the slowdown? New England Nuclear was acquired by DuPont and eventually several other companies. Amersham became a major acquisition for GE Healthcare and Mallinckrodt was absorbed by Tyco and today is part of Covidien. The regimentation that comes with larger companies apparently snuffs out the creative drive to research and develop new radiopharmaceuticals. Universities fell behind in research on new radiopharmaceuticals. As for small companies, the several-million-dollars cost and multi-year time span for FDA new drug approval makes it impossible for them to shoulder the development risk alone.

Without the introduction of novel radiopharmaceuticals, nuclear medicine's impact on patient imaging will continue to be minimal. Growth in nuclear medicine patient imaging depends on new radiopharmaceuticals for use in cardiology and neurology. Both areas grow in importance as our population ages. When Alzheimer's drugs begin to impact the market, it will be important to have a diagnostic test and therapy monitoring capability. Nuclear medicine could answer the call. There are plenty of good cameras in place already. Now we only need the fuel.

Wayne Webster is a consultant in Medical Imaging Business Development. You can send your comments or questions to W.Webster@Proactics.net.

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