1.

JNTRODUCTION
(1) The administration of radioactive substances to humans for diagnosis, therapy or research purposes is a well-established and developing branch of medical practice, and is, in most countries, recognized as a medical speciality under the name of nuclear medicine. New methods and new radiopharmaceuticals are continually being introduced. With regard to dose calculations, important basic material has been published in several ICRP Publications (e.g. ICRP, 1973, 1977, 1979, 1980, 1981), as well as in reports from the International Commission on Radiation Units and Measurements, especially ICRU Report 32 (ICRU, 1979). Several absorbed dose catalogues and collections of published values have also appeared (Garby et al., 1969; ICRP, 1971; Kaul et al., 1973a,b; Roedler et al., 1978; Johansson et al., 1981a,b; NCRP, 1982; ARSAC, 1984). Of special importance is the work of the Medical Internal Radiation Dose (MIRD) Committee of the United States Society of Nuclear Medicine and the dosimetry work performed at the Oak Ridge National Laboratory, Tennessee, USA. The Task Group has made extensive use of the information and material available from these sources.

2. SELECTION OF RADIOPHARMACEUTICALS
(2) Certain general principles were followed in establishing the list of radiopharmaceuticals to be included in this report. A radiopharmaceutical that has been described in the literature and proposed for use in humans has been includedif there is evidence that it has been in, or is coming into, common use, provided that acceptable and sufficient metabolic data for making absorbed dose calculations are available. The list of radiopharmaceuticals covers not only those used in the practice of nuclear medicine, but also some of those used in clinical research. It is important to note that the inclusion of a radiopharmaceutical in this report does not imply any recommendation regarding its use. For this reason, the amounts of administered radiopharmaceutical required for a particular investigation are not given. (3) The list is based on the judgment of the Task Group as to their past, present or potential future application in nuclear medicine procedures. Data relating to these substances have been obtained by an extensive search of the literature, partly with the help of computer-based retrieval systems. This latter technique has been especially important, since much of the information needed has been published in scientific journals covering subjects other than nuclear medicine. The current result of these efforts is a list of about 120 radiopharmaceuticals, involving the use of 71 radionuclides of 34 elements. A little less than half of the radiopharmaceuticals contain radionuclides in ionic form, whereas the rest are more complicated labelled organic molecules or complexes, or are present in cells labelled with the radiopharmaceutical. The radionuclides in these various organic or labelled cellular preparations usually have a metabolic fate different from that of the ionic form of the same radionuclide. Of the 92 compounds in ZCRP Publication 17 (ICRP, 1971), 64 are included here, which means that about 56 compounds are new in this report. Many of them are well-known radiopharmaceuticals, but it is important to note that the legal status of a substance as a radiopharmaceutical differs according to national legislation. (4) In all absorbed dose calculations, complete radionuclide and radiochemical purity is assumed. The effect of impurities on the absorbed dose is discussed in Section 7.

BIOKINETICS

AND DOSIMETRY:

GENERAL

CONSIDERATIONS

3. SELECTION

OF ORGANS AND TISSUES FOR DOSE CALCULATIONS

(5) Absorbed doses are calculated for a large number of organs and tissues (called the target organs and tissues). These absorbed doses may arise as a result of radioactive transformations occurring in other organs and tissues (called the source organs and tissues). Thus, absorbed doses in a particular organ or tissue are typically the sum of contributions from various sources, usually including the target organ or tissue itself. Two groups of target organs and tissues are included in the calculation of absorbed dose (Table 3.1): -Target organs and tissues for which the absorbed dose is always calculated (Group 1). --C&her organs and tissues, which, for some reason, receive significantly higher absorbed doses than the average to the rest of the body, or which are organs and tissues of special interest in the investigation, are also included as appropriate (Group 2). (6) The absorbed dose to organs and tissues not included in the table can usually be approximated by using the absorbed dose quoted for Other tissues (e.g. muscle). (7) The absorbed dose to the organs and tissues given in Table 3.1 is always the mean absorbed dose. In general, these mean absorbed doses are calculated assuming a uniform distribution of the radionuclide. (8) An exception is made to this assumption in the case of the kidneys where non-uniform distribution of radionuclides is taken into consideration. However, even in this case, absorbed doses to other organs and tissues are calculated under the assumption that the radionuclide is uniformly distributed throughout the kidneys; because, in practice, use of a non-uniform distribution in calculating the absorbed doses to these other organs and tissues would result in only very small changes (less than 10%) in the results obtained. (9) The lens of the eye is considered as a tissue at risk in ZCRP Publication 26 (ICRP, 1977) because of the possibility of inducing opacities that may interfere with vision. The radionuclides

Table 3.1. Organs and tissues for which the absorbed dose is calculated Group 1 Adrenals Bone surfaces Breast Gastrointestinal tract stomach wall small intestine wall upper large intestine wall lower large intestine wall Kidneys Liver Lungs Ovaries Pancreas Red bone marrow Spleen Testes Thyroid Urinary bladder wall Uterus Other tissues (e.g. muscle) Group 2 Brain Gallbladder wall Heart Salivary glands Spinal cord

RADIATION DOSE TO PATIENTS FROM RADIOPHARMACEUTICALS

in radiopharmaceuticals currently used in nuclear medicine do not concentrate in the tissues of the healthy human eye, with the possible exception of iodo-amphetamine (IMP), which is utilized in the synthesis of melanin (Winchell et al., 1980). For this reason, the lens is not included in the list of target organs and tissues. (10) In the literature, absorbed dose to total body, calculated in several different ways, is often cited. However, this approach is less useful for estimating risks than is the effective dose equivalent (see Section 6). For this reason, values of absorbed dose to total body are not given.

4. BIOKINETIC

MODELS AND DATA

(11) The Task Group has encountered several problems in finding good biokinetic information from measurements on man. In general, published data are scarce, especially with regard to quantitative measurements. The clinician is often only interested in the initial distribution and metabolism of a test substance, whereas for dosimetry calculations long-term retention is of prime importance. The Task Group wishes to repeat the plea made already in ZCRP Publication 17 (ICRP, 1971) for securing the maximum information possible from any investigation. The particular information needed for dose calculations includes fractional longterm retention of radionuclides and labelled compounds, turnover of the radiopharmaceutical and its metabolites, fractional gastrointestinal absorption values for orally-administered compounds and distribution of radionuclides within different organs. Collection of such data should be encouraged by professional and scientific societies and by regulatory authorities, and the data should be made available by publication and by storage in accessible data bases. The editors and referees of scientific journals are encouraged to request such information in papers on new radiopharmaceuticals. (12) For each compound, the Task Group has agreed upon a biokinetic model giving quantitative estimates for the distribution and metabolism of the radiopharmaceutical in the body. The literature on which this model is based is referenced. In appropriate cases, the range of pathological variation expected in the metabolic data is also indicated. (13) For absorbed dose calculations, knowledge of the time-activity curve in different organs and tissues of the body after administration of a labelled radiopharmaceutical is needed. The best way to get this information is by pharmacokinetic analysis, which includes the use of knowledge about mechanisms affecting radionuclide localization by listing the physiological assumptions regarding its behaviour in body tissues. On the basis of this knowledge, a model is defined, delineating the detailed distribution and flow, or transfer, of the radionuclide. This model, in its turn, allows the derivation of a mathematical model, consisting of differential and/or integral equations for the variation with time of the amounts of radionuclide in different parts of the body. The model may be either compartmental or non-compartmental. Knowledge of the values for compartment sizes, flow rates and other physiological parameters allows numerical solution of the equations, giving activity-time relationships for all parts of the system which are then integrated to obtain the cumulated activities needed for calculations of absorbed dose. (14) The method just outlined could, in principle, be applied to derive absorbed doses in those disease states leading to quantitative changes in the normal physiological processes. However, in general, this is not possible, since, with the exception of iodine and iron metabolism, there is insufficient information to define a complete model including all pools or compartments as well as flow rates in or out of the system and between the parts of the system. For absorbed dose calculations, only the time-activity curves are needed, and these can be established in alternative ways, as discussed in detail in ZCRU Report 32 (ICRU, 1979). The simplest way, in

BIOKINETICS

AND DOSIMETRY:

GENERAL

CONSIDERATIONS

many cases, is the direct measurement of the fractional activity of a radionuclide in different organs. The MIRD Committee has mainly used information of this kind in their calculations. A general discussion on the experimental basis for absorbed dose calculations is given in NCRP Report 83 (NCRP, 1985a). (15) Even though only time-activity relationships are needed for absorbed dose calculations, good data from quantitative measurements on man are still scarce and, when available, usually relate to only a few organs in the body. In general, therefore, it is necessary to define a type of kinetic model which is suitable for dosimetric purposes and, while not including all physiological mechanisms, nevertheless includes information on uptake and/or elimination in the organs and tissues of interest that is different from that of the remaining tissues, and which gives information on distribution and retention sufficient to approximate to the true time-activity relationships. (16) The modern approach to physiological and metabolic studies, is to avoid complicated multicompartment models based on first-order kinetics. This is because of difficulties in relating compartments to specific organs and tissues, and because many flow and transfer processes are governed not by first-order kinetics but by carrier-mediated transport mechanisms (i.e. active transport and facilitated diffusion) leading to non-linear kinetics. This has led to the use of more general expressions such as mean transit time or residence time in the description of the systems. The Task Group considered the possibility of including a simple presentation of the metabolism of a substance in these terms in order to make it easier to understand and interpret the results of an investigation (for example, a scan picture), and to evaluate it in regard to any changes caused by disease. However, for purposes of absorbed dose calculations, it is only necessary to know the resulting cumulated activity. Therefore, for ease of calculation, the Task Group chose to use exponential expressions to an extent that could be considered to be greater than is justified on a biological basis. It is emphasized that a model presented in this report, for a radiopharmaceutical labelled with a particular radionuclide, is not necessarily valid for the same radiopharmaceutical labelled with another radionuclide of the same element, if its physical half-life is substantially different. (17) In defining these simple models, the Task Group adopted some general principles. Many of the substances used in nuclear medicine are administered intravenously and are rapidly taken up in different organs and tissues. For this reason, immediate uptake is generally assumed. For radionuclides in ionic or simple chemical form, the models and data presented in ZCRP Publication 30 (ICRP, 1979, 1980, 1981) have been utilized, with some exceptions. For those radiopharmaceuticals where the MIRD Committee has published absorbed dose estimates, these have been used in preference, since they originate from direct measurements on man. For some of these radiopharmaceuticals no model is presented by the MIRD Committee, since empirically determined time-activity curves are used directly. In such cases, the Task Group has, for the sake of uniformity and for ease of calculation, constructed a model which is compatible with the published data. (18) In developing the models, the Task Group recognized the substantial difficulties in extrapolating quantitative biokinetic data obtained in animal experiments to man. However, in some cases, the human data were not sufficient for the construction of human biokinetic models. In these cases, radionuclide distributions between organs and tissues had to be based, in part, upon animal data. (19) In calculations of absorbed doses to children, the same biokinetic model as for the adult is generally used. Almost without exception, this policy leads to an overestimate of the absorbed dose due to shorter biological half-lives in children than in the adult. However, a few radiopharmaceuticals, such as Tc-phosphonates and 67Ga-citrate, are concentrated in the

RADIATION

DOSE TO PATIENTS

FROM RADIOPHARMACEUTICALS

growing regions of childrens bones and these enhanced concentrations can give rise to absorbed doses to these areas which are larger than average skeletal absorbed doses. In these tissues the absorbed dose is higher by a factor of between about two and five for Tc-phosphonates (Gelfand et al., 1983; Kaul et al., 1985) than the mean absorbed dose to the bone surfaces, which is the target tissue considered in this report. Similar ratios can be derived for 67Ga-citrate from data reported by Gelfand et al. (1983). Thus, in these cases, the use of the same biokinetic model for children as for adults underestimates radiation doses to a particular part of the skeleton, though the mean absorbed dose to bone surfaces is not likely to be substantially underestimated. In calculations of absorbed doses to children, age-dependent data are used for organ mass, blood distribution and S values. (20) The influence of pathological changes on absorbed dose has also been studied. Variations of absorbed dose in disease states can generally be calculated using the same model as for the healthy state, but with appropriate data for organ or tissue mass, uptake and retention. Separate absorbed dose estimates are presented in cases where such variations lead to significant changes in these absorbed doses. (21) The models and absorbed dose values presented are intended for use in diagnostic nuclear medicine and clinical research with radionuclides, and may be inappropriate for use in radionuclide therapy. (22) Some radiopharmaceuticals administered to lactating women may be excreted in the breast milk and thus transferred to the breast-fed child. Models for transfer of radionuclides in breast milk are not developed in this report and the reader is referred to the studies of Ahlgren et al. (1985), which contain data on the transfer of various ggmT~, 1251, i3iI and 0-1abelled radiopharmaceuticals to breast milk; see also the review by Coakley and Mountford (1985). (23) In the case of radionuclides such as jGa, l1 In, 251and *iTl, administered in forms which result in their uptake in cell nuclei, the small fraction of the energy carried by Auger electrons may have a disproportionately large effect, owing to their very short range in tissue. The assumption made here, that the absorbed dose is uniformly distributed within the cell, may therefore result in an underestimate of the risk. This problem has been discussed in ZCRP Publication 30 (ICRP, 1979, Section 4.4, Cellular Distribution of Dose) and will be kept under review by the Commission. (24) It is usually assumed that daughter radionuclides (e.g. Table 4.1) produced within the body, stay with, and behave metabolically like, their parent nuclide. This may be an oversimplification, such as in the case of 131Ba and i31Cs. This assumption may also overestimate the dose to the source organ but will have little effect on the dose to other organs and tissues.
Table 4.1. Daughter Parent Radionuclide
28Mg

radionuclides

considered

in the dose calculations

Half-life 20.9 hr 32.0 min 4.53 d 8.28 hr 9.26 hr 13.8 hr 4.58 hr 2.90 hr 11.8 d 38.9 hr

Radionuclide 2sAI WI 47sc 52mMn 62Cu 69Zn *lmKr

Half-life 2.24 min 1.53 s 3.35 d 21.1 min 9.74 min 57 min 13 s 2.06 yr 9.69 d 10.7 yr

34mC1 47Ca 52Fe 62Zn 6qmZn sRb

134rnCS
131Ba 133mpa

Ts CS
la3Ba

BIOKINETICS

AND DOSIMETRY:

GENERAL

CONSIDERATIONS

(25) For some substances, such as iodine-labelled compounds, pertechnetate and some radiopharmaceuticals used for renal studies, blocking agents may be previously or simultaneously administered (for example, to induce competitive inhibition of uptake in specific organs). In such circumstances including blocking of the thyroid, total inhibition of radionuclide uptake has been assumed, although in practice this may be difficult to achieve. (26) It is often possible to reduce the absorbed dose to a patient by increasing the rate of elimination of the radionuclide from the body, e.g. by more frequent emptying of the urinary bladder (with hydration, diuretics and catheterization), of the bowel (with laxatives and enema) and of the gallbladder (with a meal of high fat content and cholecystokinin).

5. METHODS

FOR CALCULATING

ABSORBED DOSE

5.1. Calculation of Absorbed Dose (27) The mean absorbed dose D, to a target organ or tissue Tis the sum of the contributions, D( T+ S), arising from nuclear transformations of the radionuclide in various source organs S: i.e. D, = 1 D(TcS) (5.1) s (28) Several methods of calculating the absorbed dose to an organ from radioactive sources in the same organ and in other organs have been proposed and used. For a review of these methods, the reader is referred to ZCRU Report 32 (ICRU, 1979), ZCRP Publication30 (ICRP, 1979) and NCRP Report 84 (NCRP, 1985b). The most common method currently in use was originally developed from an approach by Loevinger and Berman (1968), using tabulated data on absorbed fractions of energy in a target organ from a specific source organ (Snyder et al., 1969). This method was later improved by Snyder and his colleagues, who introduced the Svalue (Snyder et al., 1974, 1975), which also contains all necessary physical information for a specific radionuclide. With this more straightforward method, the absorbed dose in T from a radionuclide in a single source organ S is given by: D(TtS)=i& x S(TtS) (5.2)

where A, is the time-integrated, or cumulated activity, and is equal to the total number of nuclear transformations in S; and S(TcS) is the absorbed dose in Tper unit cumulated activity in S. The value of S( Tt S) depends on the radiation type, the energy emitted per transformation, the mass of the target organ and the geometry of the mathematical phantoms representing the adult and children of various ages. When the source organ is the total body less organs already listed in the biokinetic data table, a common approximation is to use the S-value calculated on the basis of total body as a source. However, a formally correct S-value for this case can be derived (Roedler et al., 1972; Cloutier et al., 1973; Roedler and Kaul, 1976; Coffey and Watson, 1979) and it is this latter method which is used in this report. (29) Numerical values of S(TcS) for different ages are available from the Oak Ridge National Laboratory, Tennessee, either in publications (Snyder et al., 1974, 1975) or directly from members of the ICRP Task Group on Dose Calculations. If S-values were not available, the absorbed dose per nuclear transformation was calculated by the use of absorbed fractions cp, derived from Snyder et al. (1978). S(T+S)=&x
T i

EiQpi

(5.3)

RADIATION

DOSE TO PATIENTS FROM RADIOPHARMACEUTICALS

where M, is the mass of the target organ or tissue (see Table A.l); Ei is the mean energy of radiation type i; Yi is the yield of radiation type i per transformation; piis the absorbed fraction of energy of radiation type i; and c is a constant, the value of which depends on the units of the included quantities (for E in joules, M, in kg and c = 1, the absorbed dose per transformation, S, will be in gray).

5.2. Calculation of Cumulated Activity (30) For a more detailed description of the mathematical analysis of biokinetic models, reference should be made to MIRD Pamphlet No. 12 (Berman, 1977) and ICRU Report 32 (ICRU, 1979). The following text only serves as a short account of the calculation of the cumulated activity in selected cases. (31) The cumulated activity A,, in a source organ or tissue S, depends on the administered activity, A,,, the physical half-life, Tp, and the biokinetics of the radiopharmaceutical. A, is obtained by integrating the time-dependent activity:
t ii,(t) = A,(u)du

s0

(5.4)

where A,(u) is the activity at time u in the source organ or tissue considered. Because of the relatively short physical half-life of radionuclides used in nuclear medicine, the upper integration limit, t, can be taken as infinity. (32) Although the mechanisms by which radionuclides are distributed within, or excreted from, the body are not necessarily well represented by first-order kinetic models, such models are generally adequate for representing overall uptake and retention of radionuclides in individual organs and tissues. Since this is all that is required for dosimetric calculations, these models are used extensively in this report. (33) A general first-order kinetic model can be represented as a system of n compartments, interlinked with constant rate coefficients. In such a system, the rate of change of the amount of material (q,) in compartment i is given by:

dq4) = - ~iiqi(t)( dt

i,qi(t)

+ ~ ljjqj(t)

j=1
j+i

(5.5)

where iii is the fraction of the amount of material in compartment i leaving per unit time; Aijis the fraction of the amount of material in compartment j flowing to compartment i per unit time; and I, is the radioactive decay constant, as appropriate. (34) A direct correspondence between compartments and anatomical regions of the body does not usually exist. For absorbed dose calculations it is, however, necessary to know the amount of substance in different regions of the body. Therefore, for practical reasons, specific organs and tissues are considered instead of compartments. The activity in an organ or tissue can usually be described sufficiently accurately by a sum of exponentials,
A,(t) = i
i=l

k,e-(*n+ A8

P-6)

where ki is a constant; and li is the biological elimination constant of the exponential component i. (35) The constants in this equation are often derived directly from measurements. Expressed

BIOKINETICS

AND DOSIMETRY:

GENERAL

CONSIDERATIONS

in terms of fractional distributions to the organ or tissue, fractions of organ or tissue contents and half-lives, which are given in the biokinetic data tables of this report, A, is given by:

where Fs is the fractional distribution to organ or tissue S, i.e. the fraction of the administered substance that would arrive in source organ or tissue S, over all time, ifthere were no radioactive decay; ai is the fraction of F, eliminated with a biological half-life Ti (Xai = 1); aj is the fraction of F, taken up with a biological half-life Tj (marked by a minus sign in the biokinetic data tables) @,aj = 1); n is the number of elimination components; m is the number of uptake components; and Ti,ert and Tj,,ff are the elimination and uptake effective half-lives respectively. Equation (5.7) is, under certain constraints, a solution to the differential equation (5.5). The effective half-life can be calculated from the corresponding biological half-life Ti and the physical half-life TP: (5.8) Equation (5.7) describes the build-up and subsequent decline of activity. If Ti = Tj for some combination of i and j, the corresponding term in the sum in eqn (5.7) becomes:

aiy-- t ev( - l@)t/Ti,,ff)

I

ln(2)

(5.9)

A special case, which often occurs, is that immediate uptake in the organ is assumed. Equation (5.7) then reduces to:
-

A,(t) A0

= F, f: ai exp
i=l

(5.10)

Integrating eqn (5.7) over time gives the normalized cumulated activity: (5.11) Or, if the reduced eqn (5.10) is integrated: (5.12) The intercept of the curve described by the exponential function for component i with the y axis in eqn (5.7) is given by: T. for Ti#Tj a. 2 IT,-T, I I (5.13)

(36) For the special case when there is one elimination component, with half-life T,,, and one uptake component, half-life TUP, ,and T,, # T,,, , the maximum uptake in an organ, A,,,, as a fraction of administered activity, is given by: Amax = flab (5.14)

RADIATION

DOSE TO PATIENTS

FROM RADIOPHARMACEUTICALS

where

a=-

Tel.eff Tupt.eff
TWff

b =

Tup1,eff

-L,eff

This equation is not used in this report but it is considered important to note that the intercept is not identical with ai, nor with A,,, when interpreting data available in the literature. (37) In cases when the retention function cannot be described by a sum of exponential functions, the cumulated activities are derived directly from the metabolic model. (38) For absorbed dose calculations in nuclear medicine, it has often been assumed that the effective half-life in an organ equals the physical half-life. The reason for this approximation is that the substance, in these cases, is labelled with a radionuclide with a physical half-life which is short in comparison with the biological half-life. For short-lived radionuclides, a slow biological excretion may not be apparent and, for absorbed dose calculations, the approximation is sufficiently accurate. The assumption has, however, the consequence that infinite biological half-lives are given in the tables and this is not strictly correct. This should be kept in mind when the biokinetic data are used.

