Joint EURADOS-EANM initiative for an advanced computational framework for the assessment of external dose rates from nuclear medicine patients.

BACKGROUND: In order to ensure adequate radiation protection of critical groups such as staff, caregivers and the general public coming into proximity of nuclear medicine (NM) patients, it is necessary to consider the impact of the radiation emitted by the patients during their stay at the hospital or after leaving the hospital. Current risk assessments are based on ambient dose rate measurements in a single position at a specified distance from the patient and carried out at several time points after administration of the radiopharmaceutical to estimate the whole-body retention. The limitations of such an approach are addressed in this study by developing and validating a more advanced computational dosimetry approach using Monte Carlo (MC) simulations in combination with flexible and realistic computational phantoms and time activity distribution curves from reference biokinetic models. RESULTS: Measurements of the ambient dose rate equivalent H*(10) at 1 m from the NM patient have been successfully compared against MC simulations with 5 different codes using the ICRP adult reference computational voxel phantoms, for typical clinical procedures with 99mTc-HDP/MDP, 18FDG and Na131I. All measurement data fall in the 95% confidence intervals, determined for the average simulated results. Moreover, the different MC codes (MCNP-X, PHITS, GATE, GEANT4, TRIPOLI-4®) have been compared for a more realistic scenario where the effective dose rate E of an exposed individual was determined in positions facing and aside the patient model at 30 cm, 50 cm and 100 cm. The variation between codes was lower than 8% for all the radiopharmaceuticals at 1 m, and varied from 5 to 16% for the face-to face and side-by-side configuration at 30 cm and 50 cm. A sensitivity study on the influence of patient model morphology demonstrated that the relative standard deviation of H*(10) at 1 m for the range of included patient models remained under 16% for time points up to 120 min post administration. CONCLUSIONS: The validated computational approach will be further used for the evaluation of effective dose rates per unit administered activity for a variety of close-contact configurations and a range of radiopharmaceuticals as part of risk assessment studies. Together with the choice of appropriate dose constraints this would facilitate the setting of release criteria and patient restrictions.

Effects of ionising radiation exposure in offspring and next generations: dosimetric aspects and uncertainties.

PURPOSE: The impact of the exposure to ionizing radiation in the offspring and next generation has been investigated in the last decades and currently is the subject of study of the ICRP Task Group 121. Studying the effects of radiation exposure in pre-conceptional and post-conceptional phases can be a challenge since potential effects to the fetus vary depending on the stage of fetal development. Epidemiology and radiobiology studies are the two sources of information one can use to correlate the radiation dose to the human body and tissues and the resulting effects. For a proper evaluation of the outcomes of such studies, and a correct appraisal of the exposure/dose-effect relationship, (i) reliable dosimetry, (ii) accurate reporting, and (iii) reproducibility of results are required. Although variables related to dose, including for instance source of radiation, geometry of irradiation, dose rate etc., are usually known, especially in radiobiology studies, often important details of the irradiation are not reported. CONCLUSIONS: Based on standards developed by the National Cancer Institute (NCI), the National Institute of Allergy and Infectious Disease (NIAID) and the National Institute of Standards and Technology (NIST), a review of the scientific studies used by the UNSCEAR to estimate the risk of hereditary effects, and by the ICRP in its current recommendations, was conducted to evaluate the way dosimetry was reported. Dosimetry and the related uncertainties were not adequately described in the vast majority of those studies. This does not necessarily mean that they do not provide relevant information, however it prevents from a thorough verification and reproduction of their findings. In order to guarantee the reliability and robustness of the process of revision of the estimates of risk and detriment it is therefore considered mandatory to include a careful check of the new relevant literature with regard to the criteria on the completeness and reproducibility of the dosimetric information.

Modelling DTPA therapy following Am contamination in rats.

