Shortage of radioactive materials needs to be resolved urgently

SGGP
Although Ho Chi Minh City is one of the localities where many hospitals are equipped with the positron emission tomography-computed tomography (PET/CT) scanners- a modern technique in cancer diagnosis, many cancer patients here are now waiting in vain to be performed this technique due to the lack of radiopharmaceuticals to run PET/CT scanners. While waiting for the Ministry of Health and hospitals to come up with solutions, some patients plan to go to Da Nang and Hanoi for PET/CT scans, despite high expenses.
Shortage of radioactive materials needs to be resolved urgently ảnh 1 A doctor checks the PET/CT scanner before operating it at Cho Ray Hospital. (Photo: SGGP)
Exhaustedly searching places to get PET/CT scans

In the past three days, Nguyen Dinh Hung, living in Binh Chanh District in HCMC, had to visit many hospitals around the city to find a place to take PET/CT scans for his mother, a patient suspected of having stomach cancer. At first, Hung went to HCMC Oncology Hospital, but the hospital said that it no longer had any radiopharmaceuticals to operate its scanner. Hung took his mother to Military Hospital 175 and then People's Hospital 115, but these two places also turned him down because their machines stopped working.
Being told by his friends that only Cho Ray Hospital had a working scanner, he registered a PET/CT scan for his mother there. However, due to the overwhelming number of patients, it takes more than a month before his mother’s turn comes. "For cancer patients, a long waiting time may cause the disease to advance to a severe stage, so my family has been considering the option of going to Hanoi or Da Nang City to get a scan early," Hung said worriedly.

Dr. Nguyen Trieu Vu, Head of the Oncology Department of Thu Duc City Hospital, said that the general situation of many cancer patients, who have been ordered to have PET/CT scans in HCMC, is to wait. Because CT and MRI scans do not provide clear results of cancers, doctors can only know the exact condition via PET/CT scan.
PET/CT is a means for diagnosis, monitoring, and treatment of many diseases, especially early detection of cancers, thanks to the use of 18F-FDG radiopharmaceuticals. While other imaging methods usually apply only to an area of the body, PET/CT scan can examine the whole body, helping diagnose diseases at the cellular and molecular levels, with high sensitiveness, specificity, and accuracy, capable of detecting lesions and pathology at a very early stage.

“PET/CT scanning does not apply to all cancer patients, but this technique helps detect metastatic lesions, assess response and risk of cancer recurrence, and is especially effective when evaluating difficult cases," said Dr. Nguyen Trieu Vu.

In HCMC, there are currently four hospitals equipped with PET/CT systems, including Cho Ray Hospital, People’s Hospital 115, Military Hospital 175, and HCMC Oncology Hospital. However, recently, the scanners of three of these four hospitals have had to suspend operations due to a shortage of radioactive materials. Only Cho Ray Hospital still has radioactive tracers to run its machine. As a result, patients at HCMC-based hospitals with PET/CT orders have flocked to Cho Ray Hospital. Meanwhile, the hospital can only handle about ten patients per day. Some patients accept to wait for a long time for their turns, but others have planned to go to Da Nang or Hanoi to perform this technique.

Meanwhile, some medical facilities in Hanoi, such as K Hospital, Military Hospital 108, and Hanoi Oncology, have PET/CT scanners for cancer diagnosis and treatment. Most of the PET/CT scanners at many hospitals in Hanoi are operating normally, with a large number of patients designated for scanning.

Early drug licensing to run the scanners

Explaining the shortage of radioactive materials for the operation of PET/CT scanners, a leader of HCMC Oncology Hospital said that the 18F-FDG radioactive materials of HCMC Oncology Hospital was supplied by a pharmaceutical company with its branch located in Thu Duc City. However, from the beginning of 2022 to now, this company has not been able to renew the drug registration certificate for circulation.
Therefore, the hospital's PET/CT scanner had operated in moderation for about half a year, then stopped altogether. Faced with the above situation, the hospital sent an official dispatch to the Department of Health of HCMC. The department will continue to report to the Drug Administration of Vietnam under the Ministry of Health (MoH) for solutions.

Deputy Minister of Health Tran Van Thuan said that the ministry had received information that PET/CT scanners for cancer diagnosis and treatment at hospitals in HCMC had to temporarily suspend operations due to the lack of radioactive materials. The MoH has directed and urged competent units to take measures to prevent shortages of drugs, chemicals, and equipment to serve patients and, at the same time, ensure clarity and transparency. While waiting for the radioactive materials to be licensed and imported into Vietnam, the MOH has been considering the option of Cho Ray Hospital sharing radioactive tracer with other hospitals in the city.
Shortage of radioactive materials needs to be resolved urgently ảnh 2 A patient undergoes a PET/CT scan for cancer diagnosis at Da Nang Hospital. (Photo: Da Nang Hospital)
Dr. Nguyen Tri Thuc, Director of Cho Ray Hospital, said that the hospital would share the source of radioactive materials with Military Hospital 175 and HCMC Oncology Hospital to serve patients. However, because the capacity of its radiopharmaceutical generator cannot be expanded, while the demand is increasing, so it cannot be met in time.

In the long term, experts believe that, when investing in PET/CT scanners, hospitals need to take into account investment in the radioactive material generators to minimize the risk of expensive PET/CT scanners being frozen as currently.

Do not abuse PET/CT scanning

According to oncologists, people need to properly understand screening for early detection of cancer and the role of PET/CT scanning because not every case that wants to diagnose and detect cancer early needs to have a PET/CT scan. In order to diagnose and detect cancer early, patients should initially check with common techniques, such as blood and urine tests, abdominal ultrasound, chest X-ray, and electrocardiogram.
If there are abnormalities, doctors will only order other techniques, such as CT scan and MRI, and only when these methods do not detect the disease is it necessary to use PET/CT scanning. Moreover, PET/CT scanning has not yet been recommended globally in screening for cancers. Instead, it is often used in assessing treatment response and monitoring recurrence and progression after the end of treatment, but the diagnostic value is not absolutely correct.

By Thanh An, Minh Khang – Translated by Thanh Nha

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