Conjoncture d'approvisionnement et essor de l'imagerie TEP : quel avenir pour le technétium-99m en médecine nucléaire ?

Molecular imaging has shown its interest in the diagnosis, staging and therapy monitoring of many diseases, especially in the field of cancer. This imaging modality can detect non-invasively early molecular changes specific to these diseases. Its expansion includes two aspects linked firstly with the advanced techniques of imaging modalities and secondly with the development of tracers as radio pharmaceuticals for imaging new molecular targets. Technetium-99m (99mTc), because of its physical characteristics, its widespread availability and low cost, is the most used radionuclide in molecular imaging with the technique of single photon emission computed tomography (SPECT). Nevertheless, the current difficulty concerning the supply and the great interest of Positron Emission Tomography (PET), the “competitor” imaging modality-using molecules labelled with fluorine-18 (18F), legitimates the question about the future of 99mTc, its supremacy and the emergence of new tracer labelled with 99mTc. Focusing on the actual and future supply situation, the place of SPECT imaging in nuclear medicine, as well as the development of new molecules labelled with 99mTc is necessary to show that this radionuclide will remain essential for the speciality in the next years.