How Bangladesh is Breaking Down Barriers to Nuclear Medicine

Future plans for NINMAS include the installation of another PET/CT machine and the establishment of a cyclotron facility for producing key radiopharmaceuticals — specialized drugs containing small amounts of radioactive material used to create medical scan images. This will allow them to expand patient care and continue to meet growing demands associated with the increasing number of cases of cardiovascular diseases, cancer, tuberculosis and diabetes, among others. These health conditions account for around 75% of nuclear medicine procedures in the country.

“With the new PET/CT machine, we expect to nearly double the number of patients we can service with our machines each week. This is very important because the population continues to grow, which means more people will need care,” said Nasreen Sultana, Associate Professor at NINMAS. “The in-house cyclotron will help us to cost-effectively produce radiopharmaceuticals used for PET scans. This will help complement what we are already getting from the research reactor nearby.”

Producing radiopharmaceuticals

The majority of the radiopharmaceuticals used in Bangladesh’s nuclear medicine centres now come from the radioisotope production laboratory housed in the Bangladesh Atomic Energy Commission’s Institute of Nuclear Science and Technology in Savar, just outside of Dhaka. The laboratory relies on a 3-megawatt (MW) research reactor to develop and supply radiopharmaceuticals used in the over 500 000 procedures performed at NINMAS and the other publicly-funded and private nuclear medicine centres every year.

“We used to only produce very small amounts of radiopharmaceuticals and could only supply Dhaka. Now we have been able to cut imports and sustainably meet the growing demand of the whole country without interruption,” said M. Azizul Haque, Head of the Radioisotope Production Division of the BAEC’s Institute of Nuclear Science and Technology.

In addition to iodine-131, which is a radioisotope primarily used to diagnose and treat thyroid conditions, the laboratory produces generators of molybdenum-99 (Mo-99)/technetium-99m (Tc-99m). Tc-99m is a radioisotope used in over 80% of nuclear medicine procedures. Each week between 18 to 20 generators — a device used to extract Tc-99m from Mo-99 for use in medicine — are produced at the laboratory at significantly lower costs than importing the already completed generators. The facilities were established through IAEA technical cooperation projects.

Through its collaboration with the IAEA, the laboratory has also established an ISO-certified clean room facility for producing Tc-99m cold kits, which are used for preparing Tc-99m radiopharmaceuticals for use in diagnostic procedures.

Now the laboratory is working with the IAEA to setup a new facility to produce lutetium-177 (Lu-177), another radioisotope used for palliation of bones for terminal cancer patients. The facility is a few months away from completion.

“We also have a plan for a new 20 to 30 MW reactor within the next 10 years. Then we can produce the isotopes locally, and then we may be able to supply it to other countries,” said Azizul Haque.