5.3. Uncertainties in Absorbed Dose Estimates (39) The uncertainty in the estimate of the mean absorbed dose for an organ or tissue reflects uncertainties in the S-value and the cumulated activity. Differences between planned and actual administered activity are considered to be minor contributors to the total uncertainty, if regular quality controi is performed (WHO, 1982, 1986; IAEA, 1984). Variation in mass of the target organ and, for photon radiation, variations in the distance between the source and target organs are the major contributors to the uncertainty in S-values; whereas physical data, e.g. the yield and energy deposition in the target organs, are not considered to be major contributors to the uncertainty. Experimental validation of calculated absorbed doses have indicated agreement within 20 to 60%, the latter for patients who differed considerably from the body size and shape assumed in the calculations (for references, see Roedler, 1981). (40) Variations in the estimated cumulated activity largely arise from uncertainties in the quantitative description of uptake, distribution and retention of the radiopharmaceutical in tissues. Functional impairment of an organ can introduce considerable variation in these factors. Variation in the bodys retention of radionuclides administered as radiopharmaceuticals is limited by the short radioactive half-life of these radionuchdes and, thus, the variation in the uptake and distribution of the radiopharmaceutical among the organs and tissues often is the major contributor to uncertainties in cumulated activity. (41) Calculations have shown (Roedler, 1981) that estimates of absorbed dose to different organs will not generally deviate from actual absorbed doses in patients by more than a factor of three. The deviation is even less for substances labelled with short-lived radionuclides such as 99mT~. The effective dose equivalent is less sensitive to variations in the distribution pattern than are organ doses and may vary within a factor of two (Kaul et al., 1984).

10

BIOKINETICS

AND DOSIMETRY:

GENERAL

CONSIDERATIONS

6. EFFECTIVE

DOSE EQUIVALENT

6.1. Use of Effective Dose Equivalent in Nuclear Medicine

(42) The mean dose equivalent H, in a target organ or tissue T is given by (ICRP, 1977): H,=D,QN (6.1)

where D, is the mean absorbed dose in T, Q is the quality factor and N is the product of any other modifying factors. The quality factor is intended to allow for the effect on the detriment of the microscopic distribution of absorbed energy. For a spectrum of radiation, an effective value, a, of Q can be calculated. In practice, for the radionuclides used in diagnostic nuclear medicine (viz low-LET radiations), this value is taken to be unity. N might take account for example of absorbed dose rate and fractionation. At present the Commission has assigned the value of unity to N. The modifying factors Q and N are dimensionless. The effective dose equivalent (HE) was developed primarily for radiation protection of occupationally exposed persons (ICRP, 1977; Statement, ICRP, 1978). It attributes weighting factors wT to organs or tissues, representing the fraction of the total stochastic risk (i.e. fatal cancer and serious inherited disorders) resulting from the irradiation of that organ or tissue T when the total body is irradiated uniformly. The effective dose equivalent is calculated by adding the weighted organ or tissue mean dose equivalents, H,, i.e., H,=zw,xH, (6.2) T where H, is the effective dose equivalent; wi is the relative radiation sensitivity of organ or tissue, T (see Table 6.1); and H, is the mean equivalent in target organ or tissue F, for the radionuclides used in diagnostic nuclear medicine it is numerically equal to that of the mean absorbed dose, since for these radionuclides the quality factor, Q, is taken as unity. (43) If the body is irradiated uniformly, all the H,s are the same and the dose equivalent at any point in the body is equal to the effective dose equivalent, H,. (44) The weighting factors used in computing this quantity, and the overall risk coefficient associated with it, are appropriate to a population including individuals of both sexes with a particular age structure. (45) The concept of the effective dose equivalent can also be useful in nuclear medicine. However, because the sex and age distribution of patients undergoing a particular nuclear

Table 6.1. Weighting factors for calculation of the effective dose equivalent (HE) Tissue Gonads Breast Red bone marrow Lungs Thyroid Bone surfaces Remainder* wr 0.25 0.15 0.12 0.12 0.03 0.03 0.30

*The weighting factor for the remainder is divided equally between the five remaining organs and tissues receiving the highest dose equivalent.

RADIATION

DOSE TO PATIENTS

FROM RADIOPHARMACEUTICALS

11

medicine examination usually differ considerably from that assumed when defining the effective dose equivalent and associated risk coefficient for adult workers, the effective dose equivalent may not be as good a measure of radiation risk in such a group as it is in workers. Nevertheless, the weighting factors assigned are probably not very sensitive to changes in age of the population. Therefore, the effective dose equivalent can be considered useful in comparisons of the radiation exposure to a patient from different procedures used in diagnostic nuclear medicine and in research. Since the risk associated with either the dose equivalent in an organ or with the effective dose equivalent depend on age at irradiation, the effective dose equivalent can only be used as a measure of the actual risk if some information is available on risk coefficients as a function of age. Furthermore, because of the averaging procedures involved, the effective dose equivalent can be an only approximate indicator of the risk to either the individual worker or the individual nuclear medicine patient. (46) The effective dose equivalent may also be one useful input for assessing clinical research projects which involve the administration of radioactive substances to volunteers. In addition, the values of dose equivalent and effective dose equivalent per unit intake given in this report could be used to define Annual Limits on Intake, by ingestion or inhalation, for occupationally exposed persons engaged in the manufacture or use of specific radiopharmaceuticals. 6.2. Calculation of the Effective Dose Equivalent (47) The organs and tissues considered for calculation of the effective dose equivalent are listed in Table 6.1. Those having specific weighting factors are always included in the calculation. For the gonads, the arithmetic mean of the absorbed doses to ovaries and testes is used in conjunction with the weighting factor of 0.25. The weighting factor for the remainder, 0.30, is equally divided between five of the remaining organs or specified tissues showing the highest absorbed dose values. Absorbed doses to skin, blood and blood vessels are not included in the calculation. (48) In the absorbed dose tables for the individual radiopharmaceuticals, those five further organs or tissues in the remainder which are included in the calculation of the effective dose equivalent for adults are marked with a preceding asterisk (*). Because many radiopharmaceuticals are excreted rapidly in the urine, the wall of the urinary bladder is often included as one of the five remaining organs and tissues used in the computation of effective dose equivalent. Furthermore, the absorbed dose to the bladder wall is often large compared with the absorbed dose to other organs and tissues in the same study, and it can contribute considerably to the effective dose equivalent. For example, with lz51-Hippuran it contributes 96% of the total dose. In cases where the contribution is more than SO%, a note at the foot of the dosimetry table states the actual contribution.

7. IMPURITIES

IN RADIOPHARMACEUTICAL
7.1. Radionuclide Impurities

PREPARATIONS

(49) Many radioactive substances for medical use contain small amounts of radionuclides other than that intended. There are several reasons for this. Usually, the contamination arises during the production process either because of activation in the target of radionuclides other than that intended, or because of an unavoidable side-reaction in the nuclear process. In other cases, when one of the components in a parent-daughter system is used, the other component may also be present, because of incomplete separation before administration of the

12

BIOKINETICS

AND DOSIMETRY:

GENERAL

CONSIDERATIONS

radiopharmaceutical. When a daughter radionuclide is administered, various amounts of the parent radionuclide may be present in the eluate from the radionuclide generator, because of breakthrough. In other cases, when the parent is administered, new daughter atoms are being continuously produced after separation and these may be radioactive. They then contribute to the impurities. Table 7.1 contains a list of the most frequent radioactive impurities in radionuclides of medical interest. Normally, the impurity can be kept at a low level and will not significantly contribute to the absorbed dose. For many radiopharmaceuticals, maximum acceptable levels of radioactive impurities are prescribed in appropriate national pharmacopoeias. (50) The values of absorbed dose and effective dose equivalent given in this report generally refer to substances containing one radionuclide alone at the moment of administration to the patient. When the radionuclide has a radioactive daughter, the contribution from the daughter produced in the body after administration is included in the calculations, but it is usually assumed that there is no daughter present at the time of administration. However, in a few cases, the daughter is a nuclide of the same element as the parent and separation before administration is.not possible. In those cases, where half-lives are short, equilibrium is assumed. For all other cases, absorbed dose contributions from known impurities of significant magnitude have to be added to the absorbed dose values presented herein. 7.2. Radiochemical Impurities (51) A radionuclide may be present in a chemical form other than that desired. Such chemical compounds may arise both during production and storage of the substance. Important examples are radiopharmaceuticals labelled with technetium or iodine. The various chemical forms can be separated, often by the use of radio-chromatographic procedures. These are extensively used both for purification and for quality control of the final product. (52) The presence of chemical forms of the radionuclide other than that intended may change the distribution and kinetics of the radionuclide. This may lead to a different distribution of the absorbed dose to some organs and tissues. (53) In this report, complete radiochemical purity has been assumed, unless otherwise stated. For this reason, absorbed doses from known impurities have to be added to the values attributed to the pure chemical species.
Table 7.1. Radionuclide contaminants of commonly used radiopharmaceuticals Main radionuclide 47Ca Fe Radioactive impurity 47Sc (daughter) 52mMn (daughter), 5sFe Fe, 6oCo =co, -20, 6oco sco, 6oco *lRb (parent) 99Mo (parent), g9Tc (daughter), II
1241 1251 ,261 1 14m~n 1261

,231 1251

In

11 3rnIn

=Au -Hg *OaTI

200T4

%n (parent) =Au 197mHg,03Hg

202fl, 203pb

RADIATION

DOSE TO PATIENTS FROM RADIOPHARMACEUTICALS

13

REFERENCES
Ahlgren, L., Ivarsson, S., Johansson, L., Mattsson, S. and Nosslin, B. (1985). Excretion of radionuclides in human breast milk after the administration of radiopharmaceuticals. J. Nucl. Med. 26, 1085-1090. ARSAC (1984). Administration of Radioactive Substances Advisory Committee. Notes for Guidance on the Administration of Radioactive Substances to Persons for Purposes of Diagnosis, Treatment or Research, EN(84)5. Published by Dept of Health and Social Security, London. Berman, M. (1977). Kinetic Models for Absorbed Dose Calculation, Medical Internal Radiation Committee (MIRD) Pamphlet No. 12. Available from Society of Nuclear Medicine, 475 Park Avenue South, New York, NY 10016, USA. Cloutier, R. J., Watson, E. E., Rohrer, R. H. and Smith, E. M. (1973). Calculating the radiation dose to an organ. J. Nucl. Med. 14, 53-55. Coakley, A. J. and Mountford, P. J. (1985). Nuclear medicine and the nursing mother. Rr. Med. J. 291, 159-160. Coffey, J. L. and Watson, E. E. (1979). Calculating doses from remaining body activity. A comparison of two methods.
Med. Phys. 6, 307-308.

Garby, L., Liifveberg, S. and Nosslin, B. (1969). Radiation Dosesfrom Radioactive Substances in Medical Use. Swedish National Institute of Radiation Protection, Stockholm (in Swedish). Gelfand, M. J., Thomas, S. R. and Kereiakes, J. Cl. (1983). Absorbed radiation dose from routine imaging of the skeleton in children. Ann. Radio1 26,421423. IAEA (1984). The Quality Control of Nuclear Medicine Instruments, Technical Document No. 317. International Atomic Energy Agency, Vienna, Austria. ICRP (1971). Protection of the Patient in Radionuclide Investigations, ICRP Publication 17. Pergamon, Oxford. ICRP (1973). Alkaline Earth Metabolism in Adult Man, ICRP Publication 20. Pergamon, Oxford. ICRP (1977). Recommendations of the International Commission on Radiological Protection, ICRP Publication 26. Pergamon, Oxford. ICRP (1978). Statementfrom the 1978 Stockholm Meeting of the ICRP, ICRP Publication 28. Pergamon, Oxford. ICRP (1979). Limitsfor Intakes of Radionuclides by Workers, ICRP Publication 30: Part 1. Pergamon, Oxford. ICRP (1980). Limits for Intakes of Radionuclides by Workers, ICRP Publication 30: Part 2. Pergamon, Oxford. ICRP (1981). Limits for Intakes of Radionuclides by Workers, ICRP Publication 30: Part 3. Pergamon, Oxford. ICRP (1987). Protection ofthe Patient in Nuclear Medicine, ICRP Publication 52. Pergamon, Oxford. ICRU (1979). Methods ofAssessment of Absorbed Dose in Clinical Use OfRadionuclides, ICRU Report 32. International Commission on Radiation Units and Measurements, Bethesda, Maryland. Johansson, L., Mattsson, S. and Carlsson, S. (1981a). Effective dose equivalent from long-lived radionuclide impurities in Tc-99mpertechnetate. In: Third International Radiopharmaceutical Dosimetry Symposium (Proc. Conf. Oak Ridge, Tennessee, 1980), HHS Publication (FDA 81-8166), pp. 6022615. Department of Health and Human Services, Bureau of Radiological Health, Rockville, Maryland. Johansson, L., Mattsson, S. and Nosslin, B. (1981b). Radiation Doses from Radioactiue Substances in Medical Use. Swedish National Institute of Radiation Protection, Stockholm. (In Swedish with an English word list). Kaul, A., Oeff, K., Roedler, H. D. and Vogelsang, T. (1973a). Radiopharmaceuticals-Biokinetic Data and Results of Radiation Dose Calculations. Informationsdienst fur Nuklearmedizin, Berlin. Kaul, A., Oeff, K., Roedler, H. D. and Vogelsang, T. (1973b). Die Strahlenbelastung son Patienten bei der nuklearmedizinischen Anwendung ofiner radioaktiver Stoffe. Informationsdienst fur Nuklearmedizin, Berlin. Kaul, A., Hinz, G., Kossel, F., Konig, K., Kragh, P., Nitschke, J., Roedler, H. D. and Schwarz, E. R. (1984). The
Efictive per Caput Dose Equivalent as a Measure of Medical Radiation Exposure of the Population-A Complement or an Alternative to the Genetically Significant Dose? ISH Report 52. Institut fur Strahlenhygiene des Bundesgesundheit-

samtes, Neuherberg, Federal Republic of Germany. Kaul, A., Krauss, 0. and Petrausch, G. (1985). Strahlenexposition durch Tc-99m-Methylendiphosphonat-lokale Dosisverteilung in Wachstum szonen des kindlichen Skeletts und Organdosen. In: Medizinische Physik 1985. (Poretti, G. ed.). Deutsche Gesellschaft fur medizinische Physik, Bern, Switzerland. Loevinger, R. and Berman, M. (1968). A schema for absorbed-dose calculations for biologically distributed radionuclides. Medical International Radiation Dose Committee (MIRD) Pamphlet No. 1. J. Nucl. Med. 9, Suppl. 1, 7-14. NCRP (1982). Nuclear Medicine-Factors ZnjIuencing the Choice and Use of Radionuclides in Diagnosis and Therapy, NCRP Report No. 70. National Council on Radiation Protection and Measurements, Bethesda, Maryland. NCRP (1985a). The Experimental Basis for Absorbed-Dose Calculations in Medical Uses of Radionuclides, NCRP Report No. 83. National Council on Radiation Protection and Measurements, Bethesda, Maryland. NCRP (1985b). General Concepts for the Dosimetry of Znternally Deposited Radionuclides, NCRP Report No. 84. National Council on Radiation Protection and Measurements, Bethesda, Maryland. Roedler, H. D. (1981). Accuracy of internal dose calculations with special consideration of radiopharmaceutical biokinetics. In: Third International Radiopharmaceutical Dosimetry Symposium (Proc. Conf. Oak Ridge, Tennessee, 1980), HHS Publication (FDA 81-8166). Department of Health and Human Welfare, Bureau of Radiological Health, Rockville, Maryland. Roedler, H. D. and Kaul, A. (1976). Dose to target organs from remaining body activity: Results of the formally exact and approximate solution. In: Radiopharmaceutical Dosimetry Symposium (Proc. Co@ Oak Ridge, Tennessee, April 1976), HEW Publication (FDA 76-8044), pp. 155-163. Department of Health. Education and Welfare, Bureau of Radiological Health, Rockville, Maryland.

14

BIOKINETICSAND

DOSIMETRY:

GENERAL CONSIDERATIONS

Roedler, H. D., Kaul, A., Bemer, W., Koeppe, P. and Glaubitt, D. (1972). Development of an extended formalism for internal dose calculations and practical applications to several biologically distributed radioelements. In: Assessment of Radioactive Contamination in Man (Proc. Symp. Stockholm, 1971), pp. 515-541. International Atomic Energy Agency, Vienna, Austria. Rocdler, H. D., Kaul, A. and Hine, G. J. (1978). Internal Radiation Dose in Diagnostic Nuclear Medicine. Hoffman, Berlin. Snyder, W. S., Ford, M. R., Warner, G. G. and Fisher, Jr, H. R. (1969). Estimates of absorbed fractions for monoenergetic photon sources uniformly distributed in various organs of a heterogeneous phantom. Medical Internal Radiation Dose Committee (MIRD) Pamphlet No. 5. J. Nucl. Med. 10, Suppl. 3. Snyder, W. S., Ford, M. R., Warner, G. G. and Watson, S. B. (1974). A Tabulation ofDose-equivalent per Microcuriedayfor Source and Target Organs ofan Adultfor Various Radionuclides, Report ORNL-5000. Oak Ridge National Laboratory, Tennessee; National Technical Information Service, Springfield, Virginia. Snyder, W. S., Ford, M. R., Warner, G. G. and Watson, S. B. (1975). s Absorbed Dose per Unit Cumulated Activityfor Selected Radionuclides and Organs, Medical Internal Radiation Dose Committee (MIRD) Pamphlet No. 11. Available from Society of Nuclear Medicine, 475 Park Avenue South, New York, NY 10016, USA. Snyder, W. S., Ford, M. R. and Warner, G. G. (1978). Estimates of Specific Absorbed Fractions for Photon Sources Un$ormly Distributed in Various Organs ofa Heterogeneous Phantom, Medical Internal Radiation Dose Committee (NM/MIRD) Pamphlet No. 5, revised. Available from Society of Nuclear Medicine, 475 Park Avenue South, New York, NY 10016, USA. Winchell, H. S., Horst, W. D., Braum, L. et al. (1980). N-isopropyl (*?)p-iodoamphetamine: Single-pass brain uptake and washout; binding to brain synaptosomes; and localisation in the dog and monkey brain. J. Nucl. Med. 21,
947-952.

WHO (1982). Quality Assurance in Nuclear Medicine. World Health Organisation, Geneva. WHO (1986). Review of Quality Control in Nuclear Medicine, bga-Schrifter g/1986. (Cradduck, T. D., BusemannSokole, E. and Roedler, H. D. eds) MMV Verlag, Munich.

APPENDIX

A: SPECIAL BIOKINETIC

MODELS

A.l. Organ and Tissue Masses for Different Ages (54) The masses of the organs and tissues are inherent in the S-values used. The values are, therefore, taken from the same sources as the S-values, These include MIRD Pamphlets (Snyder et al., 1975) and information supplied by members of the Task Group on Dose Calculations. The values, for the adult which are presented in Table A. 1, have been derived mainly from data in Reference Man (ICRP, 1975). The children and infant data have been taken from Cristy (1980). References
Cristy, M. (1980). Mathematical Phantoms Representing Children of Various Agesfor Use in Estimates of Internal Dose, Report ORNL/NUREG/TM-367. Oak Ridge National Laboratory, Tennessee. ICRP (1975). Reference Man: Anatomical, Physiological and Metabolic Characteristics, ICRP Publication 23. Pergamon, Oxford. Snyder, W. S., Ford, M. R., Warner, G. G. and Watson, S. B. (1975). SAbsorbed Dose pw Unit Cumulated Actiuityfor Selected Radionuclides and Organs, Medical Internal Radiation Dose Committee (MIRD) Pamphlet No. 11. Available from the Society of Nuclear Medicine, 475 Park Avenue South, New York, NY 10016, USA.

