Atomic medicine

Let's be healthy
Oksana Prilepina, "Rosatom Country"Rosatom is launching several bright projects in the field of nuclear medicine, some with a bid for world leadership.

Nuclear medicine in Russia is in its infancy, at least its world achievements have not been widely used. In developed countries, more than 70% of patients undergo radiation therapy, in Russia, according to various data, from 7 to 23%. Well, what is the point of treating a person with isotopes if the vast majority of Russians turn to an oncologist already at the third and fourth stages of the disease, when surgery is required and radiotherapy is not the main method? Europe is another matter: expensive mass screening — preventive examination is regularly carried out there, where the early stages of the disease are registered. But that's not the only problem. We have a full range of high-quality modern equipment of foreign production only in several medical centers in Moscow and St. Petersburg. "Technically, we have largely lagged behind the West," sighs Professor Sergey Kanaev, head of the Department of Radiation Oncology and Nuclear Medicine of the Federal State University "Russian Scientific Center for Radiology and Surgical Technology". — The throughput of installations is falling. Most of the usual oncological dispensaries have outdated therapeutic devices."

For quite a long time, the nuclear medicine market was perceived as secondary in the nuclear power industry. But things are changing. "Over the past three years, we have convinced the management of Rosatom to invest in medicine," says Alexander Kuznetsov, CEO of the Atommed Center. — This market is comparable in capacity to the market of nuclear technologies themselves. Compare: the capacity of the global nuclear market is $50-60 billion, and radiomedicine is already $25 billion. with a positive dynamics of 15-20% per year. In Russia, this segment is growing by only 5-7%, but it's a matter of time."

A targeted federal program for the development of the medical industry, including nuclear medicine, is just being formed in Russia. The creation of the first federal center for nuclear medicine in Dimitrovgrad is in full swing, with Obninsk and Tomsk next in line. In cooperation with the Federal Biomedical Agency of Russia and leading foreign manufacturers in the domestic industry, the reconstruction of the entire production medical complex - from isotopes to equipment - has begun. Last year, investments in this area amounted to 118 million rubles, this year — more than 700 million. "This figure, I have no doubt, will grow, because the direction is promising and Rosatom has unique competencies in it — not only in Russia, but also on a global scale," confirms Denis Kovalevich, Director of the Strategic Management Department of Rosatom.

"Burning offer"Molybdenum-99 is the most popular "commodity" for nuclear medicine, because it generates short—lived technetium-99m.

And technetium-99m is the main "workhorse", with the help of which up to 30 million procedures are carried out in the world per year, or 80% of the total volume of all diagnostic procedures using radionuclides. (According to some estimates, the turnover of the world market of isotopes and pharmaceuticals exceeds $3 billion. per year). The minimum requirements for molybdenum-99 in the world now amount to about 600 thousand. Ci/year. In addition, the market is steadily growing by 5-7% annually.

Traditionally, the prestigious molybdenum/technetium market is divided between Canada, European countries and South Africa, but Canada, which met up to 40% of the world's demand for Mo-99, had problems with the main operating reactor (NRU), and the niche, one might say, suddenly became vacant. Rosatom has made proposals to occupy it for a maximum of two years, which was supported by the Commission on Modernization and Technological Development of the Economy under the President of Russia. The responsible executor of the project was determined by JSC "All-Regional Association "Isotope". The project provides for the creation of production facilities at the site of JSC "SSC NIIAR" (State Scientific Center "Research Institute of Nuclear Reactors", Dimitrovgrad). The Institute did not postpone the matter, realizing the exorbitantly high price of "pitching". It so happened that almost all reactor medical isotopes in the world are produced at research reactors, and not at industrial ones. And scientists are constantly forced to choose for what purposes to spend capacity: for production, that is, market, or scientific. Dimitrovgrad is no exception. However, the Research Institute has reserves, the use of which will practically not affect the implementation of Rosatom's scientific programs, but the institute's economy can be significantly supported.

"We will use two reactors in the production of molybdenum as the main operating units, if necessary, it will be possible to connect a third one, which will create an almost continuous production," says Rostislav Kuznetsov, project manager at JSC SSC NIIAR. — We will start in the first quarter of next year, we plan to increase production to 1 thousand. Ki per week. In 2012, we will bring the volume to 2.5 thousand. Ci, that is, up to 20% of the world market. This is embedded in the technology." In December 2009, within the framework of the project, a contract was already signed with the leading manufacturer of specialized radiochemical equipment, the German company ITD, for the manufacture and supply of equipment for the first stage of the project. On April 7, 2010, the first batch was accepted — a container for the transportation of irradiated targets. On April 28, the container and part of the equipment will leave the factory in Germany, the rest will arrive in the summer.

A hot chamber for mounting equipment has been fully prepared at the NIIAR site, a machine for catching targets has been manufactured, the reactor technology of molybdenum-99 has been substantiated, the design and technology of manufacturing a target made of an alloy of uranium and aluminum has been developed.

Having engaged in a "burning offer", NIIAR will not abandon other projects. Of course, the implementation of programs related to materials science research, development and testing of new fuels, etc. will continue. The production of topical medical isotopes will also continue: ioda131, iodine-125, tungsten-188, strontium-89. "In Europe, tungsten-188 (rhenium-188 generator) and lutetium-177, which we produce and supply to our customers, are now being actively introduced into medical practice," says Rostislav Kuznetsov. — Taking into account the features and capabilities of the reactor and radiochemical base of NIIAR, we are extremely interested in alpha-emitters — decay products of thorium-228 and thorium-229. The technology of their large-scale production has not yet been mastered anywhere, but when this happens, it will be possible to start creating and introducing into clinical practice methods of influencing directly malignant tumor cells, practically not affecting healthy ones."

Serial productionIn addition to the Research Institute of Electrophysical Equipment, no one in Russia produces linear accelerators and cyclotrons.

In the mid-90s, the Institute, together with Philips, produced more than 60 linear therapeutic accelerators SL/75/5 as part of the Challenge-1 project. They were placed in clinics all over the country, and no more state orders for mass production were received by NIIEF. 20 years have passed, and again there was a whiff of change.

NIIEFA has developed the Efatom gamma tomograph, which can be used in the diagnosis of a wide range of diseases. Now its only copy is in the Moscow Clinical Hospital No. 83, but the issue of serial production is already being resolved at the highest level. Efatom has already been included in the "Register of Medical Equipment" of the Ministry of Health and Social Development of the Russian Federation and called the most important activity of Rosatom.

"Our gamma camera is not inferior to foreign analogues in clinical programs, and this is the most important thing for a doctor," says Mikhail Vorogushin, scientific director of the Scientific Research Center of the LUTS NIIEF. — In order to meet Russian needs, it is necessary to produce 300 "Efatoms". We will need to buy new production equipment, and even then we will make no more than 30 pieces a year, because we still do a lot of things."

Accelerators at 6 MeV carry out 75-80% of all irradiations of the radiological department, penetrating 7 centimeters under the skin. If you need to get deeper, then the power of the device should be more — 20 MeV. All these devices are made at the Institute, however, in single copies. "How promising is it to produce high—tech equipment in Russia?" - I ask Mikhail Vorogushin goodbye and get a counter question: "How promising is the health of the nation?"

Portal "Eternal youth" http://vechnayamolodost.ru21.02.2011