Lars Ahlgren

Ferrous sulphate gels for determination of absorbed dose distributions using MRI technique: basic studies

Two gels have been found to be suitable to load with ferrous sulphate solution. In these soft tissue equivalent phantoms, the absorbed dose distribution can be measured after irradiation in clinically used MR imaging equipment. The present studies were carried out using a 0.25 T NMR analyser without imaging properties. A ferrous sulphate solution, 0.05 M with respect to sulphuric acid, can be gelled with 4% gelatin to give a dosemeter which has a response which is linearly correlated (r = 0.998) with the absorbed dose in the interval 0-40 Gy. Ferrous sulphate solution can also be gelled with 1% agarose, but this gel has to be purged with oxygen to obtain a linear relationship (r = 0.997) in the same absorbed dose interval. The ferrous sulphate loaded gels have a sensitivity which is a factor of 2.2 or 4.0 times higher for gelatin and agarose, respectively, than the ordinary dosemeter solution. Because the standard deviation of background measurements is higher for the gels than for the dosemeter solution, the minimum detectable absorbed dose is about the same, or 1.0 Gy, for the two gels and the dosemeter solution. The sensitivity of the ferrous sulphate loaded gels shows no dependence on dose rate if the mean dose rate and the absorbed dose per pulse are within the limits normally used by accelerators for radiotherapy.

An X-ray fluorescence technique for in vivo determination of lead concentration in a bone matrix

We have previously reported the in vivo detection of lead in the skeleton of man by means of X-ray fluorescence analysis using a 740 MBq 57Co source for excitation and a 1 cm(3) Ge(Li) detector for registration of the Pb Kalpha and Kbeta radiation. The varying geometry, density and atomic composition of the tissues of interest (mainly fingers) introduce several problems in estimation of the true concentration of a given element. A two-component cylindrical finger phantom was therefore constructed from silica paraffin wax and animal bone ash. The diameter of the finger bone was estimated from X-ray examinations in two orthogonal projections. The bone mineral concentration was then estimated from the quotient of the number of coherent and Compton scattered primary photons. The lead concentration in the finger bones was then derived from a measurement on a finger phantom made of silica paraffin wax and bone ash with the same size and bone mineral concentration as the real bone. The minimum detectable lead concentration in a finger bone was 14 microgram g(-1) for 15 min measuring time. The lead concentration measured in workers from a metal industry was found to be in the range of 40-100 microgram g(-1).

Decrease of skeletal lead levels in man after end of occupational exposure

Lead levels in finger bone were monitored using an in vivo X-ray fluorescence technique in retired lead workers. Eight subjects followed for 2-5 yr directly after end of exposure all displayed a decrease. Their average half-time was 7 (range 3-15) yr. In a second group of six persons, followed from year 7 to year 13 after finishing lead work, a decrease was seen in all but one. The average half-time for this group was 8 (range 2 infinity) yr. The mean value for both groups was 7 yr. The results show that there is a decrease of lead in bone after the end of exposure and that it is considerably faster than estimated earlier from various data on lead metabolism.

Lead in Vertebral Bone Biopsies from Active and Retired Lead Workers

Samples of vertebral bone were obtained by skeletal biopsy and lead concentrations were determined by atomic absorption spectroscopy. The median level of lead in bone in 27 active lead workers was 29 micrograms/g wet weight (range 2-155), corresponding to 370 micrograms/g calcium (range 30-1,120). In 9 retired workers, the corresponding levels were 19 micrograms/g (5-76) and 250 micrograms/g calcium (60-700); in 14 reference subjects without occupational exposure, 1.3 micrograms/g (1-4) and 13 micrograms/g calcium (8-40). The bone lead content rose with time of exposure. Comparison of levels in vertebra with those in fingerbone, as measured by in vivo x-ray fluorescence in the same subjects, strongly suggested the presence of lead pools with different kinetics. The accumulation pattern, as well as the relation between levels in vertebra and fingerbone, suggests a much shorter half-time of lead in the mainly trabecular vertebral bone as compared to the mainly cortical fingerbone. Further, there was an association between vertebral and blood lead levels in the retired workers, which shows a considerable endogenous lead exposure from the skeletal pool.

Absorbed dose to technicians due to induced activity in linear accelerators for radiation therapy

Absorbed dose to the trunk and to the hands of technicians working with accelerators for radiotherapy have been measured with TL dosimeters for seven different accelerators. The contribution from induced activity in the accelerator and from radiation transmitted through the walls of the treatment room have been estimated separately. The total annual absorbed dose to the trunk and to the hands have been estimated to be 2 mGy, of which the induced activity contributes one-third (0.7 mGy). The exposure of the technicians was found to be dominated by radiation penetrating the walls of the treatment room. For one accelerator the absorbed dose rate in the treatment room was measured continuously between 0.5 min and 48 h after end of treatment. Immediately after irradiation with high-energy photons the radiation is dominated by 28Al and 62Cu T1/2 = 2.3 and 9.7 min respectively) and later by radionuclides with longer half-lives, 187W and 57Ni (T1/2 = 24 and 36 h respectively). Due to these radionuclides the radioactivity in the accelerator will build up and the technicians will therefore be irradiated every time they enter the treatment room and not only directly after a treatment with high-energy photons.

