because (as noted in Chapter 2) Mo-99 is used exclusively for diagnostic medical imaging, and all of the Mo-99 produced for this purpose is incorporated into technetium generators.

Table 5.1 provides information on historical (2002–2005) and forecast (2006–2012) growth rates for nuclear medicine procedures. The table shows total nuclear medicine procedures in the United States, the subset of those procedures2 that utilize Tc-99m (Tc-99m procedures), and Tc-99m doses.3 Several important observations can be made from this information:

  • Tc-99m was used in about two-thirds of all nuclear medicine procedures performed in the United States in 2005; this ratio is expected to decline to slightly less than 60 percent by 2012 (although in absolute numbers, there is a projected growth in procedures using Tc-99m). This relative decline is reflected by the slightly lower annual projected growth rates for Tc-99m procedures (sixth column in Table 5.1) compared to the annual projected growth rates for all nuclear medicine procedures (third column in Table 5.1). According to Bio-Tech Systems, this decline will primarily be due to the increased use of fluorine-18 labeled fluorodeoxyglucose (FDG) for some imaging procedures. FDG is described elsewhere in this chapter.

  • Annual growth rates for Tc-99m dose utilization (last column in Table 5.1) are expected to increase at a slightly higher rate (about 1 percent) than the annual growth in Tc-99m procedures. This could reflect a change in the proportion of cardiology procedures (which are projected to decrease as a percentage of all Tc-99m procedures; in 2005 they comprised about 60 percent of such procedures) to other general nuclear medicine procedures.

  • Historical annual growth rates for Tc-99m doses were above 8 percent early in this decade but are projected to decrease to between about 4 and 6 percent between 2006 and 2012. This growth rate is below the projected rate of growth of Tc-99m generator sales (see Table 5.2), which are projected to increase between about 7.5 percent and 9.4 percent per year between 2006 and 2012. As noted in the tables, the growth in sales for Tc-99m dose utilization is not expected to keep pace with Tc-99m generator sales growth rates.

The estimates for projected growth in Tc-99m from the Bio-Tech Systems report (4–6 percent) are slightly lower that the growth estimates


A nuclear medicine procedure is a medical procedure that utilizes medical isotopes such as Tc-99m. The terms “procedures” and “studies” are used interchangeably. A number of common Tc-99m procedures are listed in Table 2.1.


A Tc-99m dose contains millicurie (mCi) quantities of Tc-99m. Typical Tc-99m doses for diagnostic imaging procedures range from about 15 to 30 mCi.

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