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Yes, medical cyclotrons can produce technetium-99m (Tc-99m) directly, offering a second supply route when reactor-produced molybdenum-99 (Mo-99) and its generators are disrupted. That does not make cyclotrons a universal replacement. Each site needs suitable accelerator energy and particle type, target systems, high-current irradiation capability, chemical processing, purification, quality control, trained staff, radiation protection, waste handling and regulatory approval.
The practical answer is supply diversification: a prepared network of capable cyclotron centres could preserve access to established Tc-99m radiopharmaceuticals during a future Mo-99 shortage, while reactor-based production remains an important part of the system.
Why a Tc-99m shortage is a clinical problem
Tc-99m is central to diagnostic nuclear medicine. The US National Nuclear Security Administration (NNSA) says more than 40,000 US medical procedures use it each day. Hospitals rely on a dependable chain: reactors make Mo-99, Mo-99 is loaded into generators, and the generator supplies Tc-99m for preparation of radiopharmaceuticals used in imaging.
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That chain is vulnerable to outages at a small number of major reactors, transport interruptions, target-processing failures and scheduled maintenance. In a September 8, 2025 release, NNSA said two overseas production reactors shut down simultaneously in 2024—one scheduled and one unscheduled—causing a major global Mo-99 shortage with significant effects in the United States. The event illustrated why a single production pathway can become a clinical bottleneck.
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A medical cyclotron changes the point at which Tc-99m enters the chain. Instead of waiting for Mo-99 to decay inside a generator, a suitably equipped cyclotron centre irradiates a target and then chemically recovers and purifies Tc-99m for radiopharmaceutical production.
For the patient, the intended result is continuity: the same established Tc-99m-labelled medicines can remain usable. The International Atomic Energy Agency (IAEA) writes that alternative methods could “enable the continued use of all existing radiopharmaceuticals designed for 99mTc in nuclear medicine, for example, as diagnostic imaging agents, if another shortage should arise.” Read the full technical report, Cyclotron Based Production of Technetium-99m (2017).
How direct cyclotron production works
1. Select and prepare a target
The facility starts with a target designed for the cyclotron’s beam. Target material, geometry, cooling and containment must match the machine’s particle type and energy. Targetry is not a bolt-on accessory: it determines how much material can be irradiated, how heat is removed at high beam currents and how safely the target can be transferred to a hot cell for processing.
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The cyclotron bombards the target for a planned period. The IAEA’s 2017 guidance addresses irradiation at high beam currents because useful production requires more than simply having an accelerator on site. Beam stability, target cooling, shielding, scheduling and maintenance all affect whether a run can be completed consistently.
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3. Dissolve and process the irradiated target
After irradiation, operators move the target into shielded processing equipment. Chemical treatment separates the desired technetium from the target material and other radionuclides. The process must be engineered for remote handling, radiation safety, repeatability and recovery of reusable materials where appropriate.
4. Purify and verify the product
Purification is essential. The product needs chemical purity and specific activity suitable for labelling molecules used in medicine. Analytical testing checks radionuclidic identity, chemical impurities, concentration, sterility-related controls and other release specifications required by the applicable regulator. A cyclotron run is therefore only one stage; processing and quality release determine whether the material is clinically usable.
5. Formulate, release and distribute
Once quality tests pass, the Tc-99m solution can be supplied for preparation of radiopharmaceutical doses. Distribution planning must account for the product’s radioactive decay, transport time, dose scheduling and backup arrangements. A centre that can make Tc-99m but cannot release or deliver it on the required timetable does not provide a dependable clinical supply.
