Staff dose evaluation by application of radiation protection during endoscopic retrograde cholangiopancreatography (ERCP) procedures performed with a mobile C-arm.

BACKGROUND: The radiation dose to staff performing endoscopic retrograde cholangiopancreatography (ERCP) is not negligible. PURPOSE: To evaluate the shielding effect of a table-suspended lower-body radiation shield for the positions in the room occupied by the operator, assisting nurse, and anesthesiologist, used during ERCP procedures with a mobile C-arm. MATERIAL AND METHODS: Eye lens dose, whole body dose, and extremity dose were measured with and without a table-suspended lower-body radiation shield in a phantom model and in clinical routine work. The effect of the shield was evaluated for each scenario and compared, and a projection was made for when shielding should be required from a regulatory point of view. RESULTS: In the phantom measurements, the shield provided significant shielding effects on the body and lower extremities for the operator but no significant shielding of the eye lens. The shielding effect for the assisting nurse was limited to the lower extremity. The clinical measurements yielded the same general result as the phantom measurements, with the major difference that the shield provided no significant reduction in the whole-body dose to the operator. CONCLUSION: The table-suspended shield has a significant shielding effect for the lower extremities of the operator and assisting nurse. For annual dose-area product values >300,000 cGycm2, the protection of the operator should be reinforced with a ceiling-suspended shield to avoid doses to the eye lens and body in excess of regulatory dose restrictions.

Lifetime study in mice after acute low-dose ionizing radiation: a multifactorial study with special focus on cataract risk.

Because of the increasing application of ionizing radiation in medicine, quantitative data on effects of low-dose radiation are needed to optimize radiation protection, particularly with respect to cataract development. Using mice as mammalian animal model, we applied a single dose of 0, 0.063, 0.125 and 0.5 Gy at 10 weeks of age, determined lens opacities for up to 2 years and compared it with overall survival, cytogenetic alterations and cancer development. The highest dose was significantly associated with increased body weight and reduced survival rate. Chromosomal aberrations in bone marrow cells showed a dose-dependent increase 12 months after irradiation. Pathological screening indicated a dose-dependent risk for several types of tumors. Scheimpflug imaging of the lens revealed a significant dose-dependent effect of 1% of lens opacity. Comparison of different biological end points demonstrated long-term effects of low-dose irradiation for several biological end points.

Plasma clearance and urinary excretion after intravenous injection of stable 84Sr in humans.

Systemic kinetics and urinary excretion after intravenous injection of stable strontium 84Sr were evaluated in 42 investigations in human subjects. Tracer concentrations in plasma and urine were determined by thermal ionisation mass spectrometry. The initial strontium plasma clearance measured after tracer administration was found to be much faster than that predicted by the current model of the International Commission of Radiological Protection (ICRP). The biological half-life of the fast component plasma clearance (T(1/2)) was 0.25 h in comparison with 1.1 h of the ICRP value. This early clearance could be the consequence of a more rapid transfer from blood plasma to other compartments of the human body. In vitro blood tests have shown that strontium was not bound to red blood cells. Cumulative urinary excretion is considerably lower than the model prediction. The reason could be the reduced transfer rate of strontium from plasma to urine in the first 12 h after tracer administration. Plasma clearance and urinary excretion showed no dependency on the age or gender of the adult volunteers.

Anthropomorphic dual-lattice voxel models for optimizing image quality and dose.

Using numerical simulations, the influence of various imaging parameters on the resulting image can be determined for various imaging technologies. To achieve this, visualization of fine tissue structures needed to evaluate the image quality with different radiation quality and dose is essential. The present work examines a method that employs simulations of the imaging process using Monte Carlo methods and a combination of a standard and higher resolution voxel models. A hybrid model, based on nonlinear uniform rational B-spline and polygon mesh surfaces, was constructed from an existing voxel model of a female patient of a resolution in the range of millimeters. The resolution of the hybrid model was [Formula: see text], i.e., substantially finer than that of the original model. Furthermore, a high resolution lung voxel model [[Formula: see text] voxel volume, slice thickness: [Formula: see text]] was developed from the specimen of a left lung lobe. This has been inserted into the hybrid model, substituting its left lung lobe and resulting in a dual-lattice geometry model. "Dual lattice" means, in this context, the combination of voxel models with different resolutions. Monte Carlo simulations of radiographic imaging were performed and the fine structure of the lung was easily recognizable.

Bayesian model selection validates a biokinetic model for zirconium processing in humans.

BACKGROUND: In radiation protection, biokinetic models for zirconium processing are of crucial importance in dose estimation and further risk analysis for humans exposed to this radioactive substance. They provide limiting values of detrimental effects and build the basis for applications in internal dosimetry, the prediction for radioactive zirconium retention in various organs as well as retrospective dosimetry. Multi-compartmental models are the tool of choice for simulating the processing of zirconium. Although easily interpretable, determining the exact compartment structure and interaction mechanisms is generally daunting. In the context of observing the dynamics of multiple compartments, Bayesian methods provide efficient tools for model inference and selection. RESULTS: We are the first to apply a Markov chain Monte Carlo approach to compute Bayes factors for the evaluation of two competing models for zirconium processing in the human body after ingestion. Based on in vivo measurements of human plasma and urine levels we were able to show that a recently published model is superior to the standard model of the International Commission on Radiological Protection. The Bayes factors were estimated by means of the numerically stable thermodynamic integration in combination with a recently developed copula-based Metropolis-Hastings sampler. CONCLUSIONS: In contrast to the standard model the novel model predicts lower accretion of zirconium in bones. This results in lower levels of noxious doses for exposed individuals. Moreover, the Bayesian approach allows for retrospective dose assessment, including credible intervals for the initially ingested zirconium, in a significantly more reliable fashion than previously possible. All methods presented here are readily applicable to many modeling tasks in systems biology.

