(Dan Tri) – Over the past 40 years, Vietnam has only produced one type of radioactive medicine used in clinical treatment, and it only meets part of the needs of patients at nuclear medicine departments across the country.
Recently, the Ministry of Science and Technology said that Vietnam and Russia are cooperating to implement the Nuclear Science and Technology Research Center project, with the goal of building a nuclear reactor to support research.
Accordingly, the new nuclear reactor is expected to have a capacity of 10 MW, using low-enriched fuel manufactured by Russia. After the site survey and preliminary design, the reactor will be located in Long Khanh City, Dong Nai Province. The reactor's main task is to produce radioactive pharmaceuticals, used in cancer treatment and diagnosis.
This is considered very good news, because every year Vietnam discovers 180,000 new cancer cases, but the treatment efficiency is only about 40%, much lower than the 70% rate recorded in the world.
Dan Tri reporter contacted Dr. Nguyen Xuan Canh, Head of the Department of Nuclear Medicine, Cho Ray Hospital (HCMC) to learn about the current status of nuclear technology application in medicine, as well as the necessity of building a new nuclear reactor.
There is information that Vietnam will soon build a new nuclear reactor in Dong Nai province, a locality bordering Ho Chi Minh City, which could increase the output of radioactive drugs by 5-7 times compared to the present. What do you think about this?
– Radioactive isotopes have many applications in life, such as nuclear power, agriculture, industry... In medicine, radioactive isotopes are applied in a wide range of fields, including Nuclear Medicine, Oncology, Neurosurgery and Blood Transfusion...
For many years, the Dalat Nuclear Research Institute has produced radioactive isotope I-131 (iodine-131), supplying many hospitals to treat patients with thyroid cancer and Basedow's disease. However, due to insufficient production, some hospitals have had to import additional radioactive isotopes from abroad to serve patients.
The construction of a new nuclear reactor is of great significance, not only ensuring the domestic demand for I-131 but also producing many other types of radioactive isotopes, for both treatment and diagnosis.
Please analyze more clearly the mechanism of using radioactive isotopes in diagnosis and treatment of diseases so that people know.
– Specifically for diagnosis, we use a diagnostic radioactive isotope (emitting gamma rays) to label a biological or chemical substance (also known as a binder or conductor that the normal body or pathological tissue uses) to create a radioactive drug.
After that, the patient is given this radioactive drug by injection or oral route and doctors can record the locations of radioactive drug concentration through imaging equipment systems such as: iodine concentration meter in the thyroid gland, SPECT, SPECT/CT (to diagnose and monitor bone, kidney, thyroid, heart diseases); PET/CT (to diagnose and monitor breast, lung, colorectal, nasopharyngeal, esophageal, prostate, endocrine and liver cancers).
Also used in the diagnosis of some cardiovascular and neurological diseases. This is a method of imaging molecules, metabolism and function at the cellular level.
If we use a therapeutic radioisotope (emitting beta or alpha rays) or a radioisotope that has both diagnostic and therapeutic functions, such as I-131, to label a biological or chemical substance, we will create a radioactive drug that can be used to treat certain types of cancer.
According to him, radioactive isotopes bring many benefits in medicine. But how is the production of radioactive isotopes for application in our country today?
– As mentioned above, the Dalat Nuclear Research Institute (the only place in Vietnam that researches and creates radioactive products) only supplies the radioactive isotope I-131, which is enough to partially meet the needs of medical treatment.
In addition, there is another radioactive isotope for diagnosis, F-18, which is produced in some domestic facilities with circular accelerators (Cyclotrons), used to synthesize the radioactive drug F-18 FDG (a substance similar to glucose) used for patients in PET/CT diagnostic imaging. This radioactive drug has a half-life (T1/2) of 2 hours and a usage time of less than 8 hours.
Currently, all departments of Nuclear Medicine are capable of preparing radioactive drugs for patients to record diagnostic images on SPECT and SPECT/CT machines. However, they have to purchase raw materials such as Tc-99m radioisotope generators from abroad (such as Europe, Korea) and binders and conductors.
Each Tc-99m radioactive isotope generator costs 50-60 million VND, for use by 100-200 patients for about 2 weeks and cannot be extended, because the radioactive isotope has lost its activity. Importing is also very difficult, because strict conditions on radiation safety must be ensured.
In Vietnam, in addition to Cho Ray Hospital, which has been equipped with a Cyclotron since 2009, a number of facilities across the country such as the 108 Military Central Hospital and Da Nang General Hospital also have Cyclotrons. The cost to equip this system is about 200 billion VND, with an average construction time of 6 months.
Recently, Cho Ray Hospital has also been equipped with a Ga-68 radioactive isotope synthesis system. We had to purchase raw materials such as a Ga-68 isotope generator (with a 9-month usage period) and biological substances to successfully prepare and use the Ga-68 PSMA radioactive drug (used in diagnosing prostate cancer) and Ga-68 Dotatate (diagnosing neuroendocrine tumors).
Why does Vietnam have to depend on most of its radioactive isotopes from foreign countries, sir?
– We have asked this question for a long time. The Dalat nuclear reactor has a small capacity and has been in use for many years, so it cannot meet the production of radioactive isotopes for diagnosis and treatment of dozens of nuclear medicine departments across the country.
Second, we need to research and produce radioactive drugs for treatment that are widely used in the world, such as Sm-153 EDTMP (treatment for pain relief in bone metastases), Lu-177 Dotatate used to treat neuroendocrine tumors, or Lu-177 PSMA in the treatment of prostate cancer... In fact, in addition to I-131, the Dalat Nuclear Research Institute also prepares many other radioactive drugs, but they have not been applied to patients.
So, is investing in the production of radioactive drugs in our country feasible, sir?
– Patients’ demand for radioactive drugs is very high. At the Nuclear Medicine Department of Cho Ray Hospital alone, each month there are an average of 200 patients requiring treatment for thyroid diseases (mainly thyroid cancer) with I-131. Treatment costs are completely feasible if the drug source is self-sufficient.
Therefore, Vietnam really needs to invest in building a center for producing radioactive drugs for treatment and diagnosis on a national scale. In terms of technology, I believe we are capable of meeting the demand.
I just hope that every year, our country can produce a new type of radioactive medicine for use in patients, without having to do extensive research. Only then will it bring practical results in curing patients.
Thanks for sharing.
Speaking to Dan Tri reporter, Dr. Pham Thanh Minh, Director of the Center for Research and Preparation of Radioactive Isotopes, Da Lat Nuclear Research Institute, said that over the past 40 years (since its restoration and operation in 1984), the Institute has only produced one radioactive drug product used in treatment, which is I-131. The reason is that the capacity of the Institute's nuclear reactor is too small (heat capacity of 500 kWt), so it cannot produce other treatment products.
Therefore, when Vietnam builds a large-capacity nuclear reactor, it will focus on producing many new radioactive isotopes, used in both diagnosis and treatment.
Dr. Minh affirmed that our country is completely capable of self-sufficiency in radioactive isotope production technology. However, the project in Dong Nai is only in the initial planning stage, and there is no information about the construction implementation time.
Content: Hoang Le
Design: Thuy Tien
Photo: Hoang Le, Cho Ray Hospital, Dalat Nuclear Research Institute
Source: https://dantri.com.vn/suc-khoe/lo-phan-ung-hat-nhan-viet-nam-va-mong-moi-cua-chuyen-gia-y-hoc-20240801161602355.htm
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