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Cyclotron production and the established Mo-99 generator route
| Aspect | Reactor-produced Mo-99 and generator supply | Direct cyclotron-produced Tc-99m |
|---|---|---|
| Where Tc-99m enters the chain | Inside a generator as Mo-99 decays to Tc-99m | At the cyclotron centre during target irradiation and chemical processing |
| Primary dependency | Reactor operation, Mo-99 processing and international transport | Suitable cyclotron, targetry, processing cells, purification and release systems |
| Potential role during a shortage | Existing backbone, but exposed to reactor or logistics outages | Complementary local or regional source that can diversify supply |
| Use of existing Tc-99m radiopharmaceuticals | Established pathway | IAEA says alternative methods could preserve use of existing Tc-99m radiopharmaceuticals |
| Published cost comparison in the sources cited here | Not stated | Not stated |
| Published production-yield comparison in the sources cited here | Not stated | Not stated |
The comparison does not establish that one route is cheaper, produces more material or can replace the other everywhere. The IAEA presents cyclotron production as an alternative route and discusses using spare capacity at medical cyclotron centres; it does not provide a universal economic or yield verdict.
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Why a large cyclotron fleet does not equal immediate Tc-99m capacity
An IAEA report published in 2021 counted more than 1,300 cyclotron facilities worldwide and reported that many facilities devote about 15 to 20 hours per week to radionuclide production. Those figures show a potentially useful installed base, not a ready-made Tc-99m network. A facility may be busy with other radionuclides, lack the required energy or particle type, or have no shielded chemistry suite for technetium processing.
Capability checks that determine feasibility
- Accelerator configuration: verify beam energy, particle type, current and irradiation controls against the target design.
- Targetry: confirm target material, cooling, transfer, containment and the ability to handle repeated high-power runs.
- Processing and purification: provide shielded cells, remote or automated chemistry, validated separation steps and contamination controls.
- Quality control: install analytical instruments and validated methods for identity, purity, concentration and release testing.
- Staffing: cover cyclotron operations, radiochemistry, quality assurance, radiation protection, engineering and maintenance.
- Regulatory systems: obtain approvals for production, handling, transport, waste and clinical release in the relevant jurisdiction.
- Physical infrastructure: allow space for hot cells, ventilation, shielding, waste storage, clean areas and secure material transfer.
- Scheduling and logistics: reserve beam time, coordinate dose preparation and establish transport routes that fit clinical timetables.
Spare hours on a calendar are useful only after these constraints are solved. Converting an existing research or diagnostic facility into a reliable supplier can require new equipment, validated procedures and a different quality-management system.
Can cyclotrons solve an Mo-99 shortage?
They can reduce dependence on a disrupted Mo-99 pathway, but the evidence supports a complementary role rather than a wholesale replacement. A shortage response would work best as a network: several qualified centres produce on coordinated schedules, laboratories prepare doses, and hospitals have validated procedures for receiving and using the product.
What the route can do
- Provide a production option that does not depend on an operating Mo-99 reactor for every dose.
- Use existing Tc-99m radiopharmaceutical formulations, subject to local product and release requirements.
- Make regional supply more resilient when international reactor output or transport is interrupted.
- Use selected spare capacity at medical cyclotron centres, where the technical and regulatory prerequisites are present.
What it cannot do by itself
- Guarantee national coverage from the existence of cyclotrons alone.
- Remove the need for target manufacturing, radiochemistry, quality control, trained personnel or regulation.
- Show, without site-specific studies, how much of a shortage could be covered.
- Establish a cost or yield advantage over reactor-derived supply.
These limits matter because a shortage is measured in delivered clinical doses, not in accelerator count. Capacity must be demonstrated from target irradiation through release and transport.
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US supply-resilience projects: date the claims carefully
Federal programmes to expand domestic Mo-99 production are a separate, reactor-independent response to supply risk. NNSA’s September 8, 2025 announcement described support for US production and quoted Kasia Mendelsohn, NNSA Acting Deputy Administrator for Defense Nuclear Nonproliferation:
“We’ve spent years working with U.S. companies to reshore Mo-99 production using advanced technology that doesn’t require weapons-usable nuclear material. But NNSA hasn’t been alone in its efforts. Other agencies and departments are a big part of aiding the rebirth of this innovative U.S. industry.”