Biological monitoring, by in vivo XRF measurements, of occupational exposure to lead, cadmium, and mercury

In vivo X-ray fluorescence (XRF) techniques were used for biological monitoring of lead, cadmium, and mercury. Lead accumulates in bone, the level of which may thus be used for monitoring of exposure. However, there was no close association between lead levels in bone and exposure time, partly because of differences in exposure patterns and partly, probably, because of variations in the toxicokinetics of lead. There are at least two separate bone lead compartments. The average over-all half-time is probably 5–10 yr. The finger bone level may be an index of the lead status of the total skeleton. In lead workers, the mobilization of bone lead causes an “internal” lead exposure and affects the blood lead level considerably. In cadmium workers, in vivo XRF is a sensitive and risk-free method for assessment of accumulation in kidney cortex, the critical tissue as to toxic effects; workers displayed increased levels. However, there was no clear association with duration and intensity of exposure, cadmium levels in urine, or microglobulinuria. Determinations of kidney cadmium may add important information on the state of accumulation and, thus, risk of kidney damage. Workers exposed to elemental mercury vapor, as well as fishermen exposed to methyl mercury, had mercury levels in bone below the detection limit of the XRF method.

Repeated quantitative bone scintigraphy in patients with prostatic carcinoma treated with orchiectomy.

Bone scintigraphy was performed in 16 men with newly diagnosed prostatic carcinoma before orchiectomy as well as 2 weeks and 2 months after operation. The uptake in the lower thoracic and lumbar vertebrae was registered up to 240 min after injection of 99mTc-MDP and was then calculated for each patient and vertebra. The relative standard deviation in measured uptake due to measuring technique was estimated to be±7%. In eight patients, who had normal bone scintigraphies before orchiectomy, there were no changes in the uptake values after operation. The remaining eight patients had widespread metastatic involvement prior to treatment. Six of these patients showed a so called “flare phenomenon” in the abnormal vertebrae which means an initial increase in uptake after operation followed by a decreased uptake in response to therapy. One patient had a continuously increased uptake in all the abnormal vertebrae which correlated well with the clinical progression of the disease, while in another patient both reactions were seen. Thus, repeated quantitative bone scintigraphies using 99mTc-MDP can be made in a reproducible way and can be a useful tool to follow a patients response to treatment.

Induced activity in a high-energy linear accelerator.

Activation products which contribute significantly to the exposure of the staff operating the accelerator were found in the accelerator head in the transparent holder for the lead blocks and in the 60 degrees wedge filter made of lead. A proper choice of material in these parts of the accelerator could easily reduce this exposure without excessive changes in the construction. The absorbed dose-rate level should always be checked before maintenance is carried out inside the accelerator head.

Dynamic quantitative bone scintigraphy in patients with prostatic carcinoma treated by orchiectomy

Dynamic quantitative bone scintigraphy was performed on 31 men with prostatic carcinoma before orchiectomy as well as 2 weeks, 2 and 6 months post-operatively. After injection of technetium methylene diphosphonate Tc 99m (99mTc-MDP) the count rate was recorded as serial images over the lower thoracic and all the lumbar vertebrae from 1 to 240 min post-injection. Thirteen men had normal bone scintigrams with no changes in99mTc-MDP content at the four different investigation times. Eighteen men had skeletal metastases. Throughout the study half of the abnormal vertebrae in these patients showed an abnormal count rate after only 6 min post-injection. After 1 h it was possible in almost all abnormal vertebrae to predict abnormal bone uptake. In response to therapy a “flare phenomenon” with an increase in count rate was seen 2 weeks after orchiectomy followed by a decrease 2 months post-operatively in most of the abnormal vertebrae. The count rate decreased even below the pre-operative level after 6 months. Also, the normal vertebrae in the patients with skeletal metastases showed a tendency towards the flare phenomenon, which was not seen in patients with normal bone scintigrams.

Further Improvements of XRF Analysis of Cadmium In Vivo

Although clinically useful, current equipment and methods for X-ray fluorescence (XRF) analysis in vivo should be improved in order co: 1) obtain better detectability of heavy elements, and thus extend the measurements to new groups of persons and to new elements, 2) make the equipment transportable and easier to handle in busy work-places or as bedside instruments at hospitals when seriously ill patients are to be examined. The stepwise introduction of new instruments and methods for in vivo XRF analysis has resulted in considerable improvements of the detectability for some elements but not for others.