A.2. Blood Volume and Blood Flow Models (55) A model for predicting the distribution of a radionuclide in blood is used for substances which remain largely in the circulation, including labelled blood cells and radionuclides attached to macro-molecules. This model requires information on blood volumes in different organs and tissues. These values have been taken from Table 105 of ZCRP Publication 23 (ICRP, 1975), with the exception of the values for red bone marrow and mineral bone. For these tissues, it has been assumed that the blood volume per unit mass of tissue is a factor of five higher in the red bone marrow than in mineral bone. The value used for red bone marrow is in closer

RADIATION

DOSE TO PATIENTS

FROM RADIOPHARMACEUTICALS

15

Table A.l. Masses (g) of selected organs and tissues at different ages* (yr) Organ Adrenals Bladder content Bladder wall Breast Stomach content Stomach wall Small intestine (SI) SI wall ULI content ULI wall LLI content LLI wall Heart content Heart wall Kidneys Liver Gallbladder content Gallbladder wall Lungs Muscle Ovaries Pancreas Red marrow Cortical bone Trabecular bone Bone surfaces Spleen Testes Thyroid Uterus Total body Blood volume (ml) Adult 14 200 45 361 250 150 1040 640 220 210 135 160 454 316 310 1800 56 11 1000 28000 11 100 1500 4000 1000 120 180 35 20 80 70000 5200 15 10.5 152.0 35.9 361.0 185.0 118.0 795.0 515.0 167.0 176.0 104.0 127.0 350 240 248.0 1410.0 49 9.3 651.0 15000.0 10.7 64.9 1050.0 4000.0 1000.0 91.8 123.0 15.6 12.4 79.0 56 800 4200 10 7.22 97.3 23.2 2.60 126.0 85.1 441 .o 286.0 92.5 93.4 58.6 70.0 220 150 173.0 887.0 39 7.3 453.0 6 500.0 3.13 30.0 610.0 2 974.2 743.5 55.6 77.4 1.89 7.93 4.16 33200 2200 5 5.27 61.4 14.5 1.51 71.3 49.1 261.0 169.0 55.0 55.2 34.7 41.4 130 93 116.0 584.0 20 3.7 290.0 2000.0 1.73 23.6 320.0 1448.9 965.9 32.5 48.3 1.63 3.45 2.70 19800 1500 1 3.52 31.2 7.70 0.732 34.4 21.8 131.0 84.9 27.3 27.8 17.4 20.6 73 51 62.9 292.0 4.8 0.9 143.0 1200.0 0.714 10.3 150.0 622.8 415.2 13.7 25.5 1.21 1.78 1.45 9 720 800

*In addition to the organs and tissues listed here, ICRP Publication 23 includes various other components, including adipose and connective tissues, periarticular tissues, and skin. For a comprehensive list of organ and tissue masses, see Table 105 of ICRP Publication 23 (ICRP, 1975). ULI, Upper large intestine; LLI, lower large intestine.

agreement with those reported by Cloutier and Watson (1970). The haematocrit, or fractional red cell content of the blood, has been considered constant for blood circulating through all tissues. The data are presented in Table A.2 and refer to adults. The fractional blood volumes used for children have been calculated by assuming that the blood content in an organ or tissue per unit mass of tissue relative to that of the total body is independent of age. The total blood volume in children is taken from ZCRP Publication 23 (ICRP, 1975) and is presented in Table A.l. (56) In the biokinetic models used in this report, the term uptake or content of a radionuclide in an organ or tissue usually includes the radioactivity in blood in that organ or tissue. However, when the blood distribution model is used, a specified fraction of the activity is associated with the circulating blood. In this case, the activity in circulating blood in an organ or tissue has been added to the activity in that organ or tissue for purposes of dose calculations. (57) Table A.2 also presents the fractional cardiac output to different organs. These fractions have been calculated from data published by Spector (1956, Table 273), supplemented by data from studies of blood flow to bone, red marrow and spleen (Charkes et al., 1978; Huchzermeyer et al., 1977; Hughes Jones et al., 1957; Lahtinen et al., 1981,1982,1983; Peters et al., 1980,1984;

16

BIOKINETICS

AND DOSIMETRY:

GENERAL

CONSIDERATIONS

Table A.2. Adult values for blood content and blood flow in different organs Blood content per unit tissue mass (ml kg-) 74 236 28 25 22 161 226 139 530 127 500 179 Fractional cardiac output 1.00 0.012 0.04 0.01 0.14 0.040 0.23 0.058 1.00 0.163 0.05 0.035 0.032

Organ Total body Adrenals Bone, cortical Bone, trabecular Brain Heart wall Heart contents Kidneys Liver Lungs Muscle Red marrow Spleen Thyroid

Fractional blood volume 1.00 0.0006 0.0212 0.0048 0.0060 0.0119 0.0962 0.0135 0.0481 0.1020 0.0365 0.0173 0.0007

Simon et al., 1977; Tondevold and Eliasen, 1982; Williams et al., 1968; Wootton, 1974; Wootton et al., 1976). These data are relevant to models for very short-lived radionuclides (Section A.1 1). References
Charkes, N. D., Makler, P. T. Jr and Philips, C. (1978). Studies of skeletal tracer kinetics. I. Digital-computer solution of a five compartment model of [sFl fluoride kinetics in humans. J. Nucl. Med. 19,1301-1309. Cloutier, R. J. and Watson, E. E. (1970). Radiation dose from radioisotopes in the blood. In: Medical Radionuclides: Radiation Dose and Eficts, pp. 325346. (R. J. Cloutier, C. E. Edwards and W. S. Snyder, eds) National Technical Information Service, Springfield, Virginia. Report No. CONF 691212. Huchzermeyer, H., Schmitz-Feurerhake, I. and Reblin, T. (1977). Determination of splenic blood flow by inhalation of radioactive rare gases. Eur. J. Clin. Invest. 7, 345349. Hughes Jones, N. C., Mollison, P. L. and Veall, N. (1957). Removal of incompatible red cells by the spleen. Br. J. Haematol. 3, 125-133. ICRP (1975). Reference Man: Anatomical, Physiological and Metabolic Characteristics, ICRP Publication 23. Pergamon, Oxford. Lahtinen, T., Alhava, E. M., Karjalainen, P. and Romppanen, T. (198 1). The effect of age on blood flow in the proximal femur in man. J. Nucl. Med. 22,96&972. Lahtinen, R., Lahtinen, T. and Romppanen, T. (1982). Bone and bone-marrow blood flow in chronic granulocytic leukemia and primary myelofibrosis. J. Nucl. Med. 23,218-224. Lahtinen, R., Lahtinen, T. and Hyiidynmaa, S. (1983). Increased bone marrow blood flow in polycythemia Vera. Eur. J. Nucl. Med. 3, 19-22. Peters, A. M., Klonizakis, I., Lavender, J. P. and Lewis, S. M. (1980). Use of 1ndium-1abe11ed platelets to measure spleen function. Br. J. Haernatol. 46, 587-593. Peters, A. M., Walport, M. J., Bell, R. N. and Lavender, J. P. (1984). Methods of measuring splenic blood flow and platelet transit time with In-ill-labelled platelets. J. Nucl. Med. 25, 8690. Simon, J., &fraud, R. and Geral, J. P. (1977). Comparative study of 99Tcmpertechnetate and I-iodoantipyrine in the determination of bone blood flow. Znt. J. Nucl. Med. Biot. 4,23 l-232. Spector, W. S. (1956). Handbook of BiologicalData. Saunders, Philadelphia. Tondevold, E. and Eliasen, P. (1982). Blood flow rates in canine cortical and cancellous bone measured with 9gmTc-labelled human albumin microsphere% Acta Orthop. &and. 53, 7-l 1. Williams, R., Condon, R. E., Williams, H. S., Blendis, L. M. and Kreel, L. (1968). Splenic blood flow in cirrhosis and portal hypertension. Clin. Sci. 34, 441452. Wootton, R. (1974). The single-passage extraction of sF in rabbit bone. Clin. Sci. Mol. Med. 47, 7S773 Wootton, R., Reeve, J. and Veall, N. (1976). The clinical measurement of skeletal blood flow. Clin. Sci. Mol. Med. 50,
261-268.

A.3. Gastrointestinal Tract Model (58) The model used in ICRP Publication 30 (ICRP, 1979) for the gastrointestinal tract has

RADIATION

DOSE TO PATIENTS

FROM RADIOPHARMACEUTICALS

17

been used for both adults and children. The model, shown in Fig. A.l, consists of four compartments: stomach, small intestine (SI), upper large intestine (ULI) and lower large intestine (LLI). Immediate mixing within each compartment is assumed. (59) The same biological half-times are used for both children and adults. In fact, the mean gastrointestinal transit time in children is significantly less than that in adults, being about 24 hr as compared to 42 hr for the adult in the ICRP model (Corazziari et al., 1985). The assumption of 42 hr as transit time in children will affect estimates of the absorbed dose to different parts of the gastrointestinal tract, depending upon the physical half-life of the radionuclide; long half-life radionuclides resulting in over-estimates, and short half-life radionuclides resulting in underestimates. Furthermore, for radionuclides with a physical half-life shorter than, or comparable to, the 1 hr residence time in the stomach, the over-estimate of the residence time in the stomach of children could result in an under-estimate of the activity absorbed from the small intestine and thus an under-estimate of the absorbed dose to other organs. (60) A modified model is used for the group of non-absorbable-t inert markers used to study different aspects of the physiology of the gastrointestinal tract, e.g. oesophageal transport, gastro-oesophageal reflux, gastric emptying, entero-gastric reflux, intestinal transport and transit time, abnormal intestinal permeability, and also to delineate faecal collection periods. This group comprises substances labelled with radionuclides of scandium, chromium, technetium, indium, iodine and barium. In Section II, individual substances are identified for appropriate elements, under the heading non-absorbable markers. The modification to the standard ICRP model is that the gastric residence time is changed to 33 min for fluids and 2.1 hr for solids (Siegel et al., 1983).
Ingestion n
V

Stomach

( ST

Body fluids

Upper Large intestine fULI1

Fig. A.1 Mathematical model used to describe the kinetics of radionuclides in the gastrointestinal tract. Mass of walls* (8) 150 640 210 160 Mass of contents* (g) 250 400 220 135 Mean residence time (d) l/24 4124 13124 24124

Section of GI tract Stomach (ST) Small intestine (SI) Upper large intestine (ULI) Lower large intestine (LLI) *From ICRP Publication 23 (ICRP, 1975).

(dl) 24 6 1.8 1

tSmal1 quantities of non-absorbable markers (i.e. up to a few percent) may be absorbed into the blood. For the purposes of this report, the amounts absorbed are considered to have a negligible effect on the dose calculations.

18

BIOKINETICS

AND DOSIMETRY:

GENERAL

CONSIDERATIONS

References
Corazziari, E., Cucchiara, S., Staiano, A., Romaniello, G., Tamburrini, O., Torsoli, A. and Auricchio, S. (1985). Gastrointestinal transit time, frequency of defecation, and anorectal manometry in healthy and constipated children. J. Pediat. 106,379-382. ICRP (1979). Limitsfor Intakes of Radionuclides by Workers, ICRP Publication 30: Part 1. Pergamon, Oxford. Siegel, J. A., Wu, R. K., Knight, L. C., Zelac, R. E., Stern, H. S. and Malmud, L. S. (1983). Radiation dose estimates for oral agents used in upper gastrointestinal disease. J. Nucl. Med. 24, 835-837.

A.4. Lung Model (61) Three different groups of substances are at present in use for studies of pulmonary function, namely noble gases (xenon, krypton), aerosols (labelled with radionuclides of technetium or indium) and simple gases (CO,, O,, CO) labelled with very short-lived radionuclides ( C, 50) . The substances are administered by inhalation, either as single breath or continuously for a fixed period. (62) A dosimetric model for inhalation of aerosols is presented in ZCRP Publication 30 (ICRP, 1979). The Task Group has, however, found it difficult to apply a standard model for all substances used in medicine. Instead, the reader is referred to the description of the biokinetics for each of the substances presented in Section II of this report. Reference
ICRP (1979). Limitsfor Intakes of Radionuclides by Workers, ICRP Publication 30. Pergamon, Oxford.

AS. Kidney-Bladder Model (63) This model is applied to all substances used for kidney function tests, and to other substances if urinary excretion results in a significant absorbed dose to the bladder wall. In all these cases, the bladder is a separate entry in the biokinetic data tables in Section II. (64) It is assumed that the fraction of the total excretion which passes through the kidneys and bladder is known. Activity excreted via this route passes through the kidneys with a transit time established from other clinical studies and subsequently enters the bladder in urine, where it remains until the bladder is emptied and the radioactive contents excreted. (65) The rate at which a radionuclide is excreted is determined from a knowledge of the amount in the total body, ATB, which is assumed to be described by the sum of a series of exponential functions: A,,= i
i=1

a, exp(-(li+A,)t)

(A.11

where li is the biological elimination constant for component i; 1, is the radioactive decay constant; and ai is the fraction of the administered activity associated with component i. The cumulated activity in the kidneys from the excretion process, Ai,, is given by:

64.2)
where f, is the fraction of excreted activity which is eliminated through the kidneys; and TK is the transit time through the kidneys appropriate for the given radiopharmaceutical and physiological status, normally taken to be 5 min.

RADIATION DOSE TO PATIENTS FROM RADIOPHARMACEUTICALS

19

(66) The expression is approximate, since f, may differ for the individual components of whole-body clearance. However, for practical application, this approximation is judged to be adequate. The cumulated activity in the kidneys given in the biokinetic data for the individual substances is the sum of the cumulated activity from the excretion process and a contribution from activity distributed uniformly in the remaining organs and tissues, which can include the kidneys. (67) The cumulated activity in bladder contents, A,, is given by:
A,=f, i
i=l

aj [

l-exp(-Q,)
3P

l-exp(-(&+;l,)t,)
;li + 3~

(A-3) 1 -exp(-(&+;l,)t,) where t, is the bladder filling and voiding interval, which for the purpose of the present model is assumed to remain constant and equal to 3.5 hr, the average urinary cycle in humans (Syed, 1976). The first voiding is assumed to occur at time t, after administration of the radiopharmaceutical to the patient. In eqn (A.3), the effect of kidney residence time has been neglected, since it is usually much shorter than the bladder filling and voiding cycle. The same filling interval of 3.5 hr is used for all ages. (68) The S-values used in the case of the bladder relate to the content and the wall of the bladder as the source and target tissue respectively. It should be noted that the S-values, which for electrons and beta particles represent a surface dose to the bladder wall, are based on a fixed average bladder content of 200 ml for adults and 152,97,61 and 31 ml for l&10,5 and 1 yr old children respectively. These S-values have been used in the present report in conjunction with cumulated activities estimated for a 3.5 hr bladder voiding interval, as stated above. This method does not allow for the variation in dose-rate to the wall as the bladder fills with urine containing radionuclides. (69) Calculating the radiation dose to the bladder wall involves considering a complex relationship between urine flow rate, voiding period and the volume present in the bladder when the radiopharmaceutical is administered, and is critically dependent on the model used to describe the geometrical relationships between the wall of the bladder and the contents. Such a model was developed by Snyder and Ford (1976) to investigate the effects of the above physiological variables on absorbed dose to the bladder wall and was extended by Smith et al. (1982) to examine these effects for any radiopharmaceutical. (70) Within the ranges of urine flow rate 0.5 to 2 1 d- , of voiding period 0.5 to 8 hr and of initial bladder contents 0 to 300 ml, the predicted bladder wall dose varies over a range of about 25 times for radiopharmaceuticals that are rapidly cleared by the renal system (e.g. 31I-Hippuran), reducing to a range of about 5 times for substances that are more slowly cleared (e .g . l3 *I-Iodide). For voiding periods of 3.5 hr and longer, the bladder dose predicted by the simplified method used in this report lies within the spread of doses obtained using the above ranges of parameter values, but may be as much as 5 times lower than the highest values. As the voiding period decreases, the simple method leads to a further underestimate of the dose, which, for a period of 0.5 hr, may be of the order of 25 times.

References
Smith, T., Veal], N. and Wootton, R. (1982). Bladder wall dose from administered radiopharmaceuticals: The effect of variation in urine flow rate, voiding interval and initial bladder content. Radiat. Prof. Dosim. 2, 183-189.

20

BIOKINETICS

AND DOSIMETRY:

GENERAL

CONSIDERATIONS

Snyder, W. S. and Ford, M. R. (1976). Estimation of doses to the urinary bladder and to the gonads. In: Radiopharmaceutical Dosimetry Symp. (Proc. Conf. Oak Ridge, Tennessee, April 19X), HEW Publication (FDA 76-8044), pp. 313-349. Department of Health, Education and Welfare, Bureau of Radiological Health, Rockville, Maryland. Syed, I. B. (1976). Dosimetry of indium-113m radiopharmaceuticals with special attention to the urinary bladder. In: Radiopharmaceutical Dosimetry Symp. (Proc. Con& Oak Ridge, Tennessee, April 1976), HEW Publication (FDA 76-8044), pp. 306369. Department of Health, Education and Welfare, Bureau of Radiological Health, Rockville, Maryland.

A.6 Model for Radiopharmaceuticals Used to Measure Glomerular Filtration Rate (71) For a variety of labelled inulin and inulin-like radiopharmaceuticals used for the measurement of glomerular filtration rate (GFR) the following biokinetic model has been used. (72) After intravenous administration and initial rapid distribution in extra-cellular fluid, it is assumed that the radionuclide is excreted exclusively by the kidneys according to the kidneybladder model. In the normal case, total body retention is described by a monoexponential function with a half-time of 100 min, the fraction excreted by the kidneys being 1.O,and the renal transit time 5 min. (73) For chelated compounds (DTPA, EDTA) and also for the contrast medium sodium iothalamate, there is evidence of a small degree of in oiuo dissociation of the radioactive label, leading to longer retention of approximately 1% of the administered radionuclide. This fraction is assumed to be uniformly distributed and to be eliminated with a half-time of 7 d. This is a simplifying approximation, since the dissociated label will exhibit specific biokinetics depending upon its chemical form. Nevertheless, it is considered adequate for estimating the contributions to absorbed dose from this dissociated label, provided that the examinations are conducted with a blocked thyroid for those radiopharmaceuticals for which the dissociated label would concentrate preferentially in the thyroid. (74) In the abnormal case, it is assumed that the retention half-time of the major component is increased to 1000 min and that the renal transit time is increased to 20 min. A.7. Models for Bone Seeking Radionuclides Administered as Radiopharmaceuticals (75) As noted in ZCRP Publication 26 (ICRP, 1977), a layer of 10 pm thickness on bone surfaces, representing endosteal and periosteal cells, is considered as the radiation-sensitive bone tissue. The dose to this layer from ggmTcdistributed on bone surfaces is larger by a factor of five than that obtained from estimates using the total bone volume as a source and target tissue (Johansson, 1981). (76) S-values derived for bone surfaces as the target tissue have been used in this report. For adults these values are the same as those used in ZCRP Publication 30 (ICRP, 1979), and for children the values have been obtained directly from the Task Group on Dose Calculations. The S-values from bone to bone surfaces and to red marrow are dependent on the distribution of the activity within the bone. Two different cases can be distinguished: -Surface deposited activity in trabecular bone and cortical bone. -Activity deposited uniformly throughout the entire volume of the mineral bone: (a) in trabecular bone, (b) in cortical bone. (77) In ZCRP Publication 30 (ICRP, 1979) a general rule concerning short-lived radionuclides is given: radionuclides with a physical half-life less than 15 days are assumed to be surface deposited. In this report, the same general rule is adopted. Thus, for the absorbed dose calculations, all radionuclides with a physical half-life of less than 15 d have been assumed to be surface deposited, and those with a physical half-life longer than 15 d have been assumed to be

RADIATIONDOSE TO PATIENTS FROM RADIOPHARMACEUTICALS

21

volume distributed, unless otherwise stated. If nothing is known concerning the distribution of cumulated activity between cortical and trabecular bone, it is assumed to be uniformly distributed on surfaces or throughout the volume, as appropriate. (78) The distribution of activity thus follows the surface area or mass distribution of mineral bone. For adults, the mass ratio cortical: trabecular bone is 80: 20 and the surface area ratio is 50: 50 (ZCRP Publication 30, ICRP, 1979). These values have been taken to be valid also for 15 and 10 yr old children. For 5 and 1 yr old children, the mass ratio cortical: trabecular bone, used for the absorbed dose calculation, is assumed to be 60:40 and the surface area ratio is assumed to be 40:60. (79) As noted in Section 4, a few radiopharmaceuticals are concentrated to a significant extent in the metaphyseal growth plates ofchildrens bones. This factor is not taken into account in the dose calculations given herein. Thus, radiation doses to this part of the skeleton may be underestimated for children. However, the mean absorbed dose to bone surfaces is not likely to be substantially underestimated (see Section 4). (80) Distribution and retention data for radioisotopes of calcium, strontium and barium have been presented in ZCRP Publication 20 (1973), which also includes cumulated activities for the various radioisotopes. However, these data indicate a relatively slow uptake to bone (half-time of uptake 2-16 hr), which is inconsistent with observations in practice when these radionuclides are used for bone-scanning purposes. This is particularly notable for 87mSr which has a very short physical half-life (2.8 hr), but which has, nevertheless, been used for skeletal scintigraphy 1 hr after injection (Scheer et al., 1969). There is evidence (De Nardo, Jacobson and Raventos, 1972; Merrick, 1975; Wootton, 1981, personal communication) that the uptake to the skeleton of the alkaline earths is much faster than predicted in ZCRP Publication 20 (ICRP, 1973), having a half-time of about 15 min. However, modification of the data to allow for this rapid uptake phase makes little difference to the values of cumulated activity, except for 87mSr,where it leads to a value five times larger, because of the short half-life of the radionuclide. Consequently, the values of cumulated activity given in ZCRP Publication 20 (ICRP, 1973) for 45Ca, 47Ca, ?jr, 131Ba 133mBaand 135mBahave been used in this report, whereas those for 87mSr have been recalculated to include the rapid component of bone uptake. References
De Nardo, G. L., Jacobson, S. J. and Raventos, A. (1972). s%r bone scan in neoplastic disease. Semin. Nucl. Med. 2, 18-30. ICRP (1973). Alkaline Earth Metabolism in Adult Man, ICRP Publication 20. Pergamon, Oxford. ICRP (1977). Recommendations ofthe ICRP, ICRP Publication 26. Pergamon, Oxford. ICRP (1979). Limitsfor Intakes ofRadionuclides by Workers, ICRP Publication 30. Pergamon, Oxford. Johansson, L. (1981). S-values for bone surfaces with a source distributed homogeneously in bone volume or with a surface deposited source. In: Third International Radiopharmaceutical Dosimetry Symposium (Proc. Conf. Oak Ridge Tennessee. October, 1980), HHS Publication (FDA 81-8166), pp. 554562. Department of Health and Human Services, Bureau of Radiological Health, Rockville, Maryland. Merrick, M. V. (1975). Review article: Bone scanning. BT. J. Radiof. 48, 327-351. Scheer, K. E., Harbst, H., Kampman, H., turn Winkel, K., Maier-Borst, W., Lorenz, W. J. and Bilaniuk, L. (1969). Bone scintigraphy with l*F and 8Srm. Medical Radioisotope Scintigraphy (Proc. Symp. Salzburg, 1968), Vol. 2, pp. 325-337. International Atomic Energy Agency, Vienna, Austria.