A major challenge in modelling the decorporation of actinides (An), such as americium (Am), with DTPA (diethylenetriaminepentaacetic acid) is the fact that standard biokinetic models become inadequate for assessing radionuclide intake and estimating the resulting dose, as DTPA perturbs the regular biokinetics of the radionuclide. At present, most attempts existing in the literature are empirical and developed mainly for the interpretation of one or a limited number of specific incorporation cases. Recently, several approaches have been presented with the aim of developing a generic model, one of which reported the unperturbed biokinetics of plutonium (Pu), the chelation process and the behaviour of the chelated compound An-DTPA with a single model structure. The aim of the approach described in this present work is the development of a generic model that is able to describe the biokinetics of Am, DTPA and the chelate Am-DTPA simultaneously. Since accidental intakes in humans present many unknowns and large uncertainties, data from controlled studies in animals were used. In these studies, different amounts of DTPA were administered at different times after contamination with known quantities of Am. To account for the enhancement of faecal excretion and reduction in liver retention, DTPA is assumed to chelate Am not only in extracellular fluids, but also in hepatocytes. A good agreement was found between the predictions of the proposed model and the experimental results for urinary and faecal excretion and accumulation and retention in the liver. However, the decorporation from the skeletal compartment could not be reproduced satisfactorily under these simple assumptions.

Reproduction of a conventional anthropomorphic female chest phantom by 3D-printing: Comparison of image contrasts and absorbed doses in CT.

BACKGROUND: The production of individualized anthropomorphic phantoms via three-dimensional (3D) printing methods offers promising possibilities to assess and optimize radiation exposures for specifically relevant patient groups (i.e., overweighed or pregnant persons) that are not adequately represented by standardized anthropomorphic phantoms. However, the equivalence of printed phantoms must be demonstrated exemplarily with respect to the resulting image contrasts and dose distributions. PURPOSE: To reproduce a conventionally produced anthropomorphic phantom of a female chest and breasts and to evaluate their equivalence with respect to image contrasts and absorbed doses at the example of a computed tomography (CT) examination of the chest. METHODS: In a first step, the effect of different print settings on the CT values of printed samples was systematically investigated. Subsequently, a transversal slice and breast add-ons of a conventionally produced female body phantom were reproduced using a multi-material extrusion-based printer, considering six different types of tissues (muscle, lung, adipose, and glandular breast tissue, as well as bone and cartilage). CT images of the printed and conventionally produced phantom parts were evaluated with respect to their geometric correspondence, image contrasts, and absorbed doses measured using thermoluminescent dosimeters. RESULTS: CT values of printed objects are highly sensitive to the selected print settings. The soft tissues of the conventionally produced phantom could be reproduced with a good agreement. Minor differences in CT values were observed for bone and lung tissue, whereas absorbed doses to the relevant tissues were identical within the measurement uncertainties. CONCLUSION: 3D-printed phantoms are with exception of minor contrast differences equivalent to their conventionally manufactured counterparts. When comparing the two production techniques, it is important to note that conventionally manufactured phantoms should not be considered as absolute benchmarks, as they also only approximate the human body in terms of its absorption, and attenuation of x-rays as well as its geometry.

Dose-efficiency quantification of computed tomography systems using a model-observer.

BACKGROUND: Recent advances in computed tomography (CT) technology have considerably improved the quality of CT images and reduced radiation exposure in patients. At present, however, there is no generally accepted figure of merit (FOM) for comparing the dose efficiencies of CT systems. PURPOSE: (i) To establish an FOM that characterizes the quality of CT images in relation to the radiation dose by means of a mathematical model observer and (ii) to evaluate the new FOM on different CT systems and image reconstruction algorithms. METHODS: Images of a homogeneous phantom with four low-contrast inserts were acquired using three different CT systems at three dose levels and a representative protocol for CT imaging of low-contrast objects in the abdomen. The images were reconstructed using filtered-back projection and iterative algorithms. A channelized hotelling observer with difference-of-Gaussian channels was applied to compute the detectability ( d ' $d^{\prime}$ ). This was done for each insert and each of the considered imaging conditions from square regions of interest (ROIs) that were (semi-)automatically centered on the inserts. The estimated detectabilities ( d ' $d^{\prime}$ ) were averaged in the first step over the three dose levels ( ⟨ d ' ⟩ $\langle {d^{\prime}} \rangle $ ), and subsequently over the four contrast inserts ( ⟨ d ' ⟩ w ${\langle {d^{\prime}} \rangle _{\rm{w}}}$ ). All calculation steps included a dedicated assessment of the related uncertainties following accepted metrological guidelines. RESULTS: The determined detectabilities ( d ' $d^{\prime}$ ) varied considerably with the contrast and diameter of the four inserts, as well as with the radiation doses and reconstruction algorithms used for image generation ( d ' $d^{\prime}\;$ = 1.3-5.5). Thus, the specification of a single detectability as an FOM is not well suited for comprehensively characterizing the dose efficiency of a CT system. A more comprehensive and robust characterization was provided by the averaged detectabilities ⟨ d ' ⟩ $\langle {d^{\prime}} \rangle $ and, in particular, ⟨ d ' ⟩ w ${\langle {d^{\prime}} \rangle _{\rm{w}}}$ . Our analysis reveals that the model observer analysis is very sensitive to the exact position of the ROIs. CONCLUSIONS: The presented automatable software approach yielded with the weighted detectability ⟨ d ' ⟩ w ${\langle {d^{\prime}} \rangle _{\rm{w}}}$ an objective FOM to benchmark different CT systems and reconstruction algorithms in a robust and reliable manner. An essential advantage of the proposed model-observer approach is that uncertainties in the FOM can be provided, which is an indispensable prerequisite for type testing.

