How Is The Future Of Nuclear Medicine Evolving?
By Aishwarya Kulkarni, MarketsandMarkets
Nuclear medicine, with its fusion of medical imaging and therapeutic techniques, is reshaping the way diseases are diagnosed, treated, and managed. From detecting early signs of cancer to pinpointing neurological disorders with exceptional accuracy, nuclear medicine is propelling healthcare into a new era of precision and personalized care.
The global nuclear medicine market has experienced remarkable growth in recent years, driven by advancements in imaging and therapeutic techniques, rising prevalence of chronic diseases, and the increasing demand for personalized medicine. According to new analysis by MarketsandMarkets,1 the global nuclear medicine market is expected to reach $9.4 billion by 2028 from $5.5 billion in 2023, at a CAGR of 11.3% during the forecast period. Of the two major segments of the market (diagnostic and therapeutic), the diagnostic segment, comprising SPECT (single-photon emission computed tomography) and PET (positron emission tomography), accounted for the largest share in 2022. North America has captured the largest share of the market, while Asia Pacific is poised to witness the fastest growth over the coming years.
The nuclear medicine market is characterized by the presence of several prominent players such as Siemens Healthineers, GE Healthcare, Philips Healthcare, Curium, Cardinal Health, Bayer AG, Lantheus Holdings, Inc., and Bracco Imaging S.p.A., among others that are heavily investing in R&D activities and focusing on establishing strong sales & distributions channels across the globe. Some recent developments include:
- In January 2023, NorthStar Medical Radioisotopes achieved a major milestone in advancing its new technology for non-uranium-based production of the critical medical radioisotope, molybdenum-99 (Mo-99).
- In November 2022, Curium announced that the FDA approved DaTscan (Ioflupane I-123 injection) to assist in evaluating adult patients with suspected Parkinsonian syndromes.
- In January 2021, Advanced Accelerator Applications (AAA) signed a multiyear exclusive supply agreement for lutetium-177 with the University of Missouri Research Reactor (MURR). Through this agreement, MURR became a supplier of AAA for GMP-quality lutetium-177 chloride, the precursor for developing Lutathera and other Lu-177-based therapeutics.
Let’s look at key market drivers, market restraints, and emerging trends and technologies.
Market Drivers
The growth of nuclear medicine has been driven by several factors, including the growing prevalence and incidence of target conditions. Nuclear medicine plays a crucial role in diagnosing and treating various chronic diseases such as cancer, cardiovascular disorders, and neurological conditions. With the rising incidence of these diseases globally, there is a growing demand for nuclear medicine procedures, including PET and SPECT scans. The need for accurate and early diagnosis, disease staging, and effective treatment monitoring drives the adoption of nuclear medicine technologies.
While the early and effective diagnosis and treatment of cancer play a significant role in improving the survival rate for cancer patients, current treatment options such as chemotherapy and surgery can also have adverse reactions, such as the mutation of healthy/noncancerous cells. On the other hand, radioimmunotherapy-based (RIT) treatment facilitates the targeted and effective cellular treatment of cancer. Alpha RIT, with emitting radioisotopes, offers the advantage of high-energy deposition in a short path length. Owing to this advantage, radiation can be directed toward cancerous cells without affecting the healthy cells around them and helps in targeting treatment to a specific area.
Initiatives to reduce the gap in demand and supply for Mo-99 have also played a significant role as growth drivers. Prominent market players and other stakeholders are adopting strategies and making investments to ensure a viable supply of Mo-99 in the U.S., such as increasing manufacturing capacity. This has helped guarantee the supply to the global industry by replacing the capacity loss after the National Research Universal (NRU) research reactor in Canada and the OSIRIS research reactor in France ceased production of Mo-99 due to maintenance and repairs. The Association of Imaging Producers and Equipment Suppliers (AIPES, U.K.) coordinates the international scheduling of reactors that produce Mo-99 to help plan adequate target irradiation capacity and minimize supply risks. Major Mo-99 producers around the world participate in this initiative to plan for the replacement of closed reactors and coordinate actions to increase capacity and secure the Mo-99 and Tc-99m supply in the future. The initiatives of AIPES will ensure a systematic and stable supply of radioisotopes.
Further, nuclear medicine enables personalized medicine by providing targeted imaging and therapy options based on an individual's unique characteristics. Radiopharmaceuticals can be tailored to specific molecular targets, allowing for precise diagnosis and treatment planning. The shift toward personalized medicine is driving the demand for nuclear medicine techniques.
Overall, drivers of the nuclear medicine market encompass prevalence of chronic diseases, technological advancements, demand for personalized medicine, research & development investments, government initiatives, and the advantages offered by nuclear medicine.
Market Restraints
While the potential for nuclear medicine is vast, there are also certain constraints on its widespread adoption. One of the primary challenges is the short half-life of radiopharmaceuticals. Not using radioisotopes within their given shelf-life period leads to radiation and chemical decomposition, lowering radiochemical purity to an unacceptable form, which may prove lethal during diagnosis and therapy. Additionally, the shorter half-life of radiopharmaceuticals creates a need for radiopharmaceutical production in cyclotrons/generators within hospital premises, further increasing the capital expenditure for hospitals.
In addition, nuclear medicine involves the use of complex imaging equipment and radiopharmaceuticals, which can be costly to develop, produce, and maintain. The high up-front costs associated with nuclear medicine equipment and infrastructure can be a significant restraint for healthcare providers or facilities looking to invest in this technology.
