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Following a major shortage of 99Mo in the 2009–2010 period, concern grew that the aging reactor production facilities needed to be replaced. Most producers were using highly enriched 235U (HEU) as the target material. The Organisation for Economic Co-operation and Development and the International Atomic Energy Agency sought to remedy these issues by removing HEU from medical isotope production and implementing full cost recovery to enable new production entities to compete with the existing multipurpose reactor facilities, which were heavily subsidized by their respective governments. This review examines the various approaches to producing 99Mo and/or 99mTc with a critical eye toward their potential success in (a) producing the medical isotopes and (b) being able to successfully enter and compete in the market. Because many of the new approaches are adapting existing technologies for commercial businesses, some of the details are of a proprietary nature and not available for in-depth technical review.
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