Enhancing Access to Cancer Diagnostics with Drone Delivery of PET Isotopes: The Significance of Weather and Clinical Workflows

The short half-life of positron emission tomography (PET) radioisotopes makes transport time a critical factor in medical logistics. While drones have demonstrated advantages in short-range medical deliveries, the feasibility and benefits of long-distance drone transport remain largely unexplored. In a comparative simulation-based modelling framework, this study explores whether long-range drone transport (117–376 km) can improve delivery performance of fluorodeoxyglucose-18 ([18F]FDG) PET isotopes compared with two existing ground-only routes (146 km and 348 km) and two combined car–airplane routes (532 km and 546 km). Simulated transport times, radioactive decay losses, and economic implications were estimated using drone speeds of 150, 200, and 250 km/h. Hourly weather data from 2023–2024 were incorporated to model flight feasibility and weather-related no-fly conditions. Time savings were translated into preserved radioactive activity and analyzed together with break-even transport costs. A drone speed of 150 km/h provided limited benefit, whereas speeds of 200–250 km/h preserved activity corresponding to a reduction from the current total use of 118 GBq to 72 and 65 GBq, respectively. Weather constraints reduced feasible winter flights by up to 30%. Estimated break-even drone costs ranged from EUR 3–18/km and increased to EUR 14–20/km when accounting for preserved isotopes, corresponding to annual economic gains of EUR 1.0–1.7 million. These results suggest that long-range drone transport could reduce isotope losses and improve diagnostic capacity, although feasibility depends on drone costs, weather resilience, and integration into clinical logistics systems.