Another concern is the limited availability of radioisotopes. Nuclear medicine heavily relies on the availability of specific radioisotopes for various imaging and therapeutic applications. The production and distribution of these radioisotopes can be challenging, and there have been instances of supply shortages or disruptions of certain radioisotopes such as Tc-99m (technetium-99m), widely used for imaging and diagnostic purposes. Limited availability or inconsistent supply of radioisotopes can restrict the expansion and accessibility of nuclear medicine procedures.
The potential and limitations of nuclear medicine are underscored by these constraints. However, with ongoing technological advancements and initatives by governments and private companies, we can expect to witness further advancements as we move closer to achieving the envisioned future.
Emerging Trends And Technologies In Nuclear Medicine
In recent years, several emerging trends and technologies have been shaping the field of nuclear medicine. One such emerging trend is theranostics, which integrates diagnostics and therapeutics into a single approach. It involves the use of radioactive tracers to identify specific targets (diagnostics) and subsequently deliver targeted therapies. This approach allows physicians to personalize treatment plans by assessing a patient's response to therapy in real time. Theranostics is particularly promising for the treatment of certain types of cancer, such as neuroendocrine tumors and prostate cancer.
Molecular imaging techniques, such as PET and SPECT, have been advancing rapidly. These techniques enable the visualization and quantification of molecular processes within the body. With the development of new radiotracers and imaging agents, molecular imaging is becoming more specific and sensitive, allowing for earlier and more accurate disease detection.
In addition, hybrid imaging combines two or more imaging modalities to provide complementary information and improve diagnostic accuracy. For instance, PET-CT and PET-MRI are commonly used hybrid imaging techniques. These approaches merge functional and anatomical information, providing a comprehensive view of disease processes. Hybrid imaging is particularly valuable in oncology, cardiology, and neurology.
Developments in alpha-emitting radionuclides have shown promising outcomes in delivery of a highly localized dose of radiation to cancer cells and minimizing damage to surrounding healthy tissues. Alpha-emitting radionuclides have high linear energy transfer and a short range in tissue, making them suitable for targeted therapy in certain cancers. Examples of alpha-emitting radionuclides used in nuclear medicine include actinium-225 and lutetium-177.
Furthermore, targeted radionuclide therapy that uses radioactive substances to selectively bind to specific cells or receptors in the body is trending. By delivering radiation directly to diseased cells, targeted therapy minimizes damage to healthy tissues. For instance, several clinical trials and studies have demonstrated the efficacy of Lu-177 (lutetium-177)-based targeted therapy in patients with advanced or metastatic neuroendocrine tumors (NETs). Lu-177, a radioactive isotope emitting beta particles, penetrates and damages nearby cancer cells. This has shown success in controlling symptoms, reducing tumor size, and extending progression-free survival in patients who have failed other treatment options. As a result of these positive outcomes, targeted radionuclide therapy has gained momentum in the field of oncology and is becoming increasingly adopted as a standard treatment for certain types of cancers.
Radiomics and artificial intelligence (AI) are other emerging trends in the field of nuclear medicine. Radiomics involves the extraction and analysis of a large amount of quantitative data from medical images. AI algorithms can then process this data to extract meaningful information and make predictions about patient outcomes. In nuclear medicine, radiomics and AI have the potential to aid in image interpretation, treatment planning, and response assessment, leading to more precise and individualized patient care.
Lastly, efforts are being made to enhance the production and availability of radiopharmaceuticals. This includes the development of compact cyclotrons for on-site production of short-lived isotopes, such as fluorine-18, and the use of generator systems to produce longer-lived isotopes, such as technetium-99m. For instance, in February 2023, BWXT Medical (Canada) and Laurentis Energy Partners (Canada) completed the TC-99m Generator Program to produce Mo-99 isotopes at Ontario Power Generation’s (OPG) Darlington Nuclear Generating Station using Darlington’s CANDU reactors. Because of the exclusive design of Darlington’s CANDU reactors, medical isotopes can be generated without interrupting the generation of clean energy. Production of Mo-99 at Ontario’s Darlington Nuclear Generating Station, a world-first for a commercial power reactor, is poised to create a stable global supply of radiopharmaceuticals to identify illnesses like cancer and heart disease, among others. Such advancements aim to increase the accessibility of nuclear medicine procedures in a timely manner.
Final Thoughts
Nuclear medicine stands as a remarkable field at the forefront of medical advancements, revolutionizing diagnostics, treatment, and research. As the field continues to evolve, with ongoing research and technological advancements shaping the future of personalized medicine, nuclear medicine is forging a path toward a brighter and healthier future. The emerging trends and technologies in nuclear medicine hold great promise for improving patient outcomes and expanding the applications of nuclear medicine in the future. As technology continues to advance, we can anticipate further breakthroughs in this field. With ongoing commitment to safety, accessibility, and innovation, nuclear medicine holds tremendous potential in shaping the future of healthcare, ultimately enhancing the well-being of individuals worldwide.
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About The Author:
Aishwarya Kulkarni is team lead, healthcare, at MarketsandMarkets. She has more than five years of experience in market research and consulting in the healthcare space. Specializing in the healthcare and life sciences sectors, she possesses comprehensive knowledge spanning medical devices, pharmaceuticals, biotechnology, healthcare IT, digital health, and health services.