The feasibility of in vivo detection of lanthanum using a 241Am K x-ray fluorescence system

Long-term stability of hydroxyapatite bone phantoms for the calibration ofin vivox-ray fluorescence spectrometry-based systems of bone lead and strontium quantification

Hydroxyapatite (HAp) phantoms have been proposed as an alternative to plaster of Paris (poP) phantoms for the calibration of x-ray fluorescence-based systems for thein vivoquantification of bone lead and strontium which employ a coherent normalization procedure. The chemical composition of the material becomes critical in the calculation, or omission, of the coherent correction factor (CCF) required in this normalization procedure. This study evaluated the long-term chemical stability of HAp phantoms. Phantoms were prepared and allowed to age for a two week period and over a seven year period in ambient conditions. The chemical composition of the phantoms was then assessed by powder x-ray diffraction. Two week old phantoms were found to be composed of HAp with only a small amount of contamination from CaHPO4·2H2O. Seven year old phantoms were found to have converted nearly completely to a carbonate-bearing apatite in the form of Ca10(PO4)6(CO3)0.75(OH)0.5indicating that the HAp phantom material likely reacts with carbon dioxide in air over time forming a carbonate-bearing apatite. The influence of this chemical conversion was assessed at the level of relevant cross-sections. Calibration under the assumption that the material is HAp when in fact it is a carbonate-bearing apatite would result in not more than a 0.2%-2% bias in the total mass attenuation coefficient within the photon energy range of 0-100 keV. Differential scattering cross-section for coherent scattering was found to differ between HAp and carbonate-bearing apatite by 0.9%-2% for both a 35.5 keV and 88.0 keVγ-ray. This variation in the differential scattering cross-section for coherent scattering may introduce a ca. 2% bias in the CCF used within the coherent normalization-based calibration procedure. Using HAp phantoms as calibrators thus requires acknowledgement of this conversion in chemical form and possible introduction of uncertainty into the calibration procedure.

Investigating coherent normalization and dosimetry for the 241Am-La K XRF system

OBJECTIVES

Lanthanum (La) retention in bone has been shown to occur in individuals who are orally administered lanthanum carbonate (LaC), a drug to treat hyperphosphatemia. The breakdown of LaC in the gastrointestinal tract into La³⁺ and carbonate ions results in residual quantities of La being deposited in bone. We previously reported on a non-invasive x-ray fluorescence (XRF) system that was developed to quantify bone La concentrations and applied it to a series of excised cadaver tibiae. However, given interpatient variability in bone shape and size, differential signal attenuation that occurs in bone and tissue, patient movement and overlying tissue thickness at the measurement site, quantifying bone La concentrations during in vivo measurements in live subjects needs to be investigated further along with the radiation dose associated with the measurement.

APPROACH

Coherent normalization was investigated as a function of overlying tissue thickness, source-subject distance and bone radius through Monte Carlo simulation and experimental work. This was accomplished by observing the ratio of the net La K x-ray peak area to the coherently scattered peak area at 59.5 keV. In addition, the dose delivered during a 2000 s measurement was determined using radiochromic film.

MAIN RESULTS

The coherent normalization of the La x-ray signal was shown to be independent of overlying tissue thickness, source-subject movement and bone radius, which indicates that this normalization procedure can correct for these factors. The equivalent skin dose and effective dose were 18.0 mSv and 3.2 μSv, respectively for a five-year-old.

SIGNIFICANCE

While coherent normalization for the bone lead (Pb) and bone gadolinium (Gd) systems has been shown to be successful, we also report that this normalization procedure can correct for these interpatient variabilities in the in vivo ²⁴¹Am-La K XRF system.

Elemental analysis in living human subjects using biomedical devices

Today, patients undergoing dialysis are at low risk for aluminum-induced dementia. Workers are unlikely to experience cadmium-induced emphysema and the public's exposure to lead is an order of magnitude lower than in 1970. The research field of in vivo elemental analysis has played a role in these occupational and environmental health improvements by allowing the effects of people's chronic exposure to elements to be studied using non-invasive, painless, and relatively low-cost technology. From the early 1960s to the present day, researchers have developed radiation-based systems to measure the elemental content of organs at risk or storage organs. This reduces the need for (sometimes painful) biopsy and the risk of infection. Research and development has been undertaken on forty-nine in vivo measurement system designs. Twenty-nine different in vivo elemental analysis systems, measuring 22 different elements, have been successfully taken from design and testing through to human measurement. The majority of these systems employ either neutron activation analysis or x-ray fluorescence analysis as the basis of the measurement. In this review, we discuss eight of the successful systems, explaining the rationale behind their development, the methodology, the health data that has resulted from application of these tools, and provide our opinion on potential future technical developments of these systems. We close by discussing four technologies that may lead to new directions and advances in the whole field.

Ex vivo quantification of lanthanum and gadolinium in post-mortem human tibiae with estimated barium and iodine concentrations using K x-ray fluorescence

OBJECTIVES

Lanthanum (La) and gadolinium (Gd) are known to deposit in bone of exposed populations, namely those who are orally administered lanthanum carbonate (LaC, La₂(CO₃)₃) or are injected with Gd-based contrast agents, respectively. In this work, bone La and Gd concentrations from the environment and diet were measured using x-ray fluorescence in ten post-mortem human tibiae. As a secondary objective, bone barium (Ba) and iodine concentrations were estimated.

APPROACH

Two calibration lines were produced for La and Gd and the minimum detection limits (MDLs) of the system were determined using a 180° irradiation-detection geometry.

MAIN RESULTS

The MDLs of the system were 0.4 µg La g^-1 bone mineral and 0.5 µg Gd g^-1 bone mineral. The mean concentrations were  -0.02  ±  0.1 µg La g^-1 bone mineral and 0.1  ±  0.2 µg Gd g^-1 bone mineral in tibiae. The average Ba and iodine concentrations estimated from the experimental La calibration line and Monte-Carlo derived sensitivity factors were determined to be 3.4  ±  0.8 µg Ba g^-1 bone mineral and  -0.5  ±  0.3 µg iodine g^-1 bone mineral. Since it was discovered that four donors previously received an iodine-based contrast agent, the mean concentrations in these donors was 27.8  ± 28.4 µg iodine g^-1 bone mineral.

SIGNIFICANCE

The XRF system has determined baseline concentrations of these four heavy metals in trace quantities from natural exposure pathways (with the exception of iodine in four donors). This indicates that the system can measure low levels in ex vivo tibiae samples and can potentially be further developed for in vivo studies involving live subjects who are directly exposed to these metals.

Measurement of gadolinium retention: current status and review from an applied radiation physics perspective

OBJECTIVE

This article briefly reviews the main measurement techniques for the non-invasive detection of residual gadolinium (Gd) in those exposed to gadolinium-based contrast agents (GBCAs). Approach and Main results: The current status of in vivo Gd measurement is discussed and is put into the context of concerns within the radiology community. The main techniques are based on applied atomic/nuclear medicine utilizing the characteristic atomic and nuclear spectroscopic signature of Gd. The main emission energies are in the 40-200 keV region and require spectroscopic detectors with good energy resolution. The two main techniques, prompt gamma neutron activation analysis and x-ray fluorescence, provide adequate detection limits for in vivo measurement, whilst delivering a low effective radiation dose on the order of a few µSv.

SIGNIFICANCE

Gadolinium is being detected in measureable quantities in people with healthy renal function who have received FDA approved GBCAs. The applied atomic/nuclear medicine techniques discussed in this review will be useful in determining the significance of this retention, and will help on advising future administration protocols.