A.& Model for Colloids Taken up Preferentially in the Liver, Spleen and Red Bone Marrow (81) Colloids of Tc-sulphur and *Au were discussed in MIRD reports No. 3 and 4 respectively (MIRD, 1975a,b). The colloids were assumed to be taken up preferentially in the liver, spleen and red bone marrow, with a uniform distribution of any residue in the remainder

22

BIOKINETICSAND

DOSIMETRY:

GENERAL

CONSIDERATIONS

of the body. Uptake fractions were given for three patient categories: normal liver condition, early to intermediate diffuse parenchymal liver disease and intermediate to advanced diffuse parenchymal liver disease. These categories differ not only in biokinetics, but also with regard to liver and spleen mass. In the normal case, the uptake in liver, spleen and red marrow was set to 857 and 5% for sulphur colloid and to 90,3 and 7% for gold colloid, respectively. These values were estimates based on clinical studies, but no details about the methods used for calculating the percentages were given. However, the values are in good agreement with results obtained from animal studies. (82) Recent studies on man have shown, however, that the liver uptake is clearly lower than hitherto assumed, with corresponding increases in uptake for other organs (Herzog et al., 1984). The degree of uptake depends on the particle size of the administered colloid. (83) The Task Group had adopted the same view as the MIRD Committee with regard to choice of patient categories, definition of organs with an active uptake, organ masses and biokinetic differences between large and small colloids. The uptake values used are based on the report by Herzog et al. (1984), which contains results of quantitative measurements with conjugate whole-body counting and double-window regional counting over liver and spleen. For all types of colloid, immediate uptake is assumed. The biological half-life is assumed to be long compared with the physical half-life of the radionuclide, except for iodine-labelled albumin micro-aggregates. For these substances the metabolic breakdown of the particles is assumed to be represented by biological half-lives (fraction) of 3 hr (0.8) and 5 d (0.2). (84) The organ masses for different patient categories and uptake data for different sizes of colloid are presented in Tables A.3-A.5, respectively. For further details the reader is referred to the biokinetic data on the individual substances.
Table A.3. Organ mass (kg): based on MIRD (1975a) Condition Organ Total body Liver Spleen Red marrow 1* 70 1.8 0.17 1.5 2t 70 2.4 0.25 1.5 33 70 1.4 0.4 1.5

*Normal liver; tearly to intermediate diffuse parenchyma1 liver disease; Iintermediate to advanced diffuse parenchymal liver disease. Table A.4. Uptake values (fractions) for large colloids (100-1000 nm diameter)* Conditiont Organ Liver Spleen Red marrow Remaining tissue 1 0.70 0.10 0.10 0.10 2 0.50 0.20 0.15 0.15 3 0.30 0.30 0.25 0.15

*Examples: 99mTcsulphur colloid; 99mTctin colloid; 99mTcmicroaggregated albumin; 99mT~phytate; smIn hydroxide (colloidal); rz31 microaggregated albumin; lo1 microaggregated albumin. t&e Table A.3 footnote.

RADIATION

DOSE TO PATIENTS

FROM RADIOPHARMACEUTICALS

23

Table AS. Uptake values (fractions) for small colloids (< 100 nm diameter)* Condition? Organ Liver Spleen Red marrow Remaining tissue 1 0.70 0.10 0.15 0.05 2 0.50 0.20 0.25 0.05 3 0.30 0.30 0.30 0.10

*Examples: 99mTc minimicroaggregated sulphide colloid; 19sAu gold colloid. tSee Table A.3 footnote.

albumin; 99mT~antimony

References
Herzog, H., Spohr, G., Notohamiprodjo, G. and Feinendegen, L. E. (1984). Biokinetics of Tc-99m-marked RESradiopharmaceuticals. In: Nuklearmedizin, 21.9 Int. Annu. Meeting Sot. Nucl. Med. Europe. Urn 1983, pp. 492493. Schattauer, Stuttgart. MIRD (1975a). Medical Internal Radiation Dose Committee Estimate Report No. 3. Summary of current radiation dose estimates to humans with various liver conditions from 99mTc-sulfur colloid. J. Nucl. Med. 16, 108A-108B. MIRD (1975b). Medical Internal Radiation Dose Committee Estimate Report No. 4. Summary of current radiation dose estimates to humans with various liver conditions from 98Au-colloidal gold. J. Nucl. Med. 16, 173-174.

A.9. Model for the Liver and Biliary Excretion (85) This model is intended for substances that are actively taken up in hepatocytes and excreted, via the biliary tract, to the intestine. Typical examples are Rose Bengal labelled with radioiodine, and the large group of technetium-labelled iminodiacetic acid (IDA) derivatives (e.g. BIDA, HIDA, EIDA, PIPIDA, PBIDA, DISIDA). Several other technetium-labelled compounds have been proposed, such as pyridoxal-glutamate (PG), dihydro-thioctic acid (DHT), tetracyclines, penicillamine complexes, mercapto-isobutyric acid (MIBA), o-iodohippuran analogues (NIBC) and others, but the use of these seems to have been largely abandoned with the development ofeffective IDA substances. In this report, dose calculations are presented for Rose Bengal and for the IDA group. (86) Several biokinetic models have been presented in the literature (MIRD, 1975; Ryan et al., 1977; Wistow et al., 1977; Galli et al., 1979; Koutoulidis et al., 1979; Venot et al., 1980; Taavitsainen et al., 1980; Gelius et al., 1981; Brown et al., 1981,1982; Wu et al., 1984). They are, in general, in good agreement with each other and with the model presented here. The substance is assumed to be rapidly taken up in the liver from the blood and then excreted, via the biliary tract, partly to the gallbladder for temporary storage and partly directly to the intestine. The gallbladder empties at intervals on stimulation by food. It is further assumed that there is no reabsorption from the gut. A minor portion of the radiopharmaceutical is taken up in the kidney, instead of the liver, and excreted in urine. In pathological states (liver disease, occlusion of the biliary tract, congenital biliary atresia), the same model is used, but with different kinetic data. The compartmental model is shown in Fig. A.2. (87) The final excretion from the body follows the models for the gastrointestinal tract (Section A.3) and for the kidney-bladder s! stem (Section AS). (88) For each clinical category (see above) the fraction and half-time for movement between compartments are specified in the biokinetic data for each radiopharmaceutical. (89) The gallbladder is assumed to empty in an identical manner for all substances. The first

24

BIOKINETICS

AND DOSIMETRY:

GENERAL

CONSIDERATIONS

Kidney

Smatl mtestlne

I Excretion

I Excretion

Fig. A.2. Mathematical model used for liver and biliary The flows are defined as follows: 1, uptake in liver; 2, kidney; 3, excretion from liver to gallbladder; 4, excretion directly to small intestine; 5, emptying of gallbladder intestine.

excretion. uptake in from liver to small

emptying is after 3 hr during which time about three quarters of the radioactive material present in the bile is excreted. The second emptying is after 9 hr, again associated with the excretion of about three quarters of the radioactive material in the bile. The last emptying is after 24 hr when all the radioactive material is excreted. Earlier emptying can be induced by a meal of high fat content or by cholecystokinin.

Brown, P. H., Krishnamurthy, G. T., Bobba, V. R. and Kingston, E. (1981). Radiation-dose calculation for Tc-99m HIDA in health and disease. J. Nucl. Med. 22, 177-183. Brown, P. H., Krishnamurthy, G. T., Bobba, V. R., Kingston, E. and Turner, F. E. (1982). Radiation-dose calculation for five Tc-99m IDA hepatobiliary agents. J. Nucl. Med. 23, 1025-1030. Galli, G., Maini, C. L. and Troncone, L. (1979). Study of hepatocyte function using radiotracers. In: Principles of Radiopharmuco~ogy III, pp. 159-178. (Colombetti, L. G. ed.) CRC Press, Boca Raton, Florida. Gelius, L., Skretting, A. and Aas, M. (1981). A mathematical model for the liver uptake and excretion of g9mTc-diethyl IDA. Eur. J. Nucl. Med. 6, 139-142. Koutoulidis, C., Chiotellis, E. and Lymberis, C. (1979). Absorbed dose estimation of some 99mTc-hepatobiliary agents. Eur. J. Nucl. Med. 4, 441444. MIRD (1975). Medical Internal Radiation Dose Committee. Estimate Report No. 7. Summary of current radiation dose estimates to humans from 123-1, 124-L 125-1, 126-L 130-I and 131-I as Sodium Rose Bengal. J. Nucl. Med. 16, 1214-1217. Ryan, J., Cooper, M., Loberg, M., Harvey, E. and Sikorski, S. (1977). Technetium-99m-labelled N-(2,6-dimethylphenyl carbamoylmethyl)-iminodiacetic acid (Tc99mHIDA): A new radiopharmaceutical for hepatobiliary imaging studies. J. Nucl. Med. l&997-1004. Taavitsainen, M., Riihimiki, E. and Tlhti, E. (1980). Body disappearance and liver mean transit time of 99m-Tc-diethyl-IDA. Eur. J. Nucl. Med. 5, 147-150. Venot, A., Grandjouan, S., Steimer, J. L., Mallet, A. and Roucayrol, J. C. (1980). Improvement of dynamic cholescintigraphy through mathematical modelling of Tc-99m-diethyl-IDA pharmacokinetics. In: INSERM Colloquium, Vol. 88, pp. 459-468. INSERM, Paris. Wistow, B. W., Subramanian, G., van Heertum, R. L. et al. (1977). An evaluation of g9mTc labelled hepatobiliary agents. J. Nucl. Med. l&455-461. Wu, R. K., Siegel, J. A., Rattner, Z. and Malmud, L. S. (1984). Tc-99m HIDA dosimetry in patients with various hepatic disorders. J. Nucf. Med. 25,905-912.

A.10. Model for Cerebrospinal Fluid Space (90) The model has been constructed on the basis of the references given, especially Hilditch (1968), and is appropriate when a radionuclide attached to a chelate or protein is injected intrathecally.

RADIATION

DOSE TO PATIENTS

FROM RADIOPHARMACEUTICALS

25

(91) The anatomical model is shown in Fig. A.3. Three regions, A, B and C are distinguished. Region A is a hollow cylinder filled with cerebrospinal fluid, corresponding to the cisterna terminalis caudalis in the vertebral column. It is taken to have a volume of 28 cm3. Region B is a double-walled tube with cerebrospinal fluid in the cavity between the walls, corresponding to the space around the spinal cord and has a volume of 58 cm 3. Region C is the cisternal space localized around the brain; its volume is 20 cm3. Note that Fig. A.3 is schematic and that the proportions between A, B and C are not to scale. (92) In calculations of radiopharmaceutical kinetics, the flow model used is dependent upon the site of injection. Two sites of injection are considered. These are lumbar injection into region A and cisternal injection into region C. (93) In terms of the total activity injected into region A, half is transferred to the blood with half-times (and fractions) of 8 hr (0.97) and 30 d (0.03). The remaining half is transferred to region B with half-times (and fractions) of 20 min (0.25) and 8 hr (0.75). Of the total activity in region B, 0.5 is transferred to the blood with half-times (and fractions) of 18 hr (0.97) and 30 d (0.03) and half is transferred to region C with a half-time (and fraction) of 18 hr (1.0). All activity in C is transferred to the blood with half-times (and fractions) of 18 hr (0.97) and 30 d (0.03). (94) In the case of a cisternal injection into C, half of the total activity is transferred to the blood with half-times (and fractions) of 18 hr (0.97) and 30 d (0.03), and half is transferred to a composite region A + B with a half-time (and fraction) of 18 hr (1.0). The activity in the composite legion is transferred to the blood with half-times (and fractions) of 18 hr (0.97) and 30 d (0.03). (95) On the basis of the anatomical model shown, absorbed fractions in the spinal cord and

Fig. A.3. Model

of cerebrospinal

fluid space

26

BIOKINETICS AND DOSIMETRY: GENERAL CONSIDERATIONS

other organs and tissues were calculated specifically for this report, using the Monte Carlo method to simulate photon transport. For region C, S-values for brain as a source organ have been used. In the calculations, the masses of the brain and spinal cord have been taken to be 1400 g and 30 g, respectively (ICRP, 1975).
References
Brookeman, V. A. and Morin, R. L. (1975). Dosimetry of several DTPA radiopharmaceuticals in cisternography. J. Nucl. Med. 16, 1177-1182. DeLand, F. H. and Simmons, G. H. (1976). Spinal cord and cerebrospinal fluid. In: Radiopharmaceuticxd Dosimetry Symposium (Proc. Conf Oak Ridge, Tennessee, April 1976), HEW Publication (FDA 76-8044), pp. 390-403. US Department of Health, Education and Welfare Bureau of Radiological Health, Rockville, Maryland. Goodwin, D. A., Song, C. H., Finsto, R. and Matin, P. (1973). Preparation, physiology and dosimetry of In-Iabelled radiopharmaceuticals for cisternography. Radiology 108, 91-98. Harbert, J. C. and Zeiger, L. S. (1970). Radiation dose in encephalography. Lancer i, 954-955. Harbert, J. C., Reed, V. and McCullogh, D. C. (1973). Comparison between 1311-IHSA and 69Yb-DTPA for cisternography. J. Nucl. Med. 14, 765-768. Harbert, J. C., McCullogh, D. C., Zeiger, L. S., Davidson, J. D. and Ashburn, W. L. (1970). Spinal cord dosimetry in 311-IHSA cisternography. J. Nucl. Med. 11, 534-541. Hilditch, T. E. (1968). Radiation dose in isotope encephalography. Lancet ii, 573-574. ICRP (1975). Reference Man: Anatomical, Physiological and Metabolic Characteristics, ICRP Publication 23. Pergamon, Oxford. Jahns, E., Zeidler, U., Mariss, P. and Patzoldt, U. (1976) Strahlenbelastung bei der Cisternoszintigraphie mit 169-Yb-DTPA. Nuklearmedizin (Proc. 14th Int. Meeting, Berlin, 1976), pp. 317-319 (in German). Johnston, R. E., Staab, E. V., Brill, A. B. and Allen, J. H. (1972). Radiation dosimetry associated with the intrathecal administration of 1311human serum albumin. Br. J. Radiol. 45, 444451. McEwan, A. C. (1975). Radiation dosimetry of Yb-169 DTPA in cisternography. Aust. Radiol. 19, 8-14. Morin, R. L. and Brookeman, V. A. (1974). @Yb-DTPA distribution and dosimetry in cisternography. J. Nucl. Med. 15, 786-796. Oster, Z. H., Som, P., Gil, M. C., Fairchild, R. G., Goldman, A. G., Schachner, E. R., Sacker, D. F., Atkins, H. L., Meinken, G. E., Srivastava, S. C., Richards, P. and Brill, A. B. (1981). Ruthenium-97 DTPA: A new radiopharmaceutical for cistemography. J. Nucl. Med. 22,269-273. Partain, C. L., Alderson, P. O., Donovan, R. L., Siegal, B. A., Rujanavech, N., Johnston, R. E. and Staab, V. E. (1976). Regional kinetics of Indium 11I-DTPA in CSF imaging of normal volunteers. In: Radiopharmaceutical Dosimetry Symposium (Proc. Conf. Oak Ridge, Tennessee, April 1976), HEW Publication (FDA 76-8044), pp. 404-422. Department of Health, Education and Welfare, Rockviile, Maryland. Partain, C. L., Alderson, P. 0. and Siegel, B. A. (1974). A mathematical model for radiopharmaceutical kinetics in cisternography. J. Nucl. Med. 15, 521-522 (abstract). Rauber-Kopsch. (1943). Lehrbuch und Atlas der Anatomie des Menschen, Band III. G. Thieme, 1943, p. 21 (in German). Som, P., Hosain, F. and Wagner, Jr, H. N. (1971). Kinetics of agents used for cisternography. J. Nucl. Med. 12, 396 (abstract). Smith, P. H. S., Thomas, P.R. M., Steere, H. A., Beatty, H. E., Dawson, K. B. and Peckham, M. J. (1976). Therapeutic irradiation of the central nervous system using intrathecal gOY-DTPA. Er. J. Radio!. 49, 141-147.

A.1 1. Models for Very Short-lived Positron-emitting

Radionuclides

(96) The introduction of positron-emission computerized axial tomography (PET) has led to the increasing use of short-lived positron-emitting tracers for clinical investigation. These tracers are primarily used for research purposes, and, at present, do not result in a significant radiation exposure of the population as a whole. The principal radionuclides in current use, in various forms, are as listed below.

Radionuclide C l3N 50

Physical half-life (minj 20.3 10.0 2.03

RADIATION

DOSE TO PATIENTS

FROM RADIOPHARMACEUTICALS

27

i8F 38K 68Ga s2Rb

109.8 7.6 68.0 1.3

(97) These radionuclides are being applied in four main areas of clinical research, namely neurology, cardiology, oncology and thoracic medicine. In addition, some other short-lived emitting radionuclides, mainly *rmKr (13 s), 195mA~ (30.5 s) and r9rmIr (5 s), are proving valuable for research in the fields of thoracic medicine and cardiology, using Anger-type scintillation cameras. (98) Only relatively few centres, using complex equipment in close proximity to cyclotrons, have the capability to perform the majority of the above studies. In the development of these techniques, little information is forthcoming concerning the absorbed dose calculations. Conventional dosimetry methods, which commonly include observations of the distribution, retention and excretion of a tracer in the body and in individual organs, are impractical using the present generation of PET scanners. The short half-lives of most of these radionuclides do not allow true equilibration in body compartments. The distribution of activity, and hence of absorbed dose, is highly dependent on the physical half-life and on the mode and site of administration. Thus, the highest radiation dose may be received by tissues which are not included in current ICRP lists of sources and targets (for example, the walls of major blood vessels), or by undefined localized regions of individual organs which the ICRP model does not take into account. Although PET studies can yield precisely the type of information required for accurate dosimetry (i.e. activity concentrations in tissues), such data are obtained only for the tissues in the tomographic slices under study. Thus, the total activity in organs only partiy included in tomographic slices cannot necessarily be ascertained and the distribution of activity outside the slice is unknown. For tracers which are mainly confined to the blood, this problem can be overcome, to some extent, by measurement of activity concentrations in arterial blood and the application of a blood flow model to estimate residence times and hence radiation doses in certain organs. However, the accurate dosimetry of these radiopharmaceuticals must await the development of novel ad hoc methods of absorbed dose estimation. In the meantime, absorbed dose estimates for some of the short-lived radiopharmaceuticals, in particular C- and 150-labelled gases, have recently been calculated from models based on steady-state physiological parameters (Bigler and Sgouros, 1983; Kearfott, 1982) and this method has been used for the short-lived positron-emitting radiopharmaceuticals considered in the present report. References
Bigler, R. E. and Sgouros, G. (1983). Biological analysis and dosimetry for 50-labelled 0,. CO, and CO gases administered continuously by inhalation. J. NW/. Med. 24, 431437. Kearfott, K. J. (1982). Absorbed dose estimates for positron emission tomography (PET): CsO, CO and CO50. J. Nucl. Med. 23. 1031-1037.

APPENDIX B: CALCULATION OF ABSORBED DOSE TO ORGANS IN CASES WHERE SPECIFIC S-VALUES ARE NOT AVAILA3LE
B.1. Embryo and Fetus (99) The absorbed dose to the uterus, which is included in the dose tabulations, may be used as a substitute for the absorbed dose to the embryo. Similarly, the absorbed dose to the fetus

28

BIOKINETICS

AND DOSIMETRY:

GENERAL

CONSIDERATIONS

from radioactive substances without placental transfer is expected to be in the same range as the dose to the uterus. For radioactive substances with placental transfer, the absorbed dose to the organs and tissues of the mother is taken in this report as representative of the absorbed dose to the corresponding organs and tissues of the fetus. Human data supporting or quantifying this assumption are available only for a very few radioactive substances used in nuclear medicine, mainly l3 I and Fe. Literature references concerning the placental transfer of these substances are given in the appropriate sections of the biokinetic data. For an evaluation of the available data, reference can be made to a review by Roedler (1987).

B.2. Breast (100) Although comprehensive sets of S-values for the breast have not been published, the Metabolism and Dosimetry Research Group at the Oak Ridge National Laboratory, Tennessee, has calculated such values for children of various ages. The mathematical model of the body tissues used has been described by Christy (1980). S-values for the adult female breast are derived with an anatomical model corresponding to a female who is similar in bodyweight to the 15 yr old child.

B.3. Gallbladder (101) Substances used for hepato-biliary studies are temporarily retained in the gallbladder. Specific absorbed fractions have been produced by the ICRP Task Group on Dose Calculations for the normal gallbladder as a source and target organ. Calculations have also been performed for a pathological case in adults, where the outflow from the gallbladder is obstructed and the organ is consequently enlarged; in this case the mass has been increased to 200 g and absorbed fractions have been derived with the aid of data in MIRD Pamphlet No. 8 (Ellet and Humes, 1971). (102) For non-penetrating radiation, including beta particles, Auger electrons, positrons and photons with initial energies of less than 10 keV, there are contributions both from the gallbladder contents and from the liver. These are calculated using the following assumptions. -The liver is in close contact with three quarters of the gallbladder wall (GBW). -The absorbed dose to the wall from non-penetrating radiation in the gallbladder content (GBC) equals half of that to the content itself. -The absorbed dose to the part of the wall in contact with the liver from non-penetrating radiation in the liver (L), equals half of that to the liver itself. (103) The absorbed dose to the gallbladder wall from non-penetrating radiation (designated np) becomes: D(GBW+GBC + L),, = 0.5
X

A;,,,s(GBC+GBC),,

+0.5 x 0.75 x ALS(L+L)p

B.4. Salivary Glands (104) In cases in which the salivary glands are considered as a source organ, the same method is used to estimate the absorbed dose from this source as that given in MIRD Pamphlet No. 8 (Lathrop et al., 1976), on pertechnetate, where the absorbed dose from the salivary glands to organs other than the thyroid is calculated with the use of S-values for the thyroid as the source

RADIATION

DOSE TO PATIENTS

FROM RADIOPHARMACEUTICALS

29

organ. The contribution (105) The fractions for

absorbed dose to the thyroid is estimated in the same way, except that the from non-penetrating radiation is omitted. absorbed dose to the salivary glands themselves is estimated using absorbed small volumes given in MIRD Pamphlet No. 8 (Ellet and Humes, 1971). B.5. Lymph Nodes

(106) Due to the many different injection sites and individual circumstances regarding administration, as well as the varying masses and distribution of the lymph nodes involved, no generally applicable values for biokinetics and absorbed dose can be given. The reader is referred to other publications (zum Winkel and Hermann, 1977; Bergqvist et al., 1982; Bronskill, 1983) for more detailed discussions on this topic. References
Bergqvist, L., Strand, S.-E., Persson, B., Hafstrom, L. and Jiinsson, P.-E. (1982). Dosimetry in lymphoscintigraphy of Tc-99m antimony sulfide colloid. J. Nucl. Med. 23, 698-705. Bronskill, M. J. (1983). Radiation dose estimates for interstitial lymphoscintigraphic agents. Semin. Nucl. Med. 13, 20-25. Cristy (1980). Mathematical Phantoms Representing Children of Various Ages for Use in Estimates of Internal Dose, Report ORNL/NUREG/TM-367. Oak Ridge National Laboratory, Oak Ridge, Tennessee. Ellet, W. H. and Humes, R. J. (1971). Absorbed fractions for small volumes containing photon emitting radioactivity. Medical Internal Radiation Dose Committee (MIRD) Pamphlet No. 8. J. Nucl. Med. 12, Suppl. No. 5, 27-32. Lathrop, K. A., Atkins, H. L., Berman, M., Hays, M. T. and Smith, E. M. (1976). Summary ofcurrent radiation dose estimates to normal humans from Tc-99m as sodium pertechnetate. Medical Internal Radiation Dose Committee (MIRD) Dose Estimate Report No. E. J. Nucl. Med. 17, 74-77. Roedler, H. D. (1987). Assessment of fetal activity concentration and fetal dose for selected radionuclides based upon animal and human data. In: Age-related Factors in Radionuclide Metabolism and Dosimetry (Gerber, G. B., Metivier. H. and Smith, H. eds) Proc. Symp. CEC Angers 1986, pp. 327-338. Martinus Nijhoff, Dordrecht. Winkel zum, K. and Hermann, H. J. (1977). Scintigraphy of lymph nodes. Lymphology 10, 107-114.

