The nuclear médicine bone scan using 99mTc diphosphonate radiopharmaceuticals has been a key diagnostic procedure in a wide range of pathological conditions; trauma, metastatic spread of cancer, avascular disease, metabolic disease, degenerative disease, infection to list a few. Indeed, In Australia and no doubt many countries around the globe, the 99mTc bone scan is the most frequently performed nuclear medicine scan. Early gamma camera-based radiopharmaceuticals included 67Ga citrate and 18F sodium fluoride (NaF). 67Ga citrate has weak calcium analogue properties that were enhanced by inclusion of carrier in previous production methods. Today, carrier free 67Ga citrate sees insufficient bone accumulation for adequate bone scanning, however, from time to time enhanced bone accumulation may be noted following gadolinium enhanced MRI imaging that provides an insight into the limited capabilities of the former tracer. 18F NaF was approved in the 1970s by the USA FDA and, despite enhanced localisation properties, suffered the poor sensitivity of imaging 511 keV gamma emissions on a gamma camera compared to the 140 keV of 99mTc. The global 99mTc crisis has been widely reported and discussed, and is associated with dated reactors and lack of new reactor installations in the northern hemisphere leading to recurring 99mTc supply stress [1]. In Australia, high production capabilities in the new OPAL reactor at ANSTO generally mean there is no shortage of 99mTc . Moreover, when faults invariably occur in high end technology, Australia has had a partnership with the South African facility (NTP) that has seen 99Mo bulk transported to Australia to create an almost seamless 99mTc supply locally. Nonetheless, in early 2010 Australia suffered a 99mTc crisis with the national reactor closed for routine maintenance causing ‘shock waves’ through the nuclear medicine community

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