A boom in demand for medical isotopes could have sales of isotopes paying 60 percent of operating costs at Hanford's Fast Flux Test Facility within 10 years of a restart, according to a new report.

By 2015 to 2020, the entire $88 million annual cost of FFTF operations might be covered by medical isotopes, the report found.

It was drafted by the FFTF Standby Project Office, a joint operation of Pacific Northwest National Laboratory and Fluor Daniel Hanford.

In January, Energy Secretary Federico Pena asked the office to compile a feasibility study to help him decide in 1998 whether to order further studies on restarting the FFTF or shut it down for good.

At question is whether the FFTF could be restarted with a mission of producing tritium for weapons and phase in a second mission of producing isotopes for medical diagnosis and treatment.

The report concludes the project is feasible - with the reactor producing as many as 30 kinds of medical isotopes. And the medical isotope mission could be largely turned over to a private company.

Earlier studies have questioned whether enough need exists to use the FFTF for radioactive isotopes. But Frost & Sullivan, a company that analyzes health care markets and contributed to the report, predicted demand will escalate, potentially leaving the United States with inadequate medical supplies.

Now the United States imports 90 percent of the isotopes it uses from countries such as Canada and the former Soviet Union, which are not prepared to produce the amount of isotopes Frost & Sullivan predicts the United States will need.

The company predicted a boom in sales of isotopes from 7 percent to 15 percent a year over the coming decade. Sales of isotopes used for diagnosing disease - for instance, using radioactivity to produce an image that doctors can see - will jump from $530 million in 1996 to around $17 billion in 2020.

But the most dramatic growth is expected in the exotic isotopes that could be used not to diagnose disease, but to treat it.

As new ways to treat cancer are developed, the fledgling therapeutic market is expected to grow from $48 million in 1996 to about $6 billion in 2020, the report said.

"It's the chicken and the egg dilemma," said Walt Apley, director of the standby project office.

The medical community uses too few isotopes to operate the reactor initially just for medical isotopes. But part of the problem is that promising research is being stymied by a lack of reliable medical isotopes.

For instance, radioactive isotope copper 67 was producing good results in treating lymphoma patients at the University of California Davis Medical Center, but clinical trials had to be stopped because supplies of isotopes were too unreliable to systematically treat patients in the study.

Researchers also would like to test copper 67 for treating arthritis, breast cancer and colon cancer.

The report proposed the reactor initially be used for producing a wide range of medical isotopes for research. A reliable supply of reasonably priced isotopes should encourage doctors to test new uses of the isotopes, the study concluded.

As the doctors find disease treatments that work and gain Food and Drug Administration approval for the isotopes, demand should kick in for FFTF to produce the isotopes on a large scale.

"Without the FFTF, the capital investment associated with obtaining these isotopes is cost-prohibitive," the study said. "In effect, there is a potential for a very large market for these isotopes, but since their availability is questionable and the initial capital investment is high, the market potential is not being realized. ... Only when these trials are completed and the isotope is approved by the FDA for routine clinical use, can the market grow."

The FFTF would be essential for providing as many isotopes as possible during the early clinical trials, the study found.

Frost and Sullivan found 90 trials already under way for using medical isotopes for treating diseases such as brain disorders, heart disease, arthritis and, primarily, cancer.

Some of the most promising research uses radioactive isotopes for the difficult task of killing cancer cells that have left the main tumor. In the treatment, isotopes are attached to antibodies that travel through the body seeking cancer cells. When they find one, the antibodies latch on and the isotope they carry bombards the cancer cell with radiation. In theory, the cancer cell is killed but fewer healthy cells are damaged than in conventional external radiation or chemotherapy treatments.

The report found 30 isotopes with potential medical applications that could be produced at FFTF, but proposed focusing primarily on producing the most promising 20. They were picked both for their market demand as projected by Frost & Sullivan and their expected profitability.

Some of the 20 medical isotopes could be made less expensively at other reactors in the United States.

But overall the FFTF "can produce the purest and highest specific- activity isotopes for nuclear therapy," according to Frost & Sullivan. "Other reactors may be less expensive to run, yet the reliability, quality, and quantity of FFTF isotopes make this reactor the best choice for isotope production."

During the decade that FFTF operated until being shut down in 1992, operators demonstrated it could produce 40 medical isotopes.

Facilities would have to be improved, however, to provide medical-grade isotopes for clinical use. Start-up costs would include $15 million to $20 million for rapid retrieval systems for short-lived medical isotopes; improvements of $25 million to $30 million for two buildings and the Fuels and Materials Examination Facilities; and $5 million to $15 million to buy initial target materials, some of which could be recycled.

The isotope mission also would require more staff to produce the medical isotopes, then package, market, sell and distribute them.

"These activities are prime candidates for privatization," the report found.

Privatization could be similar to that at the Advanced Test Reactor at the Idaho National Engineering Laboratory. There, the Department of Energy through its contractor, Lockheed Martin, tests nuclear fuel for the Navy. The reactor also produces diagnostic medical isotopes, through a subcontract with MAC Isotopes for the last year.

The private company at FFTF, as at Idaho, would prepare the material for irradiation, then it would be given back to the company for packaging and distribution.