CONTENTS
Explanatory Notes
Z

Page 35 Pharmaceutical Water Inulin Carbon monoxide Carbon dioxide Erythrocytes (RBC) Spiperone Inulin Gas Gas in solution Ammonia L-Glutamate Carbon monoxide Carbon dioxide Molecular Fluoride Fluoro-deoxy-D-glucose (FDG) Ion Ion Phosphate Sulphate Chloride Ion Ion Ion Non-absorbable markers Chloride Ethylenediamine triacetic acid (EDTA) Platelets RBC RBC denatured White blood cells (WBC) Non-absorbable markers Ion Bleomycin Vitamin B 12 Ion Ion Citrate Arsenate, Arsenite Selenite Selenomethionine 31 39 41 43 47 51 53 55 57 59 61 63 65 67 69 73 75 77 81 83 85 87 89 91 95 99 103 105 109 111 113 115 117 119 125 127 135 137 141 145 147 149

Radionuclides 3H 3H C C C C 14C 13N 13N 13N 13N 150 150 150 sF *F 22Na, 24Na 2sMg 32P, 33P 35s 34mC1,w1, w1 3*K
42~ 43K

1 6

9 11 12 15 16 17 19 20 21 24

26 27 29 30 31 33 34

45Ca 47Ca Q%,% 51Cr Cr 51Cr 51Cr 51Cr Cr 51Cr 52Fe, Fe, sgFe 57co SCO, 58co wu, 67cu 62Zn, 65Zn, 6gmZn 66Ga, 67Ga, 68Ga, 72Ga 72As, 74A~, 76As 75Se Se

BIOKINETIC

MODELS

AND DATA

Se %e

35 36 37

38 43

49

76Br, Br, a2Br Br almKr a2Rb 81Rb, 84Rb, 86Rb 81Rb 85Sr, 87mSr, 8gSr ggmT~ ggmTc ggmT~ ggmT~ ggmTc g9mT~ 99mTc g9mTc ggmT~ ggmT~ 9gmTc ggmT~ ggmT~ ggmT~ ggmT~ g9mT~ 99mT~ 9gmTc Tc ggmT~ ggmT~ 99mTc 99mTc
lllln, l13mIn In, 113mIn 11 3mIn l13mIn 1 13mIn 113mIn

In,
1111~

53

In: In In In
1231

12q
1231 1231 1231 13q 1251

1241

a 1251
1311 1311

1311

1251 1251 1311

1311

Selenomethylcholesterol SeHCAT Bromide Bromospiperone Gas Ion Ion RBC denatured Ion Albumin Albumin (intrathecal) Citrate Colloids Dimercaptosuccinic acid (DMSA) Diethylenetriaminepentaacetic acid (DTPA) DTPA (intrathecal) Plasmin Glucoheptonate Penicillamine Pertechnetate Iminodiacetic acid derivatives (IDA) Fibrinogen RBC RBC denatured Phosphates/Phosphonates Aerosol Heparin Macroaggregated albumin (MAA) Non-absorbable markers Albumin microspheres Platelets WBC Ion Hydroxide (colloidal) DTPA DTPA (intrathecal) Aerosol Non-absorbable markers Platelets WBC Bleomycin Iodide Iodoamphetamine (IMP) Fibrinogen Albumin Albumin (intrathecal) MAA Non-absorbable markers

151 153 155 157 159 161 163 167 169 173 175 177 179 185 187 189 191 193 195 197 201 207 209 211 213 217 221 223 225 227 229 231 233 235 237 241 245 249 253 255 257 259 279 281 285 289 293 295

32

RADIATION
1231 1231 1251 1251 1311 1311 1251 1311 311

DOSE TO PATIENTS

FROM RADIOPHARMACEUTICALS

54 55

129Q

130cs,

13lQ

134rnCS

56 57 70 79 80

81

i31Ba, 133mBa, 135mBa 131Ba 14La iagYb 16gYb lg8AU lg7Hg lg7Hg Hg, 203Hg 201T1

Microaggregated albumin Hippuran Antipyrine Iothalamate Norcholesterol (NP 59) Polyvinylpyrrolidone (PVP) Tetraiodothyronine (T4) Triiodothyronine (T3) Reverse T3 Diiodothyronine (T2) Metaiodobenzylguanidine (MIBG) Rose bengal Gas/solution Ion Ion Non-absorbable markers DTPA DTPA DTPA (intrathecal) Colloid Chloride Bromo-mercuri-hydroxypropane (BMHP) Chlormerodrin Ion

299 305 313 315 317 319 321 323 325 327 329 333 341 347 351 355 357 359 361 363 365 367 369 371

33

RADIATION

DOSE TO PATIENTS

FROM RADIOPHARMACEUTICALS

EXPLANATORY NOTES
The individual substances presented in this section are arranged according to the atomic number of the radionuclide, beginning with the lowest number. For each nuclide the simple ion is presented first, followed by other substances containing the same nuclide. For each ion or radioactive substance the relevant isotopes of each nuclide are presented in order of increasing atomic weight. For simple ions, the element name is used for cations (e.g. potassium) and the ionic name for anions (e.g. iodide). The term labelled is in general used when the corresponding stable molecule (the mother substance) is a naturally occurring organic compound that does not itself contain the element in question (e.g. Tc-labelled albumin). The data on each substance are presented in three subsections, designated Biokinetic Model, Biokinetic Data and Table of absorbed doses per unit activity administered. Biokinetic Model Unless otherwise stated, the model refers to intravenous administration. Substances administered orally, intrathecally (by lumbar or cisternal injection) or by inhalation are presented separately. When both intravenous and oral administration are considered the models are presented together. The rate of the biological process-eg. uptake, metabolism and excretion-is usually given as the half-life of the corresponding exponential function. If the process is assumed to be multiexponential, the fraction of the organ content belonging to each exponential component is given in brackets immediately after the half-life figure. When rates are given as fractions per time unit (k), as reported in cited publications, they are transformed into half-lives according to the formula T= 0.693/k. Unless otherwise stated, complete radiochemical purity is assumed. For this reason absorbed doses from known impurities (e.g. free iodine in iodinated compounds) have to be added to the values presented. In the reference list, publications dealing with uptake in the human embryo or fetus, where appropriate, are given separately at the end under the heading Diaplacental transfer. Biokinetic Data The following abbreviations are used [for further explanation refer to appropriate sections in General Considerations of Biokinetics and Dosimetry (hereafter referred to as General Considerations)].

s Fs
T a

GIT SI ULI LLI

&IA,

Source organ or tissue Fractional distribution to organ or tissue S Biological half-life for an uptake or elimination component Fraction of F, taken up or eliminated with the corresponding half-life. A minus-sign indicates uptake Cumulated activity in organ or tissue S per unit of administered activity Gastrointestinal tract Small intestine Upper large intestine Lower large intestine 35

BIOKINETICS

AND DOSIMETRY:

GENERAL

CONSIDERATIONS

The expression Remaining Tissues is used to signify all organs and tissues not specifically mentioned in the table in question. The corresponding activity (F,) is assumed to be uniformly distributed. The data table sometimes contains empty spaces under the heading T and a, usually because the kinetics follows complex exponential, or non-exponential, expressions which cannot easily be defined in the table. This is always the case for activity in the gastrointestinal tract, and for the kidney and bladder contents, when the corresponding standard models (Appendix A.3 and A.5, General Considerations) are used. The same applies to activity in the gallbladder (Appendix A.9, General Considerations) and to substances that are administered orally as markers (Appendix A.3, General Considerations) or intrathecally (Appendix A.10, General Considerations). In all these cases details of the biokinetics can be found in the Appendices. In some other cases the data table only presents the cumulated activities, with no values for F,, T or a. This is the case for the bone-seeking alkaline earth elements; in this report calcium, strontium and barium are assumed to be distributed and retained in the body in accordance with the model presented in ICRP Publication 20 Alkaline Earth Metabolism in Adult Man (1972). Another group comprises the inhaled gases carbon monoxide, carbon dioxide, nitrogen and oxygen, where specific kinetic conditions, as described in the models, are valid. With respect to radioactive daughters, two different situations have been considered, with a corresponding difference in the presentation of the biokinetic data. For the radionuclides 47Ca, Fe, 62Zn, 134mCs,i3iBa and 133m Ba it has been assumed that the preparation administered is free from the daughter nuclide. The cumulated activity of the daughter nuclide, formed after administration, is given in the table immediately to the right of the column for the parent nuclide, and the heading for these two columns is of the form: 47Ca and 47Sc. If the substance is contaminated with the daughter nuclide at the time of administration, the contribution from this activity has to be added to the absorbed dose values presented. For some common impurities, their effective dose equivalents per unit activity administered have been given at the bottom of the appropriate dose tables. For the radionuclides 28Mg, 6gmZn and lRb, where equilibrium between parent and daughter at the time of administration is assumed, the cumulated activity from the daughter is identical to that of the parent, and therefore only one column of data has been given at the heading in this case is of the form: e.g. 28Mg (= 28Al). The nuclide 34mClrepresents a special case of equilibrium, since only 47% of the decays lead to formation of the daughter 34Cl.

Table of Absorbed Dose per Unit Activity

The doses are given as milligray (mGy) per megabequerel (MBq). The effective dose equivalent is given as millisievert (mSv) per megabequerel. All dose values are given in exponential notation (e.g. 2.6E-02=2.6 x lo-* or 0.026, and 4.9E+Ol=4.9 x lo+ or 49). The physical half-lives have been taken from ZCRP Publication 38 Radionuclide Transformations (1983). The calculations have been performed without rounding off, but the final result is given with two digits only. The significance of the dose values is discussed in Section 5.3 of General Considerations. Dose calculations have been performed for adults and for children of 15, 10,5 and 1 years of age. In a few instances (i.e. liver-spleen-bone marrow colloids in abnormal cases, and substances administered intrathecally) adequate models for children are not available. The selection of target organs has been explained in Section 3 of General Considerations. The organs (or tissues) are presented in alphabetical order except Other Tissue, which is placed at 36

RADIATION

DOSE TO PATIENTS FROM RADIOPHARMACEUTICALS

the end. The dose to organs or tissues not mentioned in the table can usually be approximated with the value given for Other Tissue. The dose to the embryo, and to the fetus when diaplacental transfer is known not to occur, can be approximated by the dose to the uterus. The effective dose equivalent, given at the bottom of each table, has been calculated according to the procedure given in ZCRP Publication 26 Recommendations of the International Commission on Radiological Protection (1977), as further discussed in Section 6.2 of General Considerations. In the calculation, doses to the gonads, breast, red bone marrow, lung, thyroid and bone surfaces are always considered, with their specific weighting factors. In addition, the five remaining organs and tissues receiving the highest dose are also included; these organs or tissues are marked with an asterisk in the table for the adult case. For children, the rule for the selection of the five additional organs may lead to a different set of organs included; this has been taken into consideration in the calculations. When the contribution to the effective dose equivalent from the bladder wall dose is more than 50% a note about the actual contribution is given at the bottom of the table.

37

RADIATION

DOSE TO PATIENTS FROM RADIOPHARMACEUTICALS

H
1 Water

WATER
jH

Biokinetic Model
ZCRP Publication 30 (ICRP, 1979) assumes a uniform soft-tissue distribution of tritiated water with a biological half-life of 10 d. This model is adopted here. Data for children have been compiled by the Task Group on Dose Calculations. Following oral administration, complete and rapid absorption can be assumed. The absorbed dose values are, therefore, identical with those for intravenous administration.

References
ICRP (1979). Limitsfor
Intake ofhdionuclides by Workers, ICRP Publication 30: Part 1. Pergamon, Oxford.

Biokinetic Data
Organ (S) Total body Adult 15 yr old 10 yr old 5 yr old 1 yr old FS 1.0 1.0 1.0 1.0 1.0 T a ASIA, 14.0 d ll.Od 7.7 d 6.0 d 5.5 d

10.0 d 7.8 d 5.4d 4.1 d 3.8 d

1.o 1.o 1.0 1.0 1.0

WATER

38
Organ

12.35

years per Adult 1.6B-02 l.bB-02 1.6E-02 2.0%02 1.6E-02 1.6E-02 1.6E-02 1.6E-02 1.6E-02 1.6E-02 1.6E-02 1.6E-02 1.6E-02 1.6E-02 1.6E-02 1.6E-02 1.6E-02 1.6E-02 1.6E-02 1.6B-02 unit Absorbed dose activity administered 15 year 1.6E-02 1.6B-02 1.6E-02 1.6E-02 1.6E-02 1.6B-02 1.6E-02 1.6E-02 1.6E-02 1.6E-02 1.6E-02 1.6B-02 1.6E-02 1.6E-02 1.6E-02 1.6E-02 1.6E-02 1.6E-02 1.6E-02 1.6E-02 10 year 1. BE-02 1. BE-02 1. BE-02 1.8E-02 1. BE-02 1.8E-02 1.8E-02 1.8E-02 1.8E-02 1. BE-02 1.0B-02 1.8E-02 1.8E-02 1.8E-02 1,8B-02 1. BE-02 1. BE-02 1. BE-02 1. BE-02 1.8B-02 (mGy/MBq) 5 year 2.4B-02 2.4E-02 2.4E-02 2.4E-02 2.4E-02 2.4E-02 2.4%02 2.4E-02 2.4E-02 2.4B-02 2.4E-02 2.4%02 2.4E-02 2.4B-02 2.4E-02 2.4E-02 2.4E-02 2.4E-02 2.4B-02 2.4B-02 1 year 4.5B-02 4.5B-02 4 *5B-02 4.5E-02 4.5E-02 4.5B-02 4.5B-02 4.5B-02 4.5E-02 4.5B-02 4.5E-02 4.53-02 4.5B-02 4.5B-02 4.5B-02 4.5B-02 4.5B-02 4.5%02 4.5E-02 4.5E-02

* *

* * *

Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small in test ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue

Bffective dose equivalent (mSv/klBq)

39

RADIATION

DOSE TO PATIENTS FROM RADIOPHARMACEUTICALS

H 1 huh

INULIN
3H Biokinetic Model After intravenous administration and initial distribution in the extracellular fluid, the substance is excreted by the renal system according to the model for GFR substances and the kidney-bladder model (Appendix Sections A.6 and AS, respectively). In the normal case, total body retention is described by a monoexponential function with a half-time of 100 min (1 .O).The fraction excreted by the kidneys equals 1.Oand the renal transit time is 5 min. For the abnormal case, it is assumed that the retention half-time in the total body is 1000 min and that the renal transit time is increased to 20 min. Biokinetic Data
a (1) Normal renal function Total body (excluding bladder contents) Kidneys Bladder contents (2) Abnormal renal function Total body (excluding bladder contents) Kidneys Bladder contents &IA0 2.41 hr 5.6 min 2.16 hr 16.7 hr 1.0 l.Od 26.4 min 1.79 hr

1.0 1.0 1.0 1.0 1.0 1.0

1.67 hr

1.0

41

BIOKINETIC MODELS AND DATA

INULIN
3H 12.35 years per Organ Adult * * Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue 1. Hz-04 1.8502 l. lE-04 1.3E-04 l. lE-04 l. lE-04 l. lE-04 1. IE-04 9.9E-04 l. lE-04 l. lE-04 l.lE-04 l. lE-04 l. lE-04 1. Hz-04 l. lE-04 l. lE-04 l. lE-04 l. lE-04 15 year 1.3E-04 2.2E-02 1.3E-04 1.3E-04 1.3E-04 1.3E-04 1.3E-04 1.3E-04 l.ZE-03 1.3E-04 1.3E-04 1.3E-04 1.3E-04 1.3E-04 1,3E-04 1.3E-04 1.3E-04 1.3E-04 1.3E-04 10 year 2.3E-04 3.5E-02 2.3E-04 2,3E-04 2.3E-04 2.3E-04 2.3E:04 2.3E-04 5 year 3.9E-04 5.53-02 3.9E-04 3.9E-04 3.9E-04 3.9E-04 3.9E-04 3.9E-04 2.7E-03 3.9E-04 3.9E-04 3.9E-04 3.9E-04 3.9E-04 3.9E-04 3.9E-04 3.9E-04 3.9E-04 3.9E-04 1 year 7.9E-04 l. lE-01 7.9g-04 ?.9E-04 7.9E-04 7.9&04 7.9g-04 7.9E-04 4.9E-03 7.9&04 7.98-04 7.9E-04 7.9E-04 7.9E-04 7.9B-04 7.98-04 ?.9E-04 7.9g-04 7.9E-04 unit Absorbed dose activity administered (mGy/MBq)

* *

I. aE-03
2.3E-04 2.3E-04 2.3E-04 2.3E-04 2.3E-04 2.3E-04 2.3E-04 2.3E-04 2.3E-04 2.3E-04

Effective dose equivalent (mSv/MBq) Bladder wall contributes

1.2B-03

1.5E-03

2.4E-03

3.8E-03

7.58-03

to

90.0

% of

the

effective

dose

equivalent.

Abnormal Organ * * Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue Adult l.lE-03 1.5&02 l. lE-03 1.4E-03 l. lE-03 l.lE-03 l. lE-03 l.lE-03 4.6E-03 l.lE-03 l.lE-03 l.lE-03 l.lE-03 l.lE-03 l.lE-03 1. IE-03 1. Hz-03 l.lE-03 l.lE-03

renal

function 10 year 2.3E-03 3.OE-02 2.3E-03 2.3E-03 2.3E-03 2.3E-03 2.3E-03 2.3E-03 8.4E-03 2.3E-03 2.3E-03 2.3E-03 2.3E-03 2.3E-03 2.3E-03 2.3E-03 2,3E-03 2.3E-03 2.3E-03 5 year 3.93-03 4.7E-02 3.9E-03 3.9E-03 3.9E-03 3.9E-03 3.9E-03 3.9E-03 1.3E-02 3.9E-03 3.9E-03 3.9E-03 3.9E-03 3.9E-03 3.9E-03 3.9E-03 3.9E-03 3.9&03 3.9E-03 1 year

15 year 1.4E-03 1.9E-02 1*4E-03 1.4E-03 1.4E-03 1.4E-03 1.4E-03 1.4E-03 5.8E-03 1.4E-03 1.4E-03 1.4E-03 1.4E-03 1.4E-03 1.4E-03 1.4E-03 1.4E-03 1.4E-03 1.4E-03

a. OE-03
9.3E-02 8.OE-03

a.oE-03 a. OE-03 a. OE-03

8.OE-03 8.OE-03 2.3E-02 8.OE-03 a. OE-03 8.OE-03 8.OE-03 8.OE-03 8.OE-03 8.OE-03 a. OE-03 8.OE-03 8.OE-03

* *

Effective dose equivalent (aSv/lmq)

2.2E-03

2.7E-03

4.4B-03

7.1B-03

1.48-02

42

RADIATION DOSE TO PATIENTS FROM RADIOPHARMACEUTICALS

C 6

Carbon monoxide

CARBON MONOXIDE
C Biokinetic Model Inhaled carbon monoxide is absorbed at the lung gas-tissue interface and enters the pulmonary blood circulation, where it is essentially completely bound to haemoglobin. Following washout from the lungs, the absorbed activity is assumed to be uniformly distributed throughout the total blood volume. Because of the short physical half-life of iC, the effective half-time of the activity absorbed into the body is taken to be the physical half-life. The lung absorption of CO has a half-time of about 5 s, which is similar to the length of the normal respiratory cycle and consequently the inhaled gas may not be completely absorbed in certain conditions. Two situations have been considered: (1) Single inhalation of gas with a 20 s breathhold. A total inhalation volume of 2.5 1is assumed to be distributed between alveolar space (2350 ml) and dead space (150 ml). No absorption occurs from the dead space, and the gas it contains is exhaled after 20 s. From the work of Bates (1952) and West et al. (1962) the alveolar transfer rate of CO is estimated to be 0.13 s- (half-time = 5.3 s) and the pulmonary blood washout rate to be 0.22 s- (half-time = 3.2 s). During a 20 s breathhold, the inhaled activity occupying the alveolar space is almost entirely absorbed. The absorbed tracer mixes within the total blood volume and cumulated activities in organs are calculated from their blood contents. The cumulated activity in the lungs results from three components, namely activity in lung gas (dead space and alveolar space), activity absorbed in pulmonary blood prior to washout, and the proportion of total blood activity present in the lungs. (2) Continuous inhalation of gas for 1 hr. In this case, each inhalation volume is assumed to be 500 ml, distributed between dead space (150 ml) and alveolar space (350 ml). Taking an inhalation rate of 12 breaths per min, the average duration of each breath is 5 s. With this shorter breathing period, only about half the inhaled CO occupying the alveolar space is absorbed and some is subsequently exhaled. Assuming that the 350 ml of inspired gas that reaches the alveolar space mixes within an extra volume of 2400 ml (functional residual volume), only a fraction (350/2750) of the residual alveolar activity at the end of the 5 s inhalation period is expired. Thus, as inhalation proceeds, activity builds up in the alveolar region until a steady state is attained after about 10 inhalations, when the intake of activity into the lungs is balanced by absorption and exhalation. The build-up of alveolar activity prior to this steady state is compensated for by the diminution of residual activity following termination of the 1 hr period of continuous inhalation, so that, for dosimetry purposes, the continuous inhalation is equivalent to the administration of activity at constant rate, given by the steady state value, for 1 hr. The cumulated activities resulting from a single breath in this situation are calculated as in (1) above, and multiplied by 720, the number of breaths in 1 hr. References
Bates, D. V. (1952). The uptake of carbon monoxide in health and in emphysema. Clin. Sci. 11,21-32. Kearfott, K. J. (1982). Absorbed dose estimates for positron emission tomography (PET): C150, CO and CO0. J. Nucl. Med. 23, 1031-1037. West, J. B., Holland, R. A. B., Dollery, C. T. and Matthews, C. M. E. (1962). Interpretation of radioactive gas clearance rates in the lung. J. Appl. Physiol. 17, l&20.

