"DOE is the only domestic supplier for many of the over 300 different isotopes it sells that are critical to medical, commercial, research, and national security applications. Previous shortages of some isotopes, such as helium-3, an isotope used to detect radiation at seaports and border crossings, highlight the importance of managing supplies of and demand for critical isotopes. Prior reports by GAO and others highlighted risks and challenges faced by the Isotope Program, such as assessing demand for certain isotopes. GAO was asked to determine (1) which isotopes are produced, sold, or distributed either by the Isotope Program or NNSA and how the two agencies make isotopes available for commercial and research applications; (2) what steps the Isotope Program takes to provide isotopes for commercial and research applications; and (3) the extent to which DOE is assessing and mitigating risks facing the Isotope Program. GAO reviewed DOE and NNSA documents, visited Oak Ridge National Laboratory, and interviewed cognizant agency officials."

Isotope production and distribution have been part of DOE's mission since at least 1954, when the Atomic Energy Act of 1954 specified the role of the U.S. government in isotope distribution. DOE's Isotope Program fills this role by providing isotopes to support the national and international need for a reliable supply for use in medicine, industry, and research. The Isotope Program provides both radioactive isotopes, called radioisotopes, and stable isotopes, which are not radioactive.

This thesis describes a proof-of-principle experiment demonstrating a technique for stable isotope enrichment called Magnetically Activated and Guided Isotope Separation (MAGIS). Over the past century many enriched isotopes have become available, thanks largely to electromagnetic separators called calutrons. Due to substantial maintenance and operating costs, the United States decommissioned the last of its calutrons in 1998, leading to demand for alternative methods of isotope separation. The work presented here suggests the promise for MAGIS as a viable alternative to the calutrons. The MAGIS technique combines optical pumping with a scalable magnetic field gradient to enrich atoms of a specific isotope in an atomic beam. Benchmarking this work against the calutron using lithium as a test case, the author demonstrated comparable enrichment in a manner that should scale to the production of similar quantities, while requiring vastly less energy input.

MANAGING CRITICAL ISOTOPES: DOE's Isotope Program Needs Better Planning for Setting Prices and Managing Production Risks

This report explores the main reasons behind the unreliable supply of Technetium-99m (Tc-99m) in health-care systems and policy options to address the issue. Tc-99m is used in 85% of nuclear medicine diagnostic scans performed worldwide – around 30 million patient examinations every year. These scans allow diagnoses of diseases in many parts of the human body, including the skeleton, heart and circulatory system, and the brain. Medical isotopes are subject to radioactive decay and have to be delivered just-in-time through a complex supply chain. However, ageing production facilities and a lack of investment have made the supply of Tc-99m unreliable. This report analyses the use and substitutability of Tc-99m in health care, health-care provider payment mechanisms for scans, and the structure of the supply chain. It concludes that the main reasons for unreliable supply are that production is not economically viable and that the structure of the supply chain prevents producers from charging prices that reflect the full costs of production and supply.

This publication is the first international survey on the beneficial uses and production of isotopes. It provides an overview of their main uses, and detailed information on the facilities that produce them world-wide.

Participants of the July 17-18, 2017, symposium titled Opportunities and Approaches for Supplying Molybdenum-99 and Associated Medical Isotopes to Global Markets examined current trends in molybdenum-99 production, prospects for new global supplies, and technical, economic, regulatory, and other considerations for supplying molybdenum-99 to global markets. This publication summarizes the presentations and discussions from the symposium.