Reliability of a new biokinetic model of zirconium in internal dosimetry: part II, parameter sensitivity analysis.

The reliability of biokinetic models is essential for the assessment of internal doses and a radiation risk analysis for the public and occupational workers exposed to radionuclides. In the present study, a method for assessing the reliability of biokinetic models by means of uncertainty and sensitivity analysis was developed. In the first part of the paper, the parameter uncertainty was analyzed for two biokinetic models of zirconium (Zr); one was reported by the International Commission on Radiological Protection (ICRP), and one was developed at the Helmholtz Zentrum München-German Research Center for Environmental Health (HMGU). In the second part of the paper, the parameter uncertainties and distributions of the Zr biokinetic models evaluated in Part I are used as the model inputs for identifying the most influential parameters in the models. Furthermore, the most influential model parameter on the integral of the radioactivity of Zr over 50 y in source organs after ingestion was identified. The results of the systemic HMGU Zr model showed that over the first 10 d, the parameters of transfer rates between blood and other soft tissues have the largest influence on the content of Zr in the blood and the daily urinary excretion; however, after day 1,000, the transfer rate from bone to blood becomes dominant. For the retention in bone, the transfer rate from blood to bone surfaces has the most influence out to the endpoint of the simulation; the transfer rate from blood to the upper larger intestine contributes a lot in the later days; i.e., after day 300. The alimentary tract absorption factor (fA) influences mostly the integral of radioactivity of Zr in most source organs after ingestion.

Reliability of a new biokinetic model of zirconium in internal dosimetry: part I, parameter uncertainty analysis.

The reliability of biokinetic models is essential in internal dose assessments and radiation risk analysis for the public, occupational workers, and patients exposed to radionuclides. In this paper, a method for assessing the reliability of biokinetic models by means of uncertainty and sensitivity analysis was developed. The paper is divided into two parts. In the first part of the study published here, the uncertainty sources of the model parameters for zirconium (Zr), developed by the International Commission on Radiological Protection (ICRP), were identified and analyzed. Furthermore, the uncertainty of the biokinetic experimental measurement performed at the Helmholtz Zentrum München-German Research Center for Environmental Health (HMGU) for developing a new biokinetic model of Zr was analyzed according to the Guide to the Expression of Uncertainty in Measurement, published by the International Organization for Standardization. The confidence interval and distribution of model parameters of the ICRP and HMGU Zr biokinetic models were evaluated. As a result of computer biokinetic modelings, the mean, standard uncertainty, and confidence interval of model prediction calculated based on the model parameter uncertainty were presented and compared to the plasma clearance and urinary excretion measured after intravenous administration. It was shown that for the most important compartment, the plasma, the uncertainty evaluated for the HMGU model was much smaller than that for the ICRP model; that phenomenon was observed for other organs and tissues as well. The uncertainty of the integral of the radioactivity of Zr up to 50 y calculated by the HMGU model after ingestion by adult members of the public was shown to be smaller by a factor of two than that of the ICRP model. It was also shown that the distribution type of the model parameter strongly influences the model prediction, and the correlation of the model input parameters affects the model prediction to a certain extent depending on the strength of the correlation. In the case of model prediction, the qualitative comparison of the model predictions with the measured plasma and urinary data showed the HMGU model to be more reliable than the ICRP model; quantitatively, the uncertainty model prediction by the HMGU systemic biokinetic model is smaller than that of the ICRP model. The uncertainty information on the model parameters analyzed in this study was used in the second part of the paper regarding a sensitivity analysis of the Zr biokinetic models.

Human biokinetic data and a new compartmental model of zirconium--a tracer study with enriched stable isotopes.

Biokinetic models describing the uptake, distribution and excretion of trace elements are an essential tool in nutrition, toxicology, or internal dosimetry of radionuclides. Zirconium, especially its radioisotope (95)Zr, is relevant to radiation protection due to its production in uranium fission and neutron activation of nuclear fuel cladding material. We present a comprehensive set of human data from a tracer study with stable isotopes of zirconium. The data are used to refine a biokinetic model of zirconium. Six female and seven male healthy adult volunteers participated in the study. It includes 16 complete double tracer investigations with oral ingestion and intravenous injection, and seven supplemental investigations. Tracer concentrations were measured in blood plasma and urine collected up to 100 d after tracer administration. The four data sets (two chemical tracer forms in plasma and urine) each encompass 105-240 measured concentration values above detection limits. Total fractional absorption of ingested zirconium was found to be 0.001 for zirconium in citrate-buffered drinking solution and 0.007 for zirconium oxalate solution. Biokinetic models were developed based on the linear first-order kinetic compartmental model approach used by the International Commission on Radiological Protection (ICRP). The main differences of the optimized systemic model of zirconium to the current ICRP model are (1) recycling into the transfer compartment made necessary by the observed tracer clearance from plasma, (2) different parameters related to fractional absorption for each form of the ingested tracer, and (3) a physiologically based excretion pathway to urine. The study considerably expands the knowledge on the biokinetics of zirconium, which was until now dominated by data from animal studies. The proposed systemic model improves the existing ICRP model, yet is based on the same principles and fits well into the ICRP radiation protection approach.