Pediatric computed tomography doses in Germany from 2016 to 2018 based on large-scale data collection.

PURPOSE: Accumulating evidence from epidemiological studies that pediatric computed tomography (CT) examinations can be associated with a small but non-zero excess risk for developing leukemia or brain tumor highlights the need to optimize doses of pediatric CT procedures. Mandatory dose reference levels (DRL) can support reduction of collective dose from CT imaging. Regular surveys of applied dose-related parameters are instrumental to decide when technological advances and optimized protocol design allow lower doses without sacrificing image quality. Our aim was to collect dosimetric data to support adapting current DRL to changing clinical practice. METHOD: Dosimetric data and technical scan parameters from common pediatric CT examinations were retrospectively collected directly from Picture Archiving and Communication Systems (PACS), Dose Management Systems (DMS), and Radiological Information Systems (RIS). RESULTS: We collected data from 17 institutions on 7746 CT series from the years 2016 to 2018 from examinations of the head, thorax, abdomen, cervical spine, temporal bone, paranasal sinuses and knee in patients below 18 years of age. Most of the age-stratified parameter distributions were lower than distributions from previously-analyzed data from before 2010. Most of the third quartiles were lower than German DRL at the time of the survey. CONCLUSIONS: Directly interfacing PACS, DMS, and RIS installations allows large-scale data collection but relies on high data-quality at the documentation stage. Data should be validated by expert knowledge or guided questionnaires. Observed clinical practice in pediatric CT imaging suggests lowering some DRL in Germany is reasonable.

A revised compartmental model for biokinetics and dosimetry of 2-[18F]FDG.

BACKGROUND: The aim was to review available biokinetic data, collect own experimental data, and propose an updated compartmental model for 2-[18F]FDG in the frame of the revision of the ICRP report on dose coefficients for radiopharmaceuticals used in diagnostic nuclear medicine. METHODS: The compartmental model was developed based on published biokinetic data for 2-[18F]FDG. Additional data on urinary excretion in 23 patients (11 males, 12 females) undergoing whole-body PET/CT examinations were obtained within this study. The unknown biokinetic model parameters were derived using the software SAAM II and verified with a modified version of IDAC-Iodide. Dose coefficients for reference adults were calculated with the programme IDAC-Dose 2.1. A dynamic bladder model was employed for urinary bladder dosimetry. RESULTS: The proposed model consists of following compartments: blood, heart wall, brain, liver, lungs, pancreas, spleen, kidneys, urinary bladder content and a generic pool compartment "Other". The latter was introduced to account for 2-[18F]FDG in body organ and tissues besides the explicitly modelled ones. The model predictions showed a good agreement with experimental data. Urinary bladder wall received the highest absorbed dose coefficient of 7.5E-02 mGy/MBq under the assumption of initial urine volume of 100 ml, first voiding at 45 min p.i. and 3.75 h voiding intervals thereafter. The effective dose coefficient calculated according to the current dosimetry framework of ICRP amounted to 1.7E-02 mSv/MBq, compared to 1.9E-02 mSv/MBq in ICRP Publication 128. CONCLUSION: A compartmental model for 2-[18F]FDG was proposed and will be used to replace the descriptive biokinetic model of ICRP Publication 128. The revised model and the provided dose coefficients are expected to improve reference dosimetry for patients administered with 2-[18F]FDG.

