Future of 99Mo reactor-independent supply

Molybdenum-99 is essential for nuclear medicine, being the parent radionuclide of 99mTc, which is commonly used in single-photon-emission computed tomography scans. Worldwide, the supply of 99Mo has faced considerable disruption twice in recent years: in 2009 triggered by the unexpected simultaneous shutdown of two nuclear research reactors, and in 2020 because of disruption to shipments of 99Mo as a consequence of severe restrictions on flights. This Perspective therefore examines alternative means of 99Mo production, via cyclotrons, electron linear accelerators and fusion neutron sources. The research and development of methods for 99Mo that can be synergic and complementary to reactors in the short-to-medium term and alternative to them in the long term is strategic for addressing potential global events that might produce reduced access to healthcare procedures relying on diagnostic as well as therapeutic radionuclides. This Perspective argues that the development of 99Mo production methods complementary to reactor-based methodology is strategic in the short-to-medium term. Localized and resilient 99Mo production routes might guarantee access to important diagnostic procedures even in the case of unpredictable global events.