A survey on current usage and future demand of medical radioisotopes and radiopharmaceuticals in Malaysia

Abstract

Globally, the growth of radiopharmaceuticals usage is contributed by the rising incidence of chronic diseases, the emergence of novel radiopharmaceuticals and imaging technology, accessibility and awareness of public towards nuclear medicine. However, the local usage and demand data of radiopharmaceuticals is still remains limited. This cross-sectional survey study was conducted with a universal sampling of all licensed nuclear medicine facilities in Malaysia. The online self-administering questionnaire was participated by public hospitals (5), university hospitals (6) and private hospitals (21). Based on the survey outcomes, 99mTc, 131I and 18F were the common radioisotopes used in current local settings. Monthly average usage of 99mTc, 131I and 18F were found to be <2000mCi, <1000mCi and >1000mCi respectively. 177Lu, 186Re and 90Y have opted as the common therapeutic radiopharmaceuticals. The highly demanded medical radioisotopes from local users were found as 99mTc, 131I, 18F, 68Ga, 51Cr, 123I, 177Lu, 153Sm, 90Y and 186Re. Apart from 18F, other radioisotopes and radiopharmaceuticals are routinely sourced from other countries. The majority of the respondents recognized the role of cyclotron based radioisotopes and expressed their willingness to purchase locally produced radioisotopes and radiopharmaceuticals. However, the majority of the respondents remain undecided with the use of in-house non-GMP graded radiopharmaceuticals. At present, the local production of radioisotope and radiopharmaceutical could not complement the growing demand for nuclear medicine facilities in Malaysia. Alternative technologies shall be explored to ensure the more affordable, accessible, and sustainable supply of radioisotopes and radiopharmaceuticals to the local market.