Tissue equivalence of 3D printing materials with respect to attenuation and absorption of X-rays used for diagnostic and interventional imaging.

INTRODUCTION: Three-dimensional printing is a promising technology to produce phantoms for quality assurance and dosimetry in X-ray imaging. Crucial to this, however, is the use of tissue equivalent printing materials. It was thus the aim of this study to evaluate the properties of a larger number of commercially available printing filaments with respect to their attenuation and absorption of X-rays. MATERIALS AND METHODS: Apparent kerma attenuation coefficients (AKACs) and absorbed doses for different X-ray spectra (tube voltages, 70-140 kV) were measured and simulated by Monte-Carlo computations for a larger number of fused-deposition-modeling (FDM) materials. The results were compared with the respective values simulated for reference body tissues. In addition, the properties of polylactide acid samples printed with reduced infill densities were investigated. RESULTS: Measured and simulated AKACs and absorbed doses agreed well with each other and in case of AKACs also with attenuation coefficients derived from the reference database of the National Institute of Standards and Technology (NIST). For lung, adipose, muscle, and bulk soft tissue as well as for spongiosa (cancellous bone), printed materials with equivalent attenuation as well as absorption properties could be identified. In contrast, none of the considered printed materials was equivalent to cortical bone. CONCLUSION: Several FDM materials have been identified as well-suited substitutes for body tissues in terms of the investigated material characteristics. They can therefore be used for in-house production of individualized and task-specific phantoms for image quality assessment and dose measurements in X-ray imaging.

Dose Variations Using an X-Ray Cabinet to Establish in vitro Dose-Response Curves for Biological Dosimetry Assays.

In biological dosimetry, dose-response curves are essential for reliable retrospective dose estimation of individual exposure in case of a radiation accident. Therefore, blood samples are irradiated in vitro and evaluated based on the applied assay. Accurate physical dosimetry of the irradiation performance is a critical part of the experimental procedure and is influenced by the experimental setup, especially when X-ray cabinets are used. The aim of this study was to investigate variations and pitfalls associated with the experimental setups used to establish calibration curves in biological dosimetry with X-ray cabinets. In this study, irradiation was performed with an X-ray source (195 kV, 10 mA, 0.5 mm Cu filter, dose rate 0.52 Gy/min, 1st and 2nd half-value layer = 1.01 and 1.76 mm Cu, respectively, average energy 86.9 keV). Blood collection tubes were irradiated with a dose of 1 Gy in vertical or horizontal orientation in the center of the beam area with or without usage of an additional fan heater. To evaluate the influence of the setups, physical dose measurements using thermoluminescence dosimeters, electron paramagnetic resonance dosimetry and ionization chamber as well as biological effects, quantified by dicentric chromosomes and micronuclei, were compared. This study revealed that the orientation of the sample tubes (vertical vs. horizontal) had a significant effect on the radiation dose with a variation of -41% up to +49% and contributed to a dose gradient of up to 870 mGy inside the vertical tubes due to the size of the sample tubes and the associated differences in the distance to the focal point of the tube. The number of dicentric chromosomes and micronuclei differed by ~30% between both orientations. An additional fan heater had no consistent impact. Therefore, dosimetric monitoring of experimental irradiation setups is mandatory prior to the establishment of calibration curves in biological dosimetry. Careful consideration of the experimental setup in collaboration with physicists is required to ensure traceability and reproducibility of irradiation conditions, to correlate the radiation dose and the number of aberrations correctly and to avoid systematical bias influencing the dose estimation in the frame of biological dosimetry.

Radiation field and dose inhomogeneities using an X-ray cabinet in radiation biology research.