That release also discussed a proposed $10 Medicare add-on for radiopharmaceuticals derived from domestically produced Mo-99 beginning January 1, 2026. It was described as part of a proposed rule, so it should not be presented as final policy without checking the current Centers for Medicare & Medicaid Services status.
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Outbyte PC Repair FREERepair Windows errors before they cause bigger problemsFix Now →Outbyte Driver Updater FREEScan for outdated or missing drivers - takes under a minuteDriver Scan →In an April 9, 2026 update, NNSA said the Department of Energy had made a conditional commitment for a loan of up to $263 million for SHINE’s Chrysalis facility. The commitment was not evidence that funds had been disbursed: technical, legal, environmental and financial conditions remained before definitive financing documents and funding. The same release said production was expected after additional completion. NNSA’s September 2025 release had described the Janesville project as approximately 75% complete at that time; that was a dated construction status, not a current completion claim.
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These domestic Mo-99 efforts and cyclotron Tc-99m production address the same vulnerability from different angles. A resilient system can need both diversified reactor supply and qualified non-reactor options.
How a hospital or regional planner should evaluate the option
- Map clinical demand. Record daily Tc-99m examinations, radiopharmaceutical formulations, delivery windows and the minimum acceptable reserve during an interruption.
- Inventory nearby cyclotrons. Ask about accelerator energy and particle type, beam current, targetry, shielding, hot-cell capacity, current radionuclide work and available production hours.
- Commission a target-and-chemistry design. Confirm target fabrication, cooling, irradiation, dissolution, separation, purification, automation and waste routes before treating the project as a supply commitment.
- Define the quality system. Specify analytical methods, batch records, release authority, deviation handling, sterility controls and compatibility with the radiopharmaceuticals your clinicians use.
- Secure regulatory approval. Identify every licence and inspection covering radioactive material, manufacturing, transport, occupational exposure, environmental discharge and clinical administration.
- Test logistics under time pressure. Model production, quality release, courier travel, dose preparation and delivery for normal days and for a failed run or delayed shipment.
- Keep a dual-source contingency. Maintain procedures for generator-derived supply where available, cyclotron supply when qualified and temporary conservation or scheduling changes during a wider disruption.
This process turns “we have a cyclotron nearby” into a measurable question: can the site repeatedly deliver released Tc-99m doses that match the hospital’s clinical schedule?
What is established—and what remains unanswered
| Question | What the cited sources establish |
|---|---|
| Is direct production technically possible? | Yes. The IAEA published technical guidance covering target preparation, high-current irradiation, processing, recovery, separation and purification for cyclotron-based Tc-99m. |
| Can existing Tc-99m medicines remain usable? | The IAEA states that alternative methods could enable continued use of existing Tc-99m radiopharmaceuticals. |
| How many potential facilities exist? | The IAEA reported more than 1,300 cyclotron facilities worldwide in 2021. |
| How much spare production time is typical? | The IAEA reported that many facilities devote about 15 to 20 hours per week to radionuclide production in its 2021 report. |
| What share of a future shortage could cyclotrons cover? | Not quantified in the cited sources; facility count and spare hours cannot be converted into a coverage percentage without site-specific data. |
| Which route is cheaper or has higher yield? | No defensible comparative cost or production-yield statistic is provided in the cited sources. |
Further reading for technical teams
The IAEA paperback Cyclotron Based Production of Technetium-99m (ISBN 978-92-0-102916-4) is aimed at scientists, cyclotron technologists, facility managers and graduate students. Its 2017 report is available as a PDF at the IAEA publication page. The IAEA’s broader 2021 discussion is available in Alternative Radionuclide Production with a Cyclotron.
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1Clear out junk files and repair common Windows errors2Fix the driver behind crashes, sound loss and screen glitches3Repair Windows errors before they cause bigger problemsBottom line: Cyclotrons are a credible way to diversify Tc-99m supply and buffer future Mo-99 disruptions, but only a coordinated, regulated production-and-distribution system can turn that technical possibility into dependable patient access.
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