Guide for good practices in a situation of ^99mTc shortage

Whereas the world nuclear medicine is facing repetitive ^99mTc shortages since the failures of the NRU Canadian reactor at the end of 2007, this publication first presents the context of Technetium-99 supply. It indicates examinations which are classified as priority and non-substitutable. Within this context of tension of supply of ^99mTc generators, it describes principles for a good use of this product, and the adaptation of examination organisation in order to optimise and to rationalise the available activity in nuclear medicine departments. Then, it focuses on some specific cases: bone scintigraphy, myocardial perfusion scintigraphy, brain scintigraphy, nuclear endocrinology, pediatrics, pulmonary embolism, lymphoma scintigraphy and detection of the sentinel node, and irradiation and radiation protection of patients