PURPOSE: X-ray cabinets are replacing 137 Cs/60 Co sources in radiation biology research due to advantages in size, handling, and radiation protection. However, because of their different physical properties, X-ray cabinets are more susceptible to experimental influences than conventional sources. The aim of this study was to examine the variations related to the experimental setups typically used to investigate biological radiation effects with X-ray cabinets. MATERIALS AND METHODS: A combined approach of physical dose measurements by thermoluminescence dosimetry and detection of biological effects by quantification of γH2AX and 53BP1 foci was used to analyze field inhomogeneity and evaluate the influence of the components of the experimental setup. RESULTS: Irradiation was performed using an X-ray tube (195 kV, 10 mA, 0.5-mm-thick copper filter, dose rate of 0.59 Gy/min). Thermoluminescence dosimetry revealed inhomogeneity and a dose decrease of up to 42.3% within the beam area (diameter 31.1 cm) compared to the dose at the center. This dose decrease was consistent with the observed decline in the number of radiation-induced foci by up to 55.9 %. Uniform dose distribution was measured after reducing the size of the radiation field (diameter 12.5 cm). However, when using 15-ml test tubes placed at different positions within this field, the dose decreased by up to 17% in comparison to the central position. Analysis of foci number revealed significant differences between the tubes for γH2AX (1 h) and 53BP1 (4 h) at different time points after irradiation. Neither removal of some tubes nor of the caps improved the dose decrease significantly. By contrast, when using 1.5-ml tubes, dose differences were less than 4%, and no significant differences in foci number were detected. CONCLUSION: X-ray cabinets are user-friendly irradiation units for investigating biological radiation effects. However, field inhomogeneities and experimental setup components considerably affect the delivered irradiation doses. For this reason, strict dosimetric monitoring of experimental irradiation setups is mandatory for reliable studies.

International intercomparison on internal dose assessment (ICIDOSE 2017).

Internal dose assessment intercomparison exercises are useful tools: to verify the performance of an internal dosimetry service; to promote the harmonisation of dose assessments; and to identify weaknesses where further improvements are necessary. However, no such international intercomparisons have been performed for more than ten years. In the period May 2014-May 2016, the 'Technical Recommendations for Monitoring Individuals for Occupational Intakes of Radionuclides' were developed on the initiative of the European Commission, and later published within the EC Radiation Protection series, as RP188. In 2017 the Working Group 'Internal Dosimetry' of the European Radiation Dosimetry Group (EURADOS) organised a new intercomparison action, named ICIDOSE 2017, with the main aim of testing the practical applicability of these technical recommendations (RP188). Four case studies were proposed to participants: an artificially created case of inhalation of 60Co to simulate a simple special monitoring case; a real case of inhalation of 125I, with simple routine monitoring; a real and more complex case of incorporation of 234+235+238U, featuring both confirmatory and special monitoring; and a complex real case of an accidental incorporation of 241Am, including multiple administrations of diethylenetriamine pentaacetic acid (DTPA). Results were received from 66 participants from 26 countries; these were compared to reference or recommended solutions, developed for each case based on the application of RP188. In cases 1, 2 and 4 only a small number of results were identified as outliers, with the spread of all the results, expressed as the geometric standard deviation (GSD) of the values, assessed as 1.07, 1.04 and 1.43, respectively. This observed spread of the submitted results was improved from those obtained from similar cases in previous intercomparison exercises, showing that the availability of RP188 contributes to the harmonisation of the internal dose assessment process. There was a much wider spread of results for the uranium case: this case was characterised by an absence of any prior knowledge of the exposure scenario, and participants assumed a range of different exposure pathways and patterns.

Method to quickly and accurately calculate absorbed dose from therapeutic and stray photon exposures throughout the entire body in individual patients.

PURPOSE: Photon radiotherapy techniques typically devote considerable attention to limiting the exposure of healthy tissues outside of the target volume. Numerous studies have shown, however, that commercial treatment planning systems (TPSs) significantly underestimate the absorbed dose outside of the treatment field. The purpose of this study was to test the feasibility of quickly and accurately calculating the total absorbed dose to the whole body from photon radiotherapy in individual patients. METHODS: We created an extended TPS by implementing a physics-based analytical model for the absorbed dose from stray photons during photon therapy into a research TPS. We configured and validated the extended TPS using measurements of 6- and 15-MV photon beams in water-box and anthropomorphic phantoms. We characterized the additional computation time required for therapeutic and stray dose calculations in a 44 × 30 × 180 cm3 water-box phantom. RESULTS: The extended TPS achieved superior dosimetric accuracy compared to the research TPS in both water and anthropomorphic phantoms, especially outside of the primary treatment field. In the anthropomorphic phantom, the extended TPS increased the generalized gamma index passing rate by a factor of 10 and decreased the median dosimetric discrepancy in the out-of-field region by a factor of 26. The extended TPS achieved an average discrepancy <1% in and near the treatment field and <1 mGy/Gy far from the treatment field in the anthropomorphic phantom. Characterization of computation time revealed that on average, the extended TPS only required 7% longer than the research TPS to calculate the total absorbed dose. CONCLUSIONS: The results of this work suggest that it is feasible to quickly and accurately calculate whole-body doses inside and outside of the therapeutic treatment field in individual patients on a routine basis using physics-based analytical dose models. This additional capability enables a more personalized approach to minimizing the risk of radiogenic late effects, such as second cancer and cardiac toxicity, as part of the treatment planning process.

