Thank you, Serge.
The chart on page 3 shows four key messages that I'll leave with you. The overall message is that nuclear medicine is one of many imaging technologies used in medicine. It is used in addition to X-rays, CT scans, MRIs, and ultrasounds.
The largest use of nuclear medicine procedures is for cardiac imaging. That's the biggest share of the pie that you see, about 56%. These scans are used to look at the blood flow through the heart during stress tests.
The second-largest use is shown as the big blue one, bone scans, which make up about 17%. They are used to detect progression of cancers going to the bone, or even just fractures of bones as well. Then all the rest of the uses are general organ scans. As opposed to MRIs and CTs, which look at how an organ looks, these procedures actually look at how an organ functions for a range of diseases, including cancer.
We'll turn to page 4. As my colleague said, Tc-99m, or technetium-99m, which is derived from moly-99, is really the predominant isotope for about 80% of nuclear medicine procedures. It has a shelf-life of about six hours--moly-99 is 66 hours--and that's why there's a supply disruption: it can't be stockpiled like vaccines. The supply disruption right now is of significant concern to patients and to doctors across the country.
There are, however, alternatives that can be used for some of these contingency planning purposes. They can't be used for ongoing replacement, but for most procedures in cardiac imaging--which, as you saw, is the area in which nuclear medicine procedures are most used--thallium-201 is an acceptable alternative, and it is being used now across the country as part of the contingency plans that are being rolled out by the medical community and by the provinces and territories.
Another alternative is 18-F fluoride, which uses PET cameras, another imaging modality. They are being made available through clinical trials for bone scanning. We also have some that are being used by.... The alternative really is to go to MRIs and CT scanning.
There is, however, a requirement for Tc-99m. There are some procedures for which there is no viable alternative. I'm thinking specifically about kids and pediatric bone scanning for cancers. In that case, the medical community and the provinces and territories are taking the available supply and targeting it to the priority procedures and making maximum use of the available isotopes. They're using longer scans, lower dosage, and longer operating hours. They're working weekends, working 24/7 in some cases, and the hospitals and the regions are sharing the patient load and the generators as well.