Your next cancer scan shouldn’t depend on Moscow’s permission

Patients scheduled for a scan or cancer treatment do not need to know how nuclear supply chains work. They need care on time. The problem is many radioactive materials used in modern medicine have a defined shelf life; they degrade over time — technically, they “decay” — so disruptions in delivery reduce the window of time in which these products can be used. Even more troublesome, most of these products come from outside the United States, making them subject to the vagaries of logistics and geopolitical pressure.That is why a development outside Lockhart, Texas, deserves attention. In August, a low-power reactor reached criticality less than a year after construction began, but it will not supply power to the Texas grid. Its purpose is to help develop the capability to produce critical radioisotopes here at home, closer to the hospitals, laboratories — even shipyards and oil and gas fields that need them.The Groves Isotope Test Reactor, built by Oklo, is a test facility designed to develop the operating experience and technical foundation for future radioisotope production. The achievement is encouraging because it shows America can still build the facilities it needs. It also comes as the country has grown too dependent on foreign suppliers for critical isotopes used in medicine, industry, research, and national security. Radioisotopes are specialized versions of common elements. Doctors use them to see inside the body, diagnose disease, and deliver certain cancer treatments. Manufacturers use them to inspect pipelines, welds, and other equipment without taking them apart. They also support scientific research, space missions, explosives detection, and national security priorities.The problem is that America does not make enough. Production is concentrated in a small number of overseas facilities, many of them aging research reactors. A delay at one plant, a problem in processing, or a disruption in shipping can quickly become a problem for hospitals and laboratories here.Molybdenum-99 shows how quickly that can happen. It’s used to produce Technetium-99m, the material physicians use in many diagnostic scans. Much of the world’s supply comes from a handful of research reactors outside the United States. When a Dutch reactor’s restart was delayed in 2024, providers were warned to prepare for shortages.A maintenance problem at a European reactor should not become a scheduling problem for American hospitals. Yet that is the risk when supply depends on a small number of aging facilities outside the United States.Worse yet, is when the facilities America relies on for critical radioisotopes are maintained in adversarial nations. Russia is a major supplier of certain specialized isotopes, while China is building capacity of its own. For some materials, there are few alternative producers anywhere in the world.Two Russian reactors provide the bulk of global supplies of Iridium-192, an isotope used in industrial radiography to test welds, castings, and forgings, making it essential to America’s oil and gas industry. Yet America hasn’t produced Ir-192 in more than 20 years. Russia also dominates production of Polonium-210, an isotope used in industrial devices in the paper and textile industry. More importantly, it serves as a lightweight heat source in radioisotope thermoelectric generators for spacecraft. As America renews its push for the stars, with plans to not only return to the moon but to establish a base there, materials to fulfill space exploration requirements will grow more critical. America must address these supply chain vulnerabilities, as it has begun to address overreliance on China for active pharmaceutical ingredients and rare earth minerals. To do so, it will need to reduce impediments to commercial investment in the construction of new nuclear facilities, while maintaining high safety standards and protocols. The reactor outside Lockhart went from construction to criticality in less than a year. It shows what can happen when an administration develops a clear vision, acts decisively, and then gives the private sector room to run. The Nuclear Regulatory Commission should follow the success demonstrated by the DOE’s pilot program with rapid certifications of next generation of reactors and isotopes facilities.PRICE CAPS SOUND GREAT — UNTIL YOU HAVE CANCER AND A TWO-YEAR WAITLISTAmerica needs enough domestic isotope capacity to ensure that an outage at a foreign reactor, a decision in Moscow or Beijing, or a breakdown in overseas shipping does not determine whether an American patient gets a scan on time, a pipeline comes online, or a space mission gets completed.The reactor outside Lockhart will not solve that problem by itself, but it demonstrates that the country is fully capable of rebuilding this capacity. We need only sustain the political will to ensure our regulatory regime maintains high safety standards, without pumping the brakes on America’s nuclear Renaissance.John Czwartacki is co-founder and President of Public Policy Solutions.