43

BIOKINETIC MODELS AND DATA

6 Carbon monoxide

BiokineticData
Organ (S) U%

(1) Single inhalation with 20 s breathhold (2.5 1) Total body Lungs Blood (2) Continuous inhalation for 1 hr (360 1) Total body Lungs
Blood

27.5 min 10.9 s 27.3 min 18.1 min 8.4s

17.9 min

CARBON MONOXIDE
Single 1% 20.38 minutes per Organ Adult * Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach vail Small inrest ULI wall LLI wall Heart Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue 7.1E-03 2.3E-03 3.4E-03 2.9E-03 2. EE-03 2. SE-03 2. SE-03 2.48-03 2.OE-02 6.7&03 S. lE-03 1.4802 2.3E-03 3.3E-03 4.2E-03 1.3E-02 2.3E-03 4.9E-03 2.3&03 2.4E-03 15 year 8.5B-03 2.7E-03 4.3E-03 3.0E-03 3.48-03 3.1E-03 3.0E-03 2.8E-03 2. SE-02 8.OE-03 5.9E-03 1.8E-02 3.OE-03 4.OE-03 5.2E-03 1.6E-02 2. SE-03 6.OE-03 3.0E-03 2.8E-03 10 year 1.4E-02 4.1E-03 7.1E-03 S. OE-03 5.1E-03 4.83-03 4.6E-03 4.4B-03 3.8E-02 1.3E-02 9.9E-03 2.9802 4.7E-03 6.2E-03 8.43-03 2.6E-02 3.8803 l.OE-02 4 v7E-03 4.3E-03 5 year 2.2E-02 6.7E-03 1.2E-02 7.0E-03 0 .OE-03 7. SE-03 7.4E-03 6.6E-03 6.OE-02 2.1E-02 1.6E-02 4.88-02 7.2E-03 9.6E-03 1.5E-02 4.3&02 5.98-03 1.7E-02 7.2E-03 6.83-03 1 year 4.4E-02 1.28-02 2.43-02 1.4E-02 1. SE-02 1.4&02 1. LE-02 1.3%02 l. lE-01 unit inhalation with 20 set breathhold Absorbed dose administered

activity

(mGy/MBq)

* * *

4.2E-02 3.OE-02 9.4E-02 1.4E-02 1.8E-02 2. W-02 8.4g-02

l . lE-02 3.3E-02 1.4E-02 1.3E-02

Effective dose equivalent (mSv/HBq)

6.6E-03

8.0&03

1.3E-02

2.11-02

4.OE-02

RADIATION

DOSE TO PATIENTS FROM RADIOPHARMACEUTICALS

Carbon monoxide

CARBON MONOXIDE
Continuous per Organ * Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Heart Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue Adult 4.7E-03 l .%-03 2.2E-03 1.9E-03 1.8E-03 1.7E-03 1.7B-03 1.6E-03 1 e3E-02 4.4E-03 3.3B-03 9.2E-03 1.5E-03 Z.ZE-03 2.7E-03 8.7E-03 1.5E-03 3.2B-03 1.5E-03 1.6E-03 unit inhalation for 1 h (mGy/MBq) 5 year 1.5E-02 4.4E-03 7.8E-03 5.1E-03 5.3E-03 5.OE-03 4.9E-03 4.5E-03 4.OE-02 1.4E-02 l.OE-02 3.2E-02 4.8E-03 6.3E-03 9.83-03 2.8E-02 3.9E-03 l. lE-02 4.8E-03 4.5E-03 1 year 2.9E-02 7. BE-03 1. fE-02 9.4E-03 9.7E-03 9.3E-03 9.2E-03 8.3E-03 71 OE-02 2.8E-02 2.OE-02 6.2E-02 8.9E-03 1.2E-02 1.9E-02 5. SE-02 7.5E-03 2.1E-02 8.9E-03 8.6E-03 Absorbed dose activity administered 15 year 5.63-03 1.8E-03 2.8E-03 2.OE-03 2.2E-03 2.OE-03 2.OE-03 1.8E-33 1.6E-02 5.3E-03 3.9E-03 l.ZE-02 2.OE-03 2.7E-03 3.4E-03 1 .OB-02 1.6E-03 4.OE-03 2.OE-03 1.9E-03 10 year 9.2E-03 2.7E-03 4.7E-03 3.3E-03 3.4E-03 3.2E-03 3.OE-03 2.9E-03 2_5E-02 8.7E-03 6. SE-03 1.9E-02 3.1E-03 4.1E-03 5.5B-03 1.7E-02 2.5B-03 6.6E-03 3.lE-03 2.9E-03

* * *

Bffective dose equivalent (mSv/klBq)

4.3B-03

5.3B-03

8_5B-03

1.4B-02

2.6B-02

45

RADIATIONDOSE TO PATIENTS FROM RADIOPHARMACEUTICALS

6 Carbon dioxide

CARBON DIOXIDE
C Biokinetic Model Following inhalation, CO, diffuses rapidly through the alveolar membrane but, unlike CO,, there is no prompt transfer of the radioactive label to a blood component. Diffusion of the tracer is, therefore, not unidirectional and activity is removed from the lungs both by pulmonary capillary blood flow and by expiration. Whole-body retention of tracer, following a single inhalation and 20 s breath-holding, can be described by a double exponential function in which fractions of 0.4 and 0.6 of the initial activity are eliminated with biological half-times of 2.2 min and 76 min respectively (Kenny et al., 1976). Based on the data of West et al. (1962) and West and Dollery (1962) the alveolar transfer rate of CO, is estimated to be 0.14 s-l (half-time 5 s). The pulmonary blood washout rate is assumed to be 0.17 s- (half-time 4 s). Two situations have been considered: (1) Single inhalation of gas with a 20 s breath-hold. A total inhalation volume of 2.5 1 is assumed to be distributed between alveolar space (2350 ml) and dead space (150 ml). No absorption occurs from the dead space, and the gas it contains is exhaled after 20 s. During a 20 s breath-hold, the inhaled activity occupying the alveolar space is almost entirely absorbed. The cumulated activity in the lungs results from three components, namely activity in lung gas (dead space and alveolar space), activity absorbed in pulmonary blood prior to washout, and the proportion of total body activity present in the lungs. (2) Continuous inhalation of gas for 1 hr. In this case, each inhalation volume is assumed to be 500 ml, distributed between dead space (150 ml) and alveolar space (350 ml). Taking an inhalation rate of 12 breaths per min, the average duration of each breath is 5 s. With this shorter breathing period, only about half the inhaled l C occupying the alveolar space is absorbed and some is subsequently exhaled. Assuming that the 350 ml of inspired gas that reaches the alveolar space mixes within an extra volume of 2400 ml (functional residual volume) only a fraction (350/2750) of the residual alveolar activity at the end of the 5 s inhalation period is expired. Thus, as inhalation proceeds, activity builds up in the alveolar region until a steady state is attained after about 10 inhalations, when the intake of activity into the lungs is balanced by absorption and exhalation. The build-up of alveolar activity prior to this steady state is compensated for by the diminution of residual activity following termination of the 1 hr period of continuous inhalation, so that, for dosimetry purposes, the continuous inhalation is equivalent to the administration of activity at constant rate, given by the steady state value, for 1 hr. The cumulated activities resulting from a single breath in this situation are calculated as in (1) above, and multiplied by 720, the number of breaths in 1 hr. References
Kenny, P. J., Watson, D. D., Janowitz, M. D., Finn, R. D. and Gilson, A. J. (1976). Dosimetry of some accelerator produced radioactive gases. In: Proc. Second Int. Radiopharmaceutical Dosimetry Symposium, Oak Ridge, Tennessee (FDA 76-8044), pp. 475487. Bureau of Radiological Health, Rockville, Maryland. West, J. B. and Dollery, C. T. (1962). Uptake of oxygen-15-labeled CO, compared with carbon-l l-labeled CO, in the lung. J. Appl. Physiol. 17, 9-13. West, J. B., Holland, R. A. B., Dollery, C. T. and Matthews, C. M. E. (1962). Interpretation of radioactive gas clearance rates in the lung. J. Appl. Physiol. 17, 14-20.

47

BIOKINETICMODELSANDDATA

Carbondioxide

Biokinetic Data
Organ (S) Q%

(1) Single inhalation with 20 s breathhold (2.5 1) Total body Lungs (2) Continuous inhalation for 1 hr (360 I) Total body Lungs

14.1 s 25.0 s 9.3 min 12.5 s

CARBON
llc 20.38 minutes

DIOXIDE

Single inhalation with 20 set breathhold

Organ

Absorhed dose per unit activity administered (mGy/MBq) Adult 15 year Z.OE-03 1.8E-03 1.7E-03 1.6E-03 1.9E-03 Z.OE-03 1.9E-03 l.BE-03 1.9E-03 1.9E-03 3.3E-03 Z.OE-03 Z.OE-03 1.8E-03 1.9E-03 1.7E-03 1.8E-03 2.OE-03 1.7E-03 10 year 3.1E-03 2.91-03 2.713-03 2.43-03 2.9E-03 3.23-03 3.OE-03 3.OE-03 3.OE-03 3.OE-03 4.71-03 3.23-03 3.23-03 2.83-03 3.OE-03 2.7E-03 3.OE-03 3.2E-03 2.7E-03 5 year 4.93-03 4.83-03 4.33-03 3.9E-03 4.71-03 5.OE-03 4.91-03 4.81-03 4.73-03 4.8E-03 7.33-03 5.OE-03 5.1E-03 4.4E-U3 4.8E-03 4.3E-03 4.8E-03 5.1E-03 4.46-03 1 year 9.33-03 8.53-03 8.2E-03 7.6E-03 8.7E-03 9.5E-03 9.1E-03 8.83-03 9.OE-03 9.x-03 1.4E-02 9.5E-03 9.53-03 8.2E-03 9.OE-03 8.3E-03 9.23-03 9.5E-03 8.4E-03

* * *

Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas

l.EE-03 1.6E-03 1.4E-03 1.6E-03 1.6E-03 1.7E-03 1.6E-03 1.7E-03 1.6E-03 1.6E-03 2.43-03 1.5E-03 1.6E-03 1.5E-03 1.6E-03 1.6E-03 1.4E-03 1.6E-03 1.4E-03

Red marrow Spleen Testes Thyroid Uterus Other tissue Effective dose equivalent (mSv/HBq)

1.7B-03

2.01-03

3.lE-03

4.93-03

9.4E-03

48

RADIATIONDOSETO PATIENTSFROM RADIOPHARMACEUTICALS

Carbon dioxide

CARBON DIOXIDE
Continuous inhalation for 1 h Absorbeddose per unit activityadministered (mGy/MBq) Organ * Adrenals * Bladderwall Bone surfaces Breast GI-tract Stomachwall * Small intest * ULI wall * LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue Effective dose equivalent (mSv/RBq) Adult 1.2E-03 l.lE-03 9.5E-04 l.OE-03 l.OE-03 l.lE-03 l.lE-03 l.lE-03 l.OE-03 l.OE-03 1.3E-03 l.OE-03 l.OE-03 l.OE-03 l.OE-03 l.lE-03 9.4E-04 l.OE-03 9.4E-04 1.1%03 15 year 1.3E-03 1.2E-03 l.lE-03 l.OE-03 1.2E-03 1.3E-03 1.3E-03 1.2E-03 1.2E-03 1.2E-03 1.8E-03 1.3E-03 1.3E-03 1.2E-03 1.2E-03 l.lE-03 1.2E-03 1.3E-03 10 year 2.1E-03 1.9E-03 1.8E-03 1.6E-03 1.9E-03 Z.lE-03 2.OE-03 2.OE-03 5 year 1 year

3.2E-03 6.1E-03 3.2E-03 5.6E-03 2.9E-03 5.5E-03 2.6E-03 S.OE-03 3.1E-03 5.8E-03 3.3E-03 6.3E-03 3.3E-03 6.OE-03 3.2E-03 5.8E-03 6.OE-03 6.OE-03 7.5E-03 6.3E-03 6.3E-03

2.OE-03 3.1E-03 2.OE-03 3.23-03 2.5E-03 3.9E-03 2.1E-03 3.4E-03 2.1E-03 3.4E-03 1.9E-03 2.OE-03 1.8E-03 2.OE-03 2.1E-03

2.9E-03 S.SE-03 3.1E-03 6.OE-03 2.9E-03 S.SE-03 3.2E-03 6.1E-03 3.4E-03 6.3E-03 2.9E-03 5.6E-03

l.lE-03 1.8E-03 1.3E-03 Z.OE-03

3.1E-03 6.OE-03

49

RADIATION

DOSE TO PATIENTS FROM RADIOPHARMACEUTICALS

C 6 RBC

COHb-LABELLED
11

ERYTHROCYTES
C

Biokinetic Model Following intravenous administration of erythrocytes containing CO-labelled haemoglonin, the label is distributed according to the relative blood content of different organs. Biological elimination of the label is negligible in relation to the physical half-life (20.3 min) of l C. Reference
Glass, H. I., Brant, A., Clark, J. C., de Garetta, A. C. and Day, L. G. (1968). Measurement cells labeled with radioactive carbon monoxide. J. Nucl. Med. 9, 571-575. of blood volume using red

Biokinetic Data
Organ (S) Blood F, 1.0 T a3 a 1.0 &/A, 29.3 min

COHb-LABELLED
3 20.38 minutes

ERYTHROCYTES

per Organ Adult * Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Heart Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue 7.6%03 2.4E-03 3.6E-03 3.1E-03 3.OE-03 2.7E-03 2.7E-03 2.6E-03 2.2E-02 ?.2E-03 5.43-03 1.4%02 2.4E-03 3,5E-03 4.4E-03 1.4E-02 2 *4E-03 5,2E-03 2.4E-03 2.5B-03

unit

Absorbed dose activity administered 15 year 9.1E-03 2 *9%03 4.6E-03 3.2E-03 3.6E-03 3.3E-03 3.2E-03 3.OE-03 2.7E-02 8.63-03 6.3E-03 1. aE-02 3.3E-03 4.3E-03 5.6E-03 1.7E-02 2.6E-03 6.5E-03 3.3E-03 3.OE-03 10 year 1.5E-02 4.43-03 7.6&03 5.3E-03 5.5E-03 5.2E-03 4.9E-03 4.7E-03 4.1E-02 1.4E-02 l. lE-02 3.OE-02 5.OE-03 6.6E-03 9.OE-03 2.8E-02 4.OE-03 l. lE-02 5.OE-03 4.6E-03

(mGy/MBq) 5 year 2.4E-02 7.2E-03 1.3E-02 a. 3E-03 8.63-03 a. lE-03 8.OE-03 ?.3E-03 6.53-02 2.3E-02 1.7E-02 4.9E-02 7. BE-03 l.OE-02 1.6E-02 4.6E-02 6.3E-03 1.8E-02 7.7E-03 ?.3E-03 1 year 4.7E-02 1.3E-02 2.5E-02 1.5E-02 1.6E-02 1. SE-02 1.5E-02 1.3E-02 l. lE-01 4.5E-02 3.2E-02 9.6%02 1. SE-02 1.9E-02 3 .OE-02 9.OE-02 1.2E-02 3.53-02 1.5E-02 1.4E-02

* * *

Effective dose equivalent (mSv/nBq)

6.9E-03

8.4E-03

1.4&02

2.2E-02

4.2&02

51

RADIATION

DOSE TO PATIENTS FROM RADIOPHARMACEUTICALS

C 6 Spiperone

SPIPERONE C
Biokinetic Model The model is the same as that described for bromospiperone (see page 157). In view of the short physical half-life of llC, bladder and GI-tract contents are not considered as sources. Biokinetic Data
Organ (S) Total body Liver Lungs Fa 1.0 0.25 0.15 T 1.69 d 10.5 d 1.69 d 10.5 d 1.69 d 10.5 d a 0.7 0.3 0.7 0.3 0.7 0.3 &IA, 29.2 min 7.3 min 4.4 min

SPIPERONE
% 20.38 minutes

per Organ Adult * Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue 3.8B-03 2.2B-03 2.2E-03 2.9E-03 2.7%03 2.63-03 2.83-03 2.3E-03 3.1E-03 2.21-02 2.0&02 2.1&03 3. SE-03 2.43-03 2.6E-03 2.2&03 2.1E-03 2.23-03 2.3E-03

unit

Absorbed dose activity administered 15 year 4.6E-03 2.5E-03 2.6B-03 2.8E-03 3.3E-03 3.lE-03 3.2%03 2.5E-03 3.7&03 2.8E-02 3.OE-02 2. a!?#-03 4.4E-03 3.0&03 3.2E-03 2.2E-03 2.6E-03 2.9E-03 2.8E-03 10 year 7 * lB-03 4.OE-03 4.lE-03 4.7E-03 5.3E-03 5.1E-03 5.4&03 4. H-03 5.7E-03 4.3E-02 4.23-02 4.6E-03 7 .OE-03 4.5E-03 5.1E-03 3.6E-03 4.3E-03 4.6E-03 4.3g-03

(mGy/MBq) 5 year l. lE-02 6.8E-03 6.5E-03 7.4&03 8.6E-03 8.3E-03 0.7E-03 6.8E-03 0.9B-03 6.3E-02 6.5E-02 7.4B-03 l. lE-02 6.8E-03 0.OE-03 5.83-03 7.lE-03 7.4E-03 6.9E-03 1 year 1.9E-02 1.2&02 1.3E-02 1.4B-02 1.7E-02 1.5E-02 1.7&02 1.3E-02 1.6&02 1.2E-01 1.3E-01 1.4E-02 2.OE-02 1.2E-02 1.5E-02 l . lE-02 1.3E-02 1.4B-02 1.3B-02

* * *

Effective dose equivalent (mBv/llBq)

.lblCRP

5.9E-03

7.0E-03

1.2E-02

1. EE-02

3 * 4%02

1s: 1-4-c

53

RADIATIONDOSE TO PATIENTS FROM RADIOPHARMACEUTICALS

6 Inulin

INULIN
14C Biokinetic Model After intravenous administration and initial distribution in the extracellular fluid, the substance is excreted exclusively by the renal system according to the model for substances used to measure glomerular filtration rate and the kidney-bladder model (see Appendix Sections A.6 and A.5, respectively). In the normal case, total body retention is described by a monoexponential function with a half-time of 100 min (1 .O).The fraction excreted by the kidneys equals 1.Oand the renal transit time is 5 min. For the abnormal case, it is assumed that the retention half-time in the total body is 1000 min and that the renal transit time is increased to 20 min. References
Marlow, C. G. and Sheppard, G. (1970). Labelled tracers of inulin for physiological measurements. Clin. Chim. Acta 28,
469-478.

Sxiklas, J. J., Hosain, F., Reba, R. C. and Wagner, H. N. (1971). Comparison of 6gYb-DTPA, 3mIn-DTPA, i4C-inulin and endogenous creatinine to estimate glomerular filtration. J. Nucl. Bid. Med. 15, 122-125.

Biokinetic Data
Organ (S) (1) Normal renal function Total body (excluding bladder contents) Kidneys Bladder contents (2) Abnormal renal function Total body (excluding bladder contents) Kidneys Bladder contents F, 1.0 1.0 1.0 1.0 1.0 1.0 16.7 hr 1.0 T 1.67 hr a As/A, 2.41 hr 5.6 min 2.16 hr l.Od 26.4 min 1.79 hr

1.0

55

C 6 huh

BIOKINETIC MODELS AND DATA

INULIN
14C

5730

years per Adult unit

Absorbed dose activity administered 15 year 1.2E-03 1.9E-01 1.2E-03 1.2E-03 1.2B-03 1.2B-03 1.2E-03 1.2E-03 1.1%02 1.2&03 1.2E-03 1.2B-03 1.2E-03 1.2E-03 1.2E-03 1.2E-03 1.2E-03 1.2E-03 1.2E-03 10 year 2.OE-03 3.OE-01 2.OE-03 2.OE-03 2.0&03 2.OE-03 2.OE-03 2.OE-03 1.6E-02 2.OE-03 2.OE-03 2.OE-03 2.OE-03 2.OE-03 2.OE-03 2,OE-03 2.OE-03 2.OE-03 2.OE-03

(mGy/MBq) 5 year 3.4E-03 4.gE-01 3.4E-03 3.4E-03 3.4E-03 3.4E-03 3.4E-03 3.4%03 2.3B-02 3.4E-03 3.43-03 3.4E-03 3.4E-03 3.4E-03 3.4E-03 3.4E-03 3.4E-03 3.4E-03 3.4E-03 1 year 6.9E-03 9.4E-01 6.9%03 6.9.E-03 6.93-03 6.9E-03 6.933-03 6.9E-03 4.3E-02 6.9B-03 6.9E-03 6.9E-03 6.913-03 6.9E-03 6.9E-03 6.9E-03 6.9E-03 6.9E-03 6.9E-03

* *

* *

Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue

9.5E-04 1.5E-01 9.5E-04 l. ZE-03 9.5E-04 9.5E-04 9.53-04 9.53-04 8.6E-03 9.5E-04 9.5E-04 9.5E-04 9.5E-04 9.5E-04 9.5E-04 9.5E-04 9.5E-04 9.5E-04 9.5E-04

Effective dose equivalent Wv/nBq) Bladder wall contributes

l . lE-02

1.3B-02

2.1E-02

3.3B-02

6.5B-02

to 81.8

X of

the

effective

dose

equivalent.

