Fears have been raised that the lives of cancer patients are being put at risk after vital scans were cancelled and delayed at the Royal Liverpool Hospital.
PET CT scans require radioactive isotopes to function, but regular "supplier issues" have meant types of the scan have been cancelled by the hospital trust - and others are subject to long delays.
The Medicine and Healthcare Products Regulatory Agency (MHRA) has also identified concerns with the hospital's Nuclear Medicine Department, which is struggling to provide the vital service.
The scans provide extremely accurate readings of how far some cancers, particularly prostate cancer, have spread in the body and are vital to making decisions about treatment.
One patient, University of Liverpool economics and social history professor Robert Lee, was put through the trauma of not knowing the next step in his cancer battle for months.
He told the ECHO: "Their waiting lists are just growing and growing, but consultants are still referring patients to them even though scans are not being done."
Professor Lee, from Birkenhead, required a particular kind of PET scan, called a Gallium 68 PSMA scan, but has since learned the Royal has not been able to offer it since the start of the year.
The 73-year-old said: "The message from the Royal was you need to go to the University College Hospital in London but they are also having a tough time obtaining the isotopes.
"For people who have financial difficulties, who don't have the resources, each week they lose is potentially life threatening or life shortening because a decision about their treatment is delayed."
Prof. Lee decided to take matters into his own hands and began ringing round other hospitals, eventually persuading his consultant at Clatterbridge Cancer Centre to refer him for a scan at Manchester's Christie Hospital.
He said he fears other patients less able to find a solution could suffer due to spiralling waiting lists.
He said: "The consequences are potentially very serious indeed...
"A prolonged delay in treatment in cases where this might have life-shortening implications; unnecessary suffering because of the failure to prescribe new therapies that can help to hold cancers in check; a higher incidence of depression, because of the uncertainty of knowing when a scan referral will be implemented.
"It's all a bit tense and worrying, and I have been diagnosed with depression."
The issue appears to relate to specialist providers which use a cyclotron, a particle accelerator machine which produces radioactive isotopes, which have experienced technical difficulties.
Risk reports presented to the hospital trust board this month stated: "PET CT requires the use of an isotope which is produced in very few areas around the country.
"18F FDG production has now resumed at the Keele cyclotron and the Preston site has closed for six months for refurbishment.
"Keele production is not 100% reliable and we are being backed up from production sites in Sutton and Guildford which are 4-5 hours away by road."
The report went on to say: "When the isotope is available extra lists are being put on PET CT to try and maintain the cancer target times. Risk remains high due to uncertainty around the availability of the isotope availability from external partners.
"In addition our own radio pharmacy department is challenged with supporting the department due to restrictions from MHRA. However the external supply although unstable has improved - but we continue to monitor risk."
Dr Paul Fitzsimmons, chief operating officer at the Royal Liverpool & Broadgreen University Hospitals Trust (RLBUHT) said: "We apologise to Prof. Lee for the delay he has experienced.
"There are a number of issues surrounding the supply of isotopes for PET-CT scans. There is an intermittent supply disruption via external providers, which has led to the delay of some PET-CT scan appointments.
"All those patients have been re-booked for a new date and we have worked hard to minimise the impact of these delays on our patients. We continue to work with suppliers to monitor this situation.
"In December 2018, the MHRA identified issues with our processes and capacity for producing isotopes within our nuclear medicine department.
"One of the recommendations made by the MHRA was to temporarily stop producing Gallium in order to focus on producing more commonly used isotopes.
"In the meantime we have been advising referring clinicians to refer patients for Gallium 68 PSMA scans to other centres. We aim to restart this service in the New Year.
"We have been working closely with the MHRA to enhance our processes for producing isotopes and an independent review in June highlighted our good manufacturing practice."
Prof. Lee is awaiting the results from his scan at the Christie.