THE EURADOS WORK TOWARDS A REVIEW ON RETROSPECTIVE DOSIMETRY AFTER INCORPORATION OF RADIONUCLIDES.

Biological dosimetry methods are well established and validated for providing dose estimates following external radiation exposures. In contrast, interpreting biological dosimetry data in cases of internal exposures is still challenging. In this context, a joint collaboration between two Working Groups (WG) of European Radiation Dosimetry Group (EURADOS), WG10 on 'Retrospective Dosimetry' and WG7 on 'Internal Dosimetry', was initiated with the aim to address the main issues related to the advantages and limitations of biological and electron paramagnetic resonance (EPR) dosimetry in cases of internal and mixed internal/external exposures. The organization of the review work, the main findings of the analysis performed and the driving lines for possible future research work are briefly described in the present document.

Current knowledge on radon risk: implications for practical radiation protection? radon workshop, 1/2 December 2015, Bonn, BMUB (Bundesministerium für Umwelt, Naturschutz, Bau und Reaktorsicherheit; Federal Ministry for the Environment, Nature Conservation, Building and Nuclear Safety).

ICRP suggested a strategy based on the distinction between a protection approach for dwellings and one for workplaces in the previous recommendations on radon. Now, the Commission recommends an integrated approach for the protection against radon exposure in all buildings irrespective of their purpose and the status of their occupants. The strategy of protection in buildings, implemented through a national action plan, is based on the application of the optimisation principle below a derived reference level in concentration (maximum 300 Bq m(-3)). A problem, however, arises that due to new epidemiological findings and application of dosimetric models, ICRP 115 (Ann ICRP 40, 2010) presents nominal probability coefficients for radon exposure that are approximately by a factor of 2 larger than in the former recommendations of ICRP 65 (Ann ICRP 23, 1993). On the basis of the so-called epidemiological approach and the dosimetric approach, the doubling of risk per unit exposure is represented by a doubling of the dose coefficients, while the risk coefficient of ICRP 103 (2007) remains unchanged. Thus, an identical given radon exposure situation with the new dose coefficients would result in a doubling of dose compared with the former values. This is of serious conceptual implications. A possible solution of this problem was presented during the workshop.

A puzzling case of contamination with 241Am.

Two people were exposed to and contaminated with 241Am. In vivo determinations of the incorporated 241Am were performed using a whole-body counter and two partial-body counters for the skull and lung, respectively. Additionally, urine samples were analysed to estimate the systemic activity removed from the body. To improve the geometry of the skull measurements, an optimised detector configuration was used, a calibration with three physical phantoms of the human head was conducted, and the morphological variability between the individuals was also considered. The results of the measurements indicate that activity is not deposited in the deep tissues, rather in the skin tissues close to the body surface. Unfortunately, the many open questions relating to the actual circumstances during and after the incident make the interpretation of this case difficult if at all possible.

Concerted Uranium Research in Europe (CURE): toward a collaborative project integrating dosimetry, epidemiology and radiobiology to study the effects of occupational uranium exposure.

The potential health impacts of chronic exposures to uranium, as they occur in occupational settings, are not well characterized. Most epidemiological studies have been limited by small sample sizes, and a lack of harmonization of methods used to quantify radiation doses resulting from uranium exposure. Experimental studies have shown that uranium has biological effects, but their implications for human health are not clear. New studies that would combine the strengths of large, well-designed epidemiological datasets with those of state-of-the-art biological methods would help improve the characterization of the biological and health effects of occupational uranium exposure. The aim of the European Commission concerted action CURE (Concerted Uranium Research in Europe) was to develop protocols for such a future collaborative research project, in which dosimetry, epidemiology and biology would be integrated to better characterize the effects of occupational uranium exposure. These protocols were developed from existing European cohorts of workers exposed to uranium together with expertise in epidemiology, biology and dosimetry of CURE partner institutions. The preparatory work of CURE should allow a large scale collaborative project to be launched, in order to better characterize the effects of uranium exposure and more generally of alpha particles and low doses of ionizing radiation.