Abnormal Organ * * Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Soleen Testes Thyroid Uterus Other tissue Adult 9.7E-03 1*3E-01 9.7&03 1.2E-02 9.7E-03 9.7E-03 9.7E-03 9.7E-03 4.OE-02 9.7E-03 9.7E-03 9.7E-03 9.7E-03 9.7E-03 9.7E-03 9.7E-03 9.7%03 9.7E-03 9.7E-03

renal

function 10 year 2.OE-02 2.6E-01 2.OE-02 2.OE-02 2.OE-02 2.OE-02 2.OE-02 2.OE-02 7.3E-02 2.OE-02 2.OE-02 2.OE-02 2.OE-02 2.OE-02 2.OE-02 2.OE-02 2.OE-02 2.OE-02 2.OE-02 5 year 3.4E-02 4.1E-01 3.4E-02 3.43-02 3.43-02 3.4E-02 3.43-02 3.4E-02 l.lE-01 3.4E-02 3.4E-02 3.4E-02 3.4E-02 3.4E-02 3.4E-02 3.4E-02 3.4E-02 3.4E-02 3.4E-02 1 year 7.OB-02 g . lE-01 7.OE-02 7.OE-02 7.OE-02 7.OE-02 7.OE-02 7.OE-02 2.OE-01 7.OE-02 7.OE-02 7.OE-02 7.OE-02 7.OE-02 7.OE-02 7.OE-02 7.OE-02 7.OE-02 7.OE-02

15 year 1.2E-02 1.7E-01 1.2E-02 1.2E-02 1.2E-02 1.2E-02 1.2E-02 1.2E-02 5.1E-02 1.2E-02 1.2E-02 1.2E-02 1.2E-02 1.2E-02 1.2E-02 1.2E-02 1.2E-02 1.2E-02 1.2E-02

* *

Effective dose equivalent (mgv/RW

1.913-02

2.3E-02

3. gg-02

6.1E-02

1.2E-01

56

RADIATION

DOSE TO PATIENTS

FROM RADIOPHARMACEUTICALS

N
7 Gas

NITROGEN GAS
13N Biokinetic Model Gaseous 13N has a very low solubility in blood and tissues and the inhaled gas is, therefore, assumed not to enter the pulmonary blood circulation. Wash-in and wash-out rates of i3N gas in lungs are assumed to be equal. Rosenzweig et al. (1969/70) measured mean wash-out rates of 4.27 min- (0.11) and 1.48 min- (0.89) following equilibration in eight subjects. The lower rate (1.48 min-) has been used in the present model for both wash-in and wash-out. Two situations have been considered: (1) Single inhalation of gas with 20 s breathhold. During the 20 s breathhold, a fraction of the 13N gas is washed in. After 20 s, this fraction washes out at the above rate, whereas the remainder is assumed to be exhaled instantaneously. (2) Continuous inhalation of gas for 1 hr. In this case, the inhalation rate is assumed to be 12 breaths per min, giving an average duration of 5 s for each breath. The 13N activity in the lungs builds up as determined by the rate constant of 1.48 min- and reaches equilibrium within 3 to 4 min (Senda et al., 1986). The build up to equilibrium is compensated for by the washout of activity following termination of the 1 hr period of continuous inhalation so that, for dosimetry purposes, the time course of lung i3N content is equivalent to constant lung activity, given by the steady state value, present for 1 hr. The equilibrium lung activity is 7.7 times the average intake of activity per 5 s breath. References
Rosenzweig, D. Y., Hughes, J. M. B. and Jones, T. (1969/70). Uneven ventilation within and between regions of the normal lung measured with nitrogen-13. Resp. Physiol. 8, 8697. Senda, M., Murata, K., Itoh, H., Yonekura, Y. and Torizuka, K. (1986). Quantitative evaluation ofregional pulmonary ventilation using PET and nitrogen-13 gas. J. Nucl. Med. 27, 268-273.

Biokinetic Data
Organ (S) (1) Single inhalation with 20 s breathhold (2.5 1) Total body Lungs (2) Continuous inhalation for 1 hr (360 1) Total body Lungs

34.5 s 34.5 s 38.7 s 38.7 s

57

BIOKINETIC MODELS AND DATA

Single 13N Organ * Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue Effective dose equivalent (=Sv/nss) 9.965 minutes

inhalation

NITROGEN GAS

with 20 s breathhold

per unit Adult 4.7E-05 1.4E-06 1.9E-05 7.OE-05 3.6E-05 5.4E-06 7.5E-06 1.5E-06 2.OE-05 4.7E-05 2.8&03 3.1E-06 5.4E-05 2.5E-05 4.1E-05 4.9E-07 2.4E-05 1.9E-06 2.6E-05 3.7g-04

Absorbed dose activity administered 15 year 7.5E-05 1.8E-06 2.5E-05 7.OE-05 4.3E-05 6.9E-06 0.4E-06 3.53-06 2.6E-05 6.4E-05 4.6E-03 3.5E-06 5.8E-05 3.6E-05 5.5%05 7.3E-07 2.9E-05 3 *OE-06 3.2E-05 5.8E-04 10 year 1.2E-04 4.OE-06 3.6E-05 1.3E-04 6.2E-05 1.4E-05 1.6E-05 5.6E-06 3.0E-05 9.1E-05 6.53-03 6.7E-06 8.3E-05 4.6E-05 8.3E-05 1.0g-06 5.OE-05 5.9E-06 4.5E-05 8.4E-04

(mGy/MBq) 5 year 1.0E-04 8.2E-06 5.7E-05 1. BE-04 8. EE-05 2.6E-05 2.7E-05 1.2E-05 6.4E-05 1.3E-04 l .OE-02 1.4%05 1.4E-04 6.2E-05 1.2E-04 2. BE-06 a. 5E-05 1.3E-05 6.93-05 1.3%03 1 year 3.2&04 1.8E-05 l.lE-04 2.7E-04 1.5E-04 4.0E-05 6.OE-05 3.OE-05 1.2%04 2.3E-04 2.OE-02 2.9E-05 2.3E-04 1 .OE-04 2.3E-04 9.OE-06 1.3&04 2.9E-05 1.2E-04 2.5%03

* * *

Continuous Organ * Adrenals Bladder wall Adult

inhalation 15 year 8.4E-05 2.OE-06 2.8E-05 7.9E-05 4,9E-05 7.7E-06 9.4E-06 3.9E-06 3.OE-05 7.2%05 5.1E-03 4 *OE-06 6.5E-05 4.OE-05 6.2E-05 0.2E-07 3.2E-05 3.4E-06 3.6E-05

for

1 h 5 year 1 year

10 year

Bone surfaces Breast GI-tract * Stomachwall Small intest

ULI wall LLI wall * * * Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue Effective dose equivalent Wv/gfW

5.23-05 1.6&06 2.2E-05 7.9E-05 4.1E-05 6.1E-06 8.43-06 1.7E-06 2.3E-05 5.23-05 3.2E-03 3.5E-06 6.1E-05 2.83-05 4.63-05 5.5B-07 2.63-05 2.1E-06 2.9E-05 4.2E-04

2.OL04 1.3E-04 4.53-06 9.2E-06 4.OE-05 6.4B-05 1.5E-04 2.1E-04 6.93-05 1.6E-05 1.9E-05 6.3E-06

3.6E-04 2.OE-05 1.3E-04 3.OE-04

9.9E-05 1.6E-04 2.93-05 5.4E-05 3.OE-05 6.7E-05 1.4E-05 3.33-05 1.3E-04 2.63-04 2.23-02 3.3E-05 2.53-04 l.lE-04 2.6E-04 l.OE-05 1.5E-04 3.3E-05 1.4E-04 2.9B-03

4.3E-05 7.1E-05 l.OE-04 1.5E-04 7.33-03 l.lE-02 7.51-06 1.6E-05 9.43-05 1.5E-04 5.2E-05 6.9E-05 9.3E-05 1.4E-04 2.OE-06 3.23-06 5.63-05 9.5E-05 6.73-06 1.5E-05 5.OL05 9.4E-04 7.73-05 1.4B-03

6.5~04

RADIATIONDOSE TO PATIENTS FROM RADIOPHARMACEUTICALS

N
7

Gas in solution

NITROGEN

GAS IN SOLUTION
13N

Biokinetic Model Because of its low solubility, 13N gas is assumed to be completely exhaled on reaching the lungs following an intravenous bolus injection of 13N gas in solution. Hughes (1979) observed a faster wash-out of 13N from the lungs following such an administration than following equilibration of inhaled gas and a wash-out rate of 1.62 min - has been estimated from his data. It is assumed that the mean transit time for an intravenously administered bolus, between injection site and lungs, is 10 s. Reference
Hughes, J. M. B. (1979). Short-life radionuclides and regional lung function. Br. J. Radial. 52, 353-370.

Biokinetic Data
Organ (S) Intravenous injection of 13N solution Total body Lungs &IA0 45.0 s 35.1 s

59

BIOKINETIC MODELS AND DATA

Gas in solution

NITROGEN GAS IN SOLUTION

13N 9.965 minutes

per Organ Adult * Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue 7.1B-05 2.3&05 3.93-05 9.3&05 5.8B-05 2.8E-05 3.OB-05 2.4E-05 4.2B-05 6. BE-05 2.9B-03 2.4B-05 7.6B-05 4.5E-05 6.3B-05 Z. ZE-05 4.3E-05 2 * 3B-05 4.6B-05

unit

Absorbed dose activity administered 15 year l.OE-04 2.7E-05 4.9E-05 10 year 1.6%04 4.4B-05 7.4B-05 1.7B-04 l . OB-04 5.83-05 5. EB-05 4.7B-05 0.OE-05 1.3B-04 6.6E-03 5.OE-05 1.3B-04 8.6B-05 l .ZB-04 3.9E-05 9.1B-05 5.OE-05 8.339-05

(mGy/MBq) 5 year 2.5B-04 7.5B-05 l.ZE-04 2.4B-04 1.5E-04 9.6B-05 9.5B-05 7.9B-05 1.3B-04 2 .OE-04 l.OB-02 8.43-05 Z . lE-04 l. ZB-04 1.9B-04 6.3E-05 1.5B-04 0,4B-05 1.3B-04 1 year 4.5E-04 1.4B-04 2.3B-04 3.0B-04 2. ?B-04 1. aB-04 1.9B-04 1.5E-04 2.5B-04 3.6B-04 2.0&-02 1.6E-04 3.6B-04 Z . ZB-04 3.63-04 1.3B-04 2.6B-04 1.6B-04 2.4E-04

9.38-05
6.9E-05 3.4B-05 3.5B-05 2.93-05 5.2B-05 9.1B-05 4.6B-03 3.1E-05 8.63-05 6.1B-05 0 *lE-05 2.43-05 5.43-05 3.1B-05 5.6E-05

* *

Effective dose equivalent (=Sv/RW

4.OB-04

6.2B-04

8.98-04

1.4B-03

2.7B-03

60

RADIATIONDOSE TO PATIENTS FROM RADIOPHARMACEUTICALS

N
1

Ammonia

AMMONIA
13N Biokinetic Model This model has been established from data given by Lockwood (1980) based on biokinetic information obtained following intravenous administration of i3N ammonia to normal subjects and patients with liver disease (Lockwood et al., 1979). The injected substance was very rapidly removed from the circulation and metabolized in tissues, some metabolic products being returned to the circulation. Body scans, at up to 50 min post-injection, showed substantial amounts of 13N in liver, brain and urinary bladder, with smaller amounts in heart and kidneys. In normal subjects, the mean transit time of 13N ammonia in the circulation was found to be 1.08 min. In the model, the injected activity is, therefore, assumed to be instantaneously and uniformly mixed in the vascular compartment and taken up in tissues with a half-time of 0.75 min. A fraction, 0.064, of the administered activity returned to the circulation as 13N metabolites, with an estimated half-time of 2 min. Fractions of 0.07 1 and 0.069 were taken up in liver and brain, respectively, and retained indefinitely. A fraction 0.064 was measured in the urinary bladder and was estimated to enter with a half-time of 8 min. In patients with severe liver disease (Lockwood et al., 1979) the fraction of the administered activity taken up by the liver was slightly larger, i.e. 0.106. References
Lockwood, A. H. (1980). Absorbed doses of radiation after an intravenous injection ofN-13 ammonia in man. J. Nucl. Med. 21,276278. Lockwood, A. H., McDonald, J. M., Reiman, R. E., Gelbard, A. S., Laughlin, J. S., Duffy, T. E. and Plum, F. (1979). The dynamics of ammonia metabolism in man: Effects of liver disease and hyperammonemia. J. Clin. Invest. 63, 449460.

Biokinetic Data
Organ (S) Total body (excluding bladder contents) Blood F, 1.0 1.0 T 8 min
42

a 0.06 0.94 1.0 -0.06 0.06 -1.0 1.0 -1.0 1.0

&IA, 13.9 min 1.73 min

Liver Brain Kidneys Bladder contents

0.07 0.07 0.06 0.06

2 min cc 45 s 45sa cc

55 s 55 s 12 s 29 s

61

N
7

BIOKINETICMODELSANDDATA

Ammonia

AMMONIA
13N

9.965 minutes Absorbeddose per unit activityadministered (mGy/YBq) Organ Adult 15 year 2.6E-03 9.9E-03 1.9E-03 4.4E-03 1.8E-03 2.1E-03 2.23-03 2.1E-03 2.1E-03 2.6E-03 5.7E-03 4.93-03 3.OE-03 2.3E-03 2.3E-03 2.1E-03 3.OE-03 1.9E-03 2.2E-03 2.43-03 10 year 4.2E-03 1.5E-02 3.1E-03 4.73-03 2.8E-03 3.2E-03 3.5E-03 3.4E-03 3.48-03 4.OE-03 8.5E-03 7.8E-03 4.8E-03 3.6E-03 3.7E-03 3.3E-03 5.OE-03 3.1E-03 3.6E-03 3.93-03 5 year 6.78-03 2.4E-02 5.1E-03 5.23-03 4.6E-03 5.2E-03 5.6E-03 5.6E-03 5.4E-03 6.1E-03 1.3E-02 1.2E-02 7.91-03 5.7E-03 5.8E-03 1 year 1.3E-02 4.5E-02 9.9E-03 7.3E-03 8.9E-03 9.9E-03 l.lE-02 l.OE-02 l.OE-02 l.lE-02 2.4E-02 2.3E-02 1.5E-02 l.lE-02 l.lE-02

Adrenals * Bladderwall Bone surfaces * Brain Breast GI-tract Stomachwall Small intest ULI wall LLI wall Heart * Kidneys * Liver Lungs Ovaries Pancreas * Red marrow Spleen Testes Thyroid Uterus Other tissue Effective dose equivalent (mSv/llBq)

2.3E-03 8.1E-03 1.6E-03 4.21-03 1.8E-03 1.7E-03 1.8E-03 1.8E-03 1.9E-03 2.1E-03 4.6B-03 4.OE-03 2.51-03 1.7E-03 1.9E-03 1.7E-03 2.5E-03 1.8E-03 1.7E-03 1.9E-03 1.6E-03 2.7E-03

5.5E-03 l.OE-02 8.OE-03 1.5E-02 4.9E-03 9.5E-03 5.8E-03 l.lE-02 6.1E-03 l.lE-02 9.4E-03 1.5E-02

1.9E-03 3.OE-03 4.9E-03 3.2E-03 4.93-03 7.7E-03

62

RADIATION

DOSE TO PATIENTS

FROM RADIOPHARMACEUTICALS

Glutamate

L-GLUTAMATE 13N Biokinetic Model Following intravenous administration of L- 13N-glutamate in man, blood activity falls rapidly, with an initial half-time of 0.4 to 1.6 min, and only about 5% remains in the circulation at 5 min (Gelbard et al., 1980). Rapid uptake occurs mainly in myocardium, liver, pancreas and salivary glands, with small amounts in kidneys. High concentrations in these organs have also been observed in small animals (Kubota et al., 1983). From human studies, there is good agreement that 0.05-0.06 of the administered substance accumulates in the myocardium (Gelbard et al., 1980; Knapp et al., 1982), whilst Gelbard et al. (1979) estimated an uptake of 0.08 to 0.12 in the pancreas. It is evident from whole-body scans that the liver takes up the largest proportion of the administered activity. Gelbard et af. (1979) estimated the pancreas: liver concentration ratio to be 9: 1. On this basis, it is estimated that liver uptake accounts for about 0.25 of the administered activity. Salivary glands (maxillary region) also exhibit high concentrations of 13N glutamate (Cooper et al., 1985; Gelbard et al., 1980) and, in the absence of quantitative information, it is assumed that the fractional uptake in the salivary gland is 0.05. The data of Knapp et al. (1984) indicate an initial kidney content of about 0.03, falling to 0.01 between 5 and 20 min after administration; in contrast, the 13N content of other organs and tissues is reasonably constant up to 20 min. Therefore, for the kidneys, the biological half-time is taken to be 10 min, whereas, for other organs and tissues, the period of retention is assumed to be long in comparison with the physical half-life of 13N. References
Cooper, A. J. L., Gelbard, A. S. and Freed, B. R. (1985). Nitrogen-13 as a biochemical tracer. In: Advances in Enzymology, pp. 251-356. (Meister, A., ed.) Advances in Enzymology, Wiley, New York. Gelbard, A. S., Benua, R. S., McDonald, J. M., Reiman, R. E., Vomero, J. J. and Laughlin, J. S. (1979). Organ imaging with N-13-L-glutamate. J. Nucl. Med. 20, 663. Gelbard, A. S., Benua, R. S., Reiman, Rr E., McDonald, J. M., Vomero, J. J. and Laughlin, J. S. (1980). Imaging of the human heart after administration of L-(N-13) glutamate. J. Nucl. Med. 21,988-991. Knapp, W. H., Helus, F., Ostertag, H., Tillmanns, H. and Kiibler, W. (1982). Uptake and turnover of L-(13N)-glutamate in the normal human heart and in patients with coronary artery disease. Eur. J. Nucl. Med. 7, 211-215. Knapp, W. H., Helus, F., Sinn, H., Ostertag, H., Georgi, P., Brandeis, W. E. and Braun, A. (1984). N-13 L-glutamate uptake in malignancy: Its relationship to blood flow. J. Nucl. Med. 25989-997. Kubota, K., Fukuda, H., Yamada, K., Endo, S., Ito, M., Abe, Y., Yamaguchi, T., Fujiwara, T., Sato, T., Yamaura, H., Matsuzawa, T., Ishiwata, K., Iwata, R. and Ido, T. (1983). Experimental pancreas imaging study with 13N-glutamate using positron computer tomography. Eur. J. Nucl. Med. 8,528-530.

Biokinetic Data
Organ (S) Total body Liver Pancreas Heart (myocardium) Salivary glands Kidneys Fs 1.0 0.25 0.1 0.06 0.05 0.03 ;100min co co co co 10 min T a 0.97 0.03 1.0 1.0 1.0 1.0 1.0 &IA, 14.2 min 3.6 min 1.44 min 51.8 s 43.1 s 13.0 s

63

N 7 Glutamate

BIOKINETIC MODELS AND DATA

L-GLUTAMATE
13N 9.965 minutes

per Organ Adult Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Heart Kidneys Liver Lungs Ovaries Pancreas Salivary 2,8E-03 7.9E-04 9.OE-04 l.lE-03 Z. lE-03 l. ZE-03 1.4E-03 8.9E-04 1.6E-02 3.9E-02 1.3E-02 1.3E-03 8.2E-04 7.9E-02 S. lE-02 l. lE-03 2.4E-03 ?.6E-04 8. H-04 8.6E-04 l.lE-03

unit

Absorbed dose activity administered 15 year 3.4E-03 9. SE-04 l. lE-03 l. lE-03 2. SE-03 1.5E-03 1.6E-03 l .OE-03 Z .OE-02 4.9E-02 1.7E-02 1.7E-03 l.ZE-03 l.ZE-01 6.3E-02 1.4E-03 2.8E-03 8.2E-04 1 .OE-03 l.lE-03 1.3E-03 10 year 5.3E-03 1.6E-03 1.7E-03 1.9E-03 3.8E-03 2. SE-03 2.7E-03 1.7E-03 3.2E-02 6.9E-02 2.6E-02 2. SE-03 1.9E-03 Z.SE-01 8.4E-03 Z. lE-03 4.4E-03 1.3&03 4.7E-03 1.9E-03 Z.OE-03

(mGy/.MBq) 5 year 7.6E-03 2.7E-03 2.7E-03 3.1E-03 5.9E-03 4.OE-03 4.2E-03 2.8E-03 S.OE-02 l.OE-01 3.83-02 4.OE-03 3.1E-03 3.1E-01 l.lE-01 3.OE-03 6.5E-03 Z. ZE-03 2.8E-03 3.1E-03 3.1E-03 1 year 1.3E-02 4.81-03 5,4E-03 5.88-03 l.OE-02 7.4E-03 8.OE-03 S. ZE-03 9.1E-02 1. EE-01 7.3E-02 7.3E-03 5.9E-03 7.1E-01 1.7E-01 5.3E-03 l. lE-02 4.3E-03 5. SE-03 5.8E-03 5.9E-03

* * *

* *

glands

Red marrow Spleen Testes Thyroid Uterus Other tissue

Effective dorc equivalent (rSv/neq)

1.3E-02

1.7E-02

2.9E-02

3.9E-02

7.7E-02

64

RADIATION DOSE TO PATIENTS FROM RADIOPHARMACEUTICALS

8 Carbon monoxide

CARBON MONOXIDE
I50

Biokinetic Model The same model is used as for C-labelled carbon monoxide (see p. 43).

Reference
Bigler, R. E. and Sgouros, G. (1983). Biological analysis and dosimetry for t50-labelled O,, CO, and CO gases administered continuously by inhalation. J. Nucl. Med. 24,431437.

