Tim Meyer and Dr Nigel Lockyer

"Isotope Valley": A vision for Canadian success in science, technology and innovation

By Tim Meyer & Dr Nigel Lockyer

The story of medical isotopes is a ripe example of the challenges and opportunities Canada faces in translating world-class scientific excellence into economic growth and enhanced quality of life. We are at a pivotal moment in this evolving story which has all the key ingredients of a high-stakes adventure that typifies how Canada deals with its historical strengths, modern-day research breakthroughs, domestic regulatory hurdles, and the confusing malaise (or maze) of international markets. Let's take a closer look.

Canada enjoys a worldwide reputation in nuclear science and technology, from Candu reactors to the steady production of 30%-40% of the world's medical isotopes (globally, more than 30 million patient doses per year). TRIUMF, Canada's national laboratory for particle and nuclear physics, is an integral part of Canada's global stature as one of the world leaders in utilizing isotopes for science and medicine.

As a performer of basic research, TRIUMF enables Canadian (and international) study of the mechanisms that cause stars to explode, and the detailed structure of nuclei, as well as testing symmetries of space, matter, and time. But what makes this research excellence a hot bed of innovation dubbed "Isotope Valley"?

The general public is perhaps more familiar with TRIUMF's medical-isotope program. With its partner Nordion, Inc, over 2.5 million patient doses of medical isotopes or 15% of Canada's export are produced in Vancouver using small medical cyclotrons with about 90 employees.

The cyclotrons are from Advanced Cyclotron Systems Inc. ACSI is located in Richmond BC and controls 15-20% of the global sales with a staff of more than 100 employees manufacturing cyclotrons. ACSI has risen to prominence because it sells the highest intensity machines of this kind (based on TRIUMF designs) and the good news is that its share of new sales is growing. In addition, Best Medical Inc has opened a cyclotron-design centre in Vancouver, leveraging the pool of local expertise.

TRIUMF has been providing the world renowned Pacific Parkinson's Research Centre at UBC with imaging isotopes for over 20 years. Before acquiring its own ACSI-manufactured cyclotron, the BC Cancer Agency's growing nuclear-medicine program relied on TRIUMF for clinical cancer diagnosis and staging. And Genome BC has been exploring labeling of DNA with isotopes in collaboration with TRIUMF and BC Cancer. Indeed, the Vancouver region is emerging as "Isotope Valley."

And here's where the plot thickens from research excellence to potential business relevance. One of these myriad medical isotopes is technetium-99m (Tc-99m), used in over 30 million cardiology and oncology procedures worldwide every year. Doctors appreciate its ease of use and it is found in just about every hospital. However, it is only produced in nuclear reactors using highly enriched weapons-grade uranium through a nuclear-fission process.

The Government of Canada is expected to cease production with the aging Chalk River NRU reactor in 2016. This decision is driven by the age of the reactor, the expense to maintain it, and the desire worldwide to limit the transportation and use of weapons-grade uranium. So what will happen next?

Following the advice of an international expert panel, Natural Resources Canada funded several teams to come up with alternative production methods. Recently, one team led by TRIUMF that includes the BC Cancer Agency, London Lawson Medical Centre and the Centre for Probe Development and Commercialization at McMaster University, announced success with an approach that uses conventional medical cyclotrons. The team produced enough Tc-99m overnight for an urban area the size of Vancouver. No nuclear material is used at all.

However, the new supply chain is quite different to the existing one — actually, quite disruptive. Rather than a central reactor making huge quantities for central distribution, the new paradigm would have every major medical centre, whether it is a hospital or a university, using an already-existing medical cyclotron to make Tc-99m. There are already 18 cyclotrons spread across Canada and hundreds in the US. Presently, medical cyclotrons are primarily used to produce medical isotopes for positron emission tomography. Adding Tc-99m production is easy and requires only a few hours per day.

When it is time to retire the NRU's isotope mission in 2016, all the regulatory paperwork needs to be in place for the alternative cyclotron method.

Is there a business angle? Yes, but now we face Canada's Achilles heel — how does innovation transfer from the universities into real business? Researchers have done their job and invented a new method, thereby solving a problem for society, and have proven that it works. But how does this invention get picked up by the private sector?

Not so easily it turns out. One has to make money in the private sector. World governments heavily subsidize reactors, making the cost of Tc-99m artificially low.

One fact is definitely a Canadian problem. This new method is not attractive to investors if Canada were the only market. Our population is far too small (about 5% of the global demand). The US does not have this problem.

Can these research relationships be turned into business arrangements for companies working with academia? One way to help provide a key international "check box" is for the new Tc-99m product to be used first here in Canada where our health standards are some of the highest in the world. We can return to the research-excellence tableau: TRIUMF brings international relationships to the table in developed and developing countries. And Canadian universities have broad international research agreements as well. But capital must be raised. Does that come from the private sector or government or both? Perhaps, but who blinks first, government or private investors?

This set of circumstances may sound unique but every commercialization effort from academia faces similar challenges, and every invention must break into the international market to be profitable. Once we solve that problem, Canadian ingenuity driven by our superb university system will be able to compete globally with the best — in key areas where we have a track record.

Tim Meyer is head of strategic planning & Communication at TRIUMF and Dr Nigel Lockyer is its outgoing director.