cine technologies find more widespread application, especially in developing countries. At present, almost all of the Mo-99/Tc-99m produced in the world is consumed by developed countries. There is a huge potential market for these isotopes in those countries that hold most of the world’s peoples such as India and China. Their demand for Mo-99 will almost certainly increase substantially as the increasingly affluent segments of their populations demand improved health care. The relative low cost and ease of use of Tc-99m installations that rely on conventional gamma cameras will give these modalities a competitive advantage over PET, CT, and MRI.

What is not clear at this point is whether these developing countries will develop indigenous production of Mo-99 or will purchase this isotope on world markets. If countries choose to purchase Mo-99 there could be significant impacts on Mo-99 supplies, supply reliability (Chapter 4), and prices in the United States. Although these impacts are likely to occur on timescales that are beyond the 5-year focus of this report, they should be of intense interest to Mo-99 producers who are contemplating conversion from highly enriched uranium (HEU)- to low enriched uranium (LEU)-based production or the construction of new facilities. It seems likely that, absent the development of truly superior imaging technologies, there will continue to be a flourishing long-term global market for these isotopes.

Finally, although it is beyond the scope of this report, decisions by developing countries to produce Mo-99 domestically also have implications for HEU minimization. It will be important for the U.S. government, especially the Department of State and the Department of Energy-National Nuclear Security Administration, as well as the International Atomic Energy Agency to encourage these countries to take the LEU path for Mo-99 production.

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