Models and phantoms for internal dose assessment.

Radiation doses delivered by incorporated radionuclides cannot be directly measured, and they are assessed by means of biokinetic and dosimetric models and computational phantoms. For emitters of short-range radiation like alpha-particles or Auger electrons, the doses at organ levels, as they are usually defined in internal dosimetry, are no longer relevant. Modelling the inter- and intra-cellular radiation transport and the local patterns of deposition at molecular or cellular levels are the challenging tasks of micro- and nano-dosimetry. With time, the physiological and anatomical realism of the models and phantoms have increased. However, not always the information is available that would be required to characterise the greater complexity of the recent models. Uncertainty studies in internal dose assessment provide here a valuable contribution for testing the significance of the new dose estimates and of the discrepancies from the previous values. Some of the challenges, limitations and future perspectives of the use of models and phantoms in internal dosimetry are discussed in the present manuscript.

A recycling model of the biokinetics of systemic tellurium.

PURPOSE: To develop a compartmental model of the systemic biokinetics of tellurium required for calculating the internal dose and interpreting bioassay measurements after incorporation of radioactive tellurium. MATERIALS AND METHODS: The compartmental model for tellurium was developed with the software SAAM II v. 2.0 (©The Epsilon Group, Charlottesville, Virginia, USA). Model parameters were determined on the basis of published retention and excretion data in humans and animals. RESULTS: The model consists of two blood compartments, one compartment each for liver, kidneys, thyroid, four compartments for bone tissues and a generic compartment for the soft tissues. The model predicts a rapid urinary excretion of systemic tellurium: 45% in the first 24 h and 84% after 50 d. Faecal excretion amounts to 0.4% after 3 d and 9% after 50 d. Whole body retention is 55% after one day, and 2.8% after 100 d. These values as well as the retained fractions in the single organs are reasonably consistent with the available human and animal data (studies with swine and guinea pigs). CONCLUSIONS: The proposed model gives a realistic description of the available biokinetic data for tellurium and will be adopted by the International Commission on Radiological Protection for applications in internal dosimetry.

Developing a physiologically based approach for modeling plutonium decorporation therapy with DTPA.

PURPOSE: To develop a physiologically based compartmental approach for modeling plutonium decorporation therapy with the chelating agent Diethylenetriaminepentaacetic acid (Ca-DTPA/Zn-DTPA). MATERIALS AND METHODS: Model calculations were performed using the software package SAAM II (©The Epsilon Group, Charlottesville, Virginia, USA). The Luciani/Polig compartmental model with age-dependent description of the bone recycling processes was used for the biokinetics of plutonium. RESULTS: The Luciani/Polig model was slightly modified in order to account for the speciation of plutonium in blood and for the different affinities for DTPA of the present chemical species. The introduction of two separate blood compartments, describing low-molecular-weight complexes of plutonium (Pu-LW) and transferrin-bound plutonium (Pu-Tf), respectively, and one additional compartment describing plutonium in the interstitial fluids was performed successfully. CONCLUSIONS: The next step of the work is the modeling of the chelation process, coupling the physiologically modified structure with the biokinetic model for DTPA. RESULTS of animal studies performed under controlled conditions will enable to better understand the principles of the involved mechanisms.

Considerations on the ICRP model predictions of the transfer of (137)Cs from food to the milk and urine of lactating mothers.

A recent work has shown that the current ICRP biokinetic model for the transfer of caesium radionuclides from food to human breast milk was able to describe with satisfactory accuracy (137)Cs activity concentrations in human breast samples collected a few weeks after the Chernobyl accident as well as in samples collected some years later. However, systematic discrepancies were observed for the predictions of the activity concentrations in urine samples. In the present work, modifications to the model were investigated with the aim of improving the agreement between model predictions and data. It turned out that the disagreement for the urine data was ascribable to the mathematical simplifications used by the ICRP to describe urinary excretion in the first few days after delivery. However, the predictive performances of the model remained unchanged even when differences in the bioavailability of caesium from the ingested food types were considered or metabolic interactions between caesium and potassium were introduced into the model formulation.