The role of IRE in Nuclear Medicine The success story of a cooperation between South-Africa and Belgium Catherine Gernay Director IRE

Main topics What is IRE ? Medical Isotopes for diagnosis: a global just-in-time supply chain IRE and NTP: a long-standing and successful cooperation

Main topics What is IRE ? Medical Isotopes for diagnosis: a global just-in-time supply chain IRE and NTP: a long-standing and successful cooperation

Belgium: a global actor in nuclear medicine

5 Welcome to Belgium ! Strategic location for logistics  Transport Road network 4 int’l airports < 350km  Research Reactors 3 reactors < 300km 1 reactor < 1000km Other companies on our site:  Cyclotron isotope production  Gamma sterilization  Transport

6 Presentation of IRE A short movie introduction …

National Institute for Radioelements 150 employees Turnover M€ 45 Mission  Contribute to public health Production of radionuclides for nuclear medicine Minimum impact on its workers, local residents and the environment  Environmental monitoring Measurement and monitoring of radionuclides Management of radioactive waste Consultancy projects to improve nuclear safety

Innovation Modernization of production facilities Continuous safety improvement Construction of the new plant which will process LEU targets

A subsidiary of IRE and SFPI Created July 1 st employees 2 main activities  Radiopharmaceuticals production  Services related to environmental monitoring Recent developments:  Partnership in China, Clinical study initiated on pain palliation (Bone Cancer) in Shanghai IRE-ELiT Environment & Lifescience Technology

Main topics What is IRE ? Medical Isotopes for diagnosis: a global just-in-time supply chain IRE and NTP: a long-standing and successful cooperation

Main fields of application of nuclear medicine Images courtesy Prof. R. Baum, Bad Berka (Germany) Imaging modalities – Scintigraphy Approx. 30 Million procedures/year worldwide (Bone, cardiac, lungs, liver, etc) Diagnosis Radio-therapy: treatment of Cancers and pain palliation Approx. 3 Million treatments/year worldwide (Oncology) Therapy

Diagnostic applications SPECT Technologies PET Technologies

SPECT technologies: ire_en.flv PET technologies: Main fields of application of nuclear medicine Approx. 3 Million treatments/year worldwide. => Oncology. Radiotarget V1.mp4Radiotarget V1.mp4 Images courtesy Prof. R. Baum, Bad Berka (Germany) 1. Diagnosis2. Therapy Changed layout

Particle treatment Oncology. An outstanding expertise in Belgium: The protontherapy by 2. Therapy

A Just-in-time process … Processing Generator manufacturer Reactor 235 U Targets 99 Mo Liquid Generator 99 Mo/ 99m Tc RadioPharmacy / Hospital The manufacture of Tc-m99 (SPECT) 80% of the imaging procedures worldwide 150 hours 12 hours 120 hours

Reactors: NRU (CAN), HFR (NL), BR2 (BE), Safari (SA), Osiris (FR), OPAL (AUS) Processors: MDS-Nordion (CAN), IRE (BE), Covidien (NL), NTP (SA), ARI (AUS) Generators: LMI (US), Mallinckrodt NL & US, GE (GB), IBA (FR), NTP (SA), ANSTO (AUS), FUJI RI & NMP (JPN), CIC (China), … Five reactors provide over 90% of the main radioisotopes worldwide HFR 1966 BR OSIRIS 1966 SAFARI 1965 NRU 1957 OPAL 2008 LVR

Reactors: NRU (CAN), HFR (NL), BR2 (BE), Safari (SA), Osiris (FR), OPAL (AUS) Processors: Nordion (CAN), IRE (BE), Covidien (NL), NTP (SA), Ansto (AUS) Generators: LMI (US), Covidien NL & US, GE (GB), IBA (FR), NTP (SA), Ansto (AUS), FUJI RI & NMP (JPN), CIC (China), Monrol (Tu), Ipen (BRA) BR International cooperation is crucial to ensure security of supply

Main topics What is IRE ? Medical Isotopes for diagnosis: a global just-in-time supply chain IRE and NTP: a long-standing and successful cooperation

IRE and NTP : A long-standing and successful relationship  A historical relation initiated by IRE in the 90s  Two partners of similar sizes, backing each other up on the main radio-isotopes  Similar business cultures focused on patient safety and security of supply  The IRE-NTP consortium meets ca. 50% of the world demand in medical radioisotopes  In shortage times, we ramp up to 70% of the world market >> a highly valued cooperation by the nuclear medicine community on 5 continents !!