Biokinetic Data
Organ (1) Single inhalation with 20 s breathhold (2.5 1) Total body Lungs Blood (2) Continuous inhalation for 1 hr (360 1) Total body Lungs Blood

2.80 min 10.5 s 2.63 min 1.86 min 8.1 s 1.73 min

65

0 8 Carbon monoxide

BIOKINETIC MODELS AND DATA

CARBON MONOXIDE
Single 150 122.24 seconds per Organ Adult * Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest IJLI wall LLI wall Heart Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue l.lE-03 3.1E-04 4.2E-04 4.1E-04 3.6E-04 3.3E-04 3.4%04 3.2E-04 3.3E-03 l .OE-03 7. H-04 3.4E-03 3.1E-04 4.2E-04 5.3E-04 2.1E-03 3.1E-04 7.7E-04 3. DE-04 3.2E-04 15 year 1.3E-03 3.7E-04 6.7E-04 4.2%04 4 *5.8-04 4. H-04 4.1%04 3.83-04 4.OE-03 1.3E-03 8.6E-04 4.8B-03 4.1E-04 5.2E-04 8.1E-04 2.6E-03 3.5E-04 9.6E-04 4.1E-04 3.9E-04 10 year 2.2E-03 5.8E-04 l. lE-03 7.0804 6.9E-04 6.5E-04 6.3E-04 6.lE-04 6.3E-03 2.1E-03 1.5E-03 7.5E-03 6.4E-04 8.1804 1.3E-03 4.38-03 5. SE-04 1.6E-03 6.3E-04 6.2!3-04 5 year 3.6E-03 9*6E-04 1.9E-03 l.lB-03 l. lE-03 l.OE-03 l . OE-03 9.7E-04 l .OE-02 3.4E-03 2.4E-03 1.2E-02 l .OE-03 1.3E-03 2.4E-03 7.1&03 8.7E-04 2.7E-03 l .OE-03 9.8E-04 1 year 7.2E-03 1.8E-03 3.83-03 2,1E-03 Z. lE-03 2.OE-03 2e OE-03 1.8E-03 1.8E-02 6.8E-03 4.7E-03 2.4E-02 1.9E-03 2.4E-03 4.8E-03 1.48-02 1.7E-03 5.4E-03 1.9E-03 1.9E-03 unit Absorbed dose activity administered (mGy/RRq) inhalation with 20 s breathhold

* * *

Effective dose equivalent (mSv/BBq)

1.1%03

1.5%03

2. bB-03

3.9B-03

7.6%03

Continuous Organ * Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Heart Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue Adult 7 .OE-04 2.OE-04 2.78-04 2 *7E-04 2.4E-04 2.2E-04 2.2E-04 2.1E-04 2.1E-03 6.7804 4.7E-04 2.3E-03 2.OE-04 2.8E-04 3.5804 1.4E-03 2.OE-04 5.1E-04 2.08-04 2.lE-04

inhalation 15 year 8.8E-04 2.43-04 4*4B-04 2.8E-04 3.OE-04 2.73-04 2.7E-04 2.5E-04 2.6E-03 8.3E-04 5.7E-04 3.4E-03 2.7E-04 3.4E-04 5.3E-04 1.7E-03 2.3E-04 6.3E-04 2.73-04 2.6E-04

for 10 year 1.5E-03 3.8E-04 7.4E-04 4.6E-04 4.6E-04 4.3E-04 4.2E-04 4.OE-04 4.1E-03 1.4E-03 9.7E-04 5.3E-03 4.21-04 5.3E-04 8.88-04 2.8E-03 3.6804 l.lE-03 4.2E-04 4.1%04

1 h 5 year 1 year

2.bE-03 6.3&04
1.3E-03 7.3E-04 7.3E-04 6.81-04 6. BE-04 6,4E-04 6.6E-03 2.3E-03 1.6E-03 8.5E-03 6.6E-04 8.4E-04 1.6E-03 4.73-03 5.7&04 1.8&03 6.6E-04 6.5E-04

4.7%03
1.2E-03

2.5E-03
1.4&03 1.4E-03 1.3E-03 1.3E-03 1.2E-03 1. x-02 4.5E-03 3.1E-03 1.7E-02 1.3E-03 1.6E-03 3.1E-03 9.4E-03 l. lE-03 3.53-03 1.3E-03 1.3E-03

* * *

Effective dose equivalent (mSv/naS)

7.6B-04

1.0%03

1.6%03

2.6B-03

5.1B-03

66

RADIATIONDOSE TO PATIENTS FROM

RADIOPHARMACEUTICALS

Carbon dioxide

CARBON DIOXIDE
150 Biokinetic Model Inhaled Ci50, passes through the alveolar membrane, the I50 label exchanges with water in the pulmonary capillary blood and there is no return of the label into the alveolar gas. The tracer, now in the form of HzlO, is carried to the left side of the heart and subsequently, during systemic circulation, it equilibrates rapidly with the total body water. In normal adults the half-time for absorption of C150, by the lungs is less than 1 s, so that essentially all the tracer occupying the alveolar space in each inhalation is absorbed. The half-time for clearance of H,O from the lungs is 2 to 5 s in normal individuals, and a value of 4 s has been used for dose calculations. The biological half-time for whole-body retention of water is about 10 d, so the effective half-time for the 5O tracer is taken as the radioactive half-life (124 s). Two situations have been considered: (1) Single inhalation of gas with a 20 s breath-hold. A total inhalation volume of 2.5 1 is assumed to be distributed between alveolar space (2350 ml) and dead space (150 ml). No absorption occurs from the dead space, and the CO, it contains is exhaled after 20 s, allowance being made for radioactive decay. The tracer in the alveolar space is absorbed and subsequently distributed uniformly in total body water. (2) Continuous inhalation of gas for 1 hr. In this case, each inhalation volume is assumed to be 500 ml, distributed between dead space (150 ml) and alveolar space (350 ml). Taking an inhalation rate of 12 breaths per min, the average duration of each breath is 5 s. Even with this shorter period, the C?O, in the alveolar space is assumed to be totally absorbed by the lungs. Since the activity concentration in the dead space varies between zero and that of the delivered gas, the average concentration is assumed to be half of that of the delivered gas. Cumulated activities resulting from a single breath were estimated as in (1) above and multiplied by 720, the number of breaths in 1 hr. References
Bigler, R. E., Kostick, J. A. and Gillespie, J. R. (1981). Compartmental analysis of the steady-state distribution of i50, and H2150 in total body. J. Nucl. Med. 22,959-965. Bigler, R. E. and Sgouros, G. (1983). Biological analysis and dosimetry for 50-labelled O,, CO, and CO gases administered continuously by inhalation. J. Nucl. Med. 24,431437. Dollery, C. T., Heimburg, P. and Hugh-Jones, P. (1962). The relationship between blood flow and clearance rate of radioactive carbon dioxide and oxygen in normal and oedematous lungs. J. Physiol. 162,93-104. Kearfott, K. J. (1982). Absorbed dose estimates for positron emission tomography (PET): CisG, CO and COi50. J. Nucl. Med. 23, 1031-1037. Kenny, P. J., Watson, D. D., Janowitz, M. D., Finn, R. D. and Gilson, A. J. (1976). Dosimetry of some accelerator produced radioactive gases. In: Proc. Second Int. Radiopharmaceutical Dosimetry Symposium, Oak Ridge, Tennessee, (FDA 76-8044), pp. 475487. Oak Ridge National Laboratories, Oak Ridge, Tennessee.

Biokinetic Data
Organ (S) (1) Single inhalation with 20 s breathold (2.5 I) Total body Lungs (2) Continuous inhalation for 1 hr (360 I) Total body Lungs
&IA,

2.83 min 8.8 s 2.1 min 6.4 s

67

0 8

BIOKINETIC MODELS AND DATA

Carbon dioxide

Single 150 122.24 seconds

CARBON DIOXIDE
inhalation with

20 s breathhold

per Organ Adult * * Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue 4. PE-04 4.4%04 4.1E-04 4. BE-04 4.4E-04 4.6E-04 4.63-04 4.58-04 4.3E-04 4.4E-04 1.2E-03 4.3E-04 4.4E-04 4.213-04 4.4B-04 4.4E-04 4.1E-04 4.3E-04 4.1E-04

unit

Absorbed dose activity administered 15 year 5.53-04 5.2E-04 5.0&04 4.7E-04 5.3E-04 5.5E-04 5.4E-04 5.2E-04 5.3E-04 5.4E-04 1. BE-03 5.6E-04 5.7E-04 5.2E-04 5.4E-04 4. PE-04 5.2B-04 5.6E-04 5.OE-04 10 year P.OE-04 8.4%04 8.1E-04 7.7E-04 8.53-04 P.OE-04 0.7E-04 8.6B-04 8.6&04 0.0E-04 2.6E-03 P . OE-04 9.2E-04 0.4B-04 0.7E-04 0.OE-04 8.6E-04 P. lE-04 8.2E-04

(mGy/MBq) 5 year 1.4E-03 1.4&03 1.3E-03 1.3E-03 1.4E-03 1.5E-03 1.4E-03 1.4B-03 1.4E-03 1.4E-03 4.OE-03 1.5%03 1.5E-03 1.3B-03 1.4B-03 1.3B-03 1.4E-03 1.5E-03 1.3%03 1 year 2.&l-03 2.6E-03 2.6%03 2.5E-03 2.7&03 2.8B-03 2.7E-03 2.7E-03 2.7B-03 2.0B-03 0.OE-03 2 *W-03 2.83-03 2 s6E-03 2 *7E-03 2.6E-03 2.8B-03 2.83-03 2.6E-03

*
*

Effective dose equivaleut Wv/llBg)

5.4E-04

6.8B-04

l . lB-03

1.7E-03

3.3%03

Continuous Organ * * Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other Effective tissue Adult 3.63-04 3.33-04 3.OE-04 3.5E-04 3.2E-04 3.4E-04 3.43-04 3.4&04 3.2E-04 3.3E-04 8.7E-04 3.2E-04 3.3E-04 3.1E-04 3.2E-04 3.3E-04 3.0%04 3.2E-04 3.0&04

inhalation 15 year 4.1E-04 3.0E-04 3.7E-04 3.53-04 4 *OR-04 4.1E-04 4.OE-04 3. PE-04 3. PE-04 4.OE-04 1.3E-03 4.1E-04 4,2E-04 3. PE-04 4.OE-04 3.7E-04 3.8E-04 4.1E-04 3.73-04

for 10 year 6.7E-04 6.3E-04 6.OE-04 5.7E-04 6.3E-04 6.7E-04 6.4E-04 6.43-04

1 h 5 year l. lE-03 l.OE-03 9.7E-04 9.3&04 l . OE-03 l. lE-03 l.lE-03 l . OE-03 l.OE-03 l . OE-03 2. PE-03 l.lE-03 l. lE-03 9. PE-04 l .OE-03 9.7E-04 l. lE-03 l. lE-03 P.EB-04 1 year 2.1B-03 1. PE-03 1. PE-03 1.8E-03 2.OE-03 2.1E-03 2.OE-03 2.OE-03 2.OE-03 2.OE-03 5.8E-03 2.1E-03 2.1E-03 1. PE-03 2.OE-03 1. PE-03 2.1E-03 2.1E-03 1. PE-03

* * *

6.4E-04 6.5E-04 1. PE-03 6.7E-04 6. BE-04 6.2E-04 6.53-04 5. PE-04 6.4B-04 6,0E-04 6.1E-04

dose aquiraleat (=Sv/lIBq)

4.0~04

5.oB-04

7.8E-04

1.2B-03

2.4B-03

68

RADIATION

DOSE TO PATIENTS

FROM RADIOPHARMACEUTICALS

0 8 Molecular

OXYGEN
150 Biokinetic Model Inhaled molecular oxygen passes from the alveoli to the pulmonary capillary blood, where it is bound to haemoglobin. In tissues, it combines with hydrogen ions to form 150-labelled water of metabolism. The radiation dose to a given organ is, therefore, determined by both its blood and water contents. In addition to these two contributions, the dose to the lungs includes contributions from radioactivity in lung gas (dead space and alveolar space) and from 150, absorbed in pulmonary capillary blood prior to washout. It is assumed that the 0, concentration in the delivered gas is 21%; the resting oxygen consumption is 240 ml/min; total blood volume is 5200 ml; and the concentration of oxygen in blood is 0.16 ml OJml blood. It is further assumed that the biological elimination rate of absorbed l 5O is negligible in comparison with its rate of radioactive decay (half-life 2.06 min). Two situations have been considered: (1) Single inhalation of gas with a 20 s breathhold. A total inhalation volume of 2.5 1 of air is assumed to be distributed between alveolar space (2350 ml) and dead space (150 ml). No absorption occurs from the dead space and the 1502 it contains is exhaled after 20 s. From the resting 0, utilization rate given above, the rate of alveolar transfer of 0, to pulmonary blood is estimated to be 0.0086 s-l. In a 20 s breathhold, therefore, only a small proportion (about 15%) of the inhaled OZ is absorbed, and the cumulated activity in alveolar gas is calculated on the assumption that the residual radioactive gas is completely exhaled at the end of the 20 s breathholding period. Cumulated activity due to absorbed 150, in pulmonary blood prior to washout is calculated using a clearance rate of 0.22 s-l. The cumulated activity in total blood due to dissolved or haemoglobin-bound 0, is calculated from the absorbed activity and an estimated rate constant of 0.0048 s- for diffusion of oxygen from blood to tissues. The 0 that is metabolized to H,O in tissues is assumed to be distributed uniformly in the total body. (2) Continuous inhalation of gas for 1 hr. In this case, each inhalation volume is assumed to be 500 ml, distributed between dead space (150 ml) and alveolar space (350 ml). Taking an inhalation rate of 12 breaths per min, the average duration of each breath is 5 s, during which time about 4.5% of the radioactivity in gas within the lung is absorbed. Assuming that the 350 ml of inspired gas that reaches the alveolar space mixes within an extra volume of 2400 ml (functional residual volume), only a fraction (350/2750) of the residual alveolar activity at the end of the 5 s inhalation period is expired. As inhalation proceeds, activity builds up in the alveolar region until a steady state is reached after about 2 min, when the intake of activity into the lungs is balanced by absorption and exhalation. The concentration of 0, in the dead space is taken as the average of that of the inhaled air and that of the alveolar air exhaled after 5 s. For this calculation, the concentration in exhaled alveolar gas is taken as that obtaining after sufficient breaths have been taken for equilibrium to be reached. The build up of alveolar activity prior to achievement of the steady state is compensated for by the corresponding diminution of residual activity following termination of the 1 hr period of continuous inhalation, so that, for dosimetry purposes, the continuous inhalation is equivalent to the administration of activity at constant rate, given by the steady state 69

0 8 Molecular

BIOKINETIC

MODELS

AND DATA

value, for 1 hr. The cumulated activities resulting from a single breath in this situation are calculated as in (1) above and multiplied by 720, the number of breaths in 1 hr. References
Altman, P. L. and Dittmer, D. S. (1971). In: Respiration and Circuhtion. Federation of American Societies for Experimental Biology, Bethesda, Maryland. Bigler, R. E., Kostick, J. A. and Gillespie, J. R. (1981). Compartmental analysis of the steady-state distribution of 150, and H,r50 in total body. J. Nucl. Med. 22,959-965. Bigler, R. E. and Sgouros, G. (1983). Biological analysis and dosimetry for 50-labelled O,, CO, and CO gases administered continuously by inhalation. J. Nucl. Med. 24431437. Kearfott, K. J. (1982). Absorbed dose estimates for positron emission tomography (PET): Ct50, CO and CO150. J. Nucl. Med. 23, 1031.-1037. West, J. B., Holland, R. A. B., Dollery, C. T. and Matthews, C. M. E. (1962). Interpretation of radioactive gas clearance rates in the lung. J. Appl. Physiol. 17, 14-20.

Biokinetic Data
Organ (S) (1) Single inhalation with 20 s breathhold (2.5 1) Total body Lungs Blood (2) Continuous inhalation for 1 hr (360 I) Total body Lungs Blood As/A, 43 s 18.3 s 13 s 49 s 19.9 s 15.4 s

70

RADIATION

DOSE TO PATIENTS FROM RADIOPHARMACEUTICALS

0 8 M&Cular

OXYGEN GAS
Single 150 122.24 seconds per Organ Adult * Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Heart Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue 1.5E-04 5.9E-05 7.3E-05 l .OE-04 E.OE-05 6.3E-05 6.51-05 6.1E-05 3.3E-04 1.3E-04 l. lE-04 2.4B-03 5.9E-05 9.3E-05 8.6E-05 2.2E-04 5.8E-05 l .OE-04 5.7E-05 6.9E-05 15 year 1.9E-04 7.OE-05 l .OE-04 l .OE-04 9.7E-05 7.8E-05 7.7E-05 7.2E-05 4.1E-04 1.5E-04 1.4E-04 3.71-03 7.6E-05 l. lE-04 1.2E-04 2. EE-04 6.6E-05 1.3E-04 7.6E-05 8.5E-05 10 year 3.OE-04 l. lE-04 1.7E-04 l.EE-04 1.5E-04 1.3E-04 1.2E-04 1.2E-04 6.3E-04 2.5E-04 2.3E-04 5.4E-03 1.2E-04 1.7E-04 1.9E-04 4.6E-04 l .OE-04 2.2E-04 1.2E-04 1.3E-04 5 year 4.9E-04 1.9E-04 2.8E-04 2.7E-04 2.4E-04 2.OE-04 2.0&04 1.9E-04 9.9E-04 4.2E-04 3.6E-04 8.4E-03 2.OE-04 2.8E-04 3.3E-04 7.5E-04 1.7E-04 3.7E-04 2.OE-04 2. IE-04 1 year 9.5E-04 3.5E-04 5.6E-04 4.9E-04 4.4E-04 3.9E-04 3.9E-04 3.6E-04 1.8E-03 8.2E-04 7.OE-04 1.7&02 3.8E-04 5.1E-04 6.3E-04 1.5&03 3.3E-04 7.1E-04 3 *8E-04 4.1E-04 unit Absorbed dose activity administered (mGy/MBq) inhalation with 20 set breathhold

* * *

Effective dose equivalent (mSv/lIBq)

3.9E-04

5.7&04

8.5E-04

1.3E-03

2 . ?E-03

Continuous Organ * Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Heart Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue Adult 1.7E-04 6,9E-05 8.5E-05 1.2E-04 9.2E-05 7.4E-05 7.6E-05 7.1E-05 3.9E-04 1.5E-04 1.3E-04 2.6E-03 6.9E-05 l.lE-04 l .OE-04 2.6E-04 6.8E-05 1.2E-04 6.8E-05 8.OE-05

inhalation 15 year 2,2E-04 8.2E-05 1.2E-04 1.2E-04 l. lE-04 9.23-05 9.OE-05 8.4E-05 4.8E-04 1.8E-04 1.6E-04 4. IE-03 9.OE-05 1.3E-04 1.4E-04 3.3E-04 7.73-05 1.5E-04 8.9E-05 9.8E-05

for 10 year 3.5E-04 1.3E-04 2.0&04 2.1E-04 1.7E-04 1.5E-04 1.5E-04 1.4E-04 7.4E-04 3.OE-04 2.7E-04 5.9E-03 1.4E-04 2.0&04 2.2E-04 5.4E-04 1.2E-04 2.6E-04 1.4E-04 1.5E-04

1 h 5 year 5.7E-04 2.2E-04 3.3E-04 3.1E-04 2.7E-04 2.4E-04 2.4E-04 2,2E-04 1.2E-03 4.9E-04 4.2E-04 9.2E-03 2.3E-04 3.2E-04 3. EE-04 8. BE-04 2.OE-04 4.3E-04 2.3E-04 2,5E-04 1 year l. lE-03 4.1E-04 6.5E-04 5.6E-04 5.1E-04 4.6E-04 4.6E-04 4.3E-04 2.1E-03 9.6E-04 8.1E-04 1.9E-02 4.5E-04 5.9E-04 7.4E-04 1.7E-03 3.9E-04 a. 3E-04 4.5E-04 4.8E-04

* * *

Effective dose equivalent Wv/llBq)

4.3E-04

6.4E-04

9.5E-04

1.5E-03

3. W-03

71

RADIATION

DOSE TO PATIENTS FROM RADIOPHARMACEUTICALS

F 9 Fluoride

FLUORIDE
*F Biokinetic Model Following the intravenous administration of Na*F, half of the fluorine is rapidly taken up by the skeleton where it remains for a time which is long in comparison with the radioactive half-life of lsF. The remainder is distributed in the extracellular fluid and eliminated within a few hours by renal excretion. The fraction of 0.5 which is taken up by the skeleton is deposited on bone surfaces with an uptake half-time of 20 min and is assumed to be retained permanently. The remaining fraction is eliminated by the renal system with half-times of 10 min (0.25) and 3.2 hr (0.75) according to the kidney-bladder model. References
Blau, M., Ganatra, R. and Bender, M. A. (1972). *F-fluoride for bone imaging. Sentin. Nucl. Med. 2,31-37. Charkes, N. D., Makler, P. T. and Philips, C. (1978). Studies of skeletal tracer kinetics. 1. Digital-computer solution of a five-compartment model of (*F) fluoride kinetics in humans. J. Nucl. Med. 19, 1301-1309. Wootton, R., Reeve, J. and Veal], N. (1976). The clinical measurement of skeletal blood flow. Chin. Sci. Mol. Med. 50, 261-268.

Biokinetic Data
Organ (S) Total body (excluding bladder contents) Bone surfaces Kidneys Bladder contents Fs 1.0 T 10 min 3.2 hr oc, 20 min co a 0.13 0.37 0.50 - 1.0 1.0 &IA@ 1.98 hr

0.5 0.5 0.5

1.12 hr 1.5 min 25.1 min

73

F 9 Fluoride

BIOKINETIC MODELS AND DATA

FLUORIDE
18F 109.77 minutes

per Organ Adult * * Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach vall Small intest ULI wall LLI wall l . OE-02 2.2E-01 4.OE-02 6. X-03 6.7B-03 9.4B-03 8.93-03 1.3E-02 2.OE-02 6.9E-03 6.8B-03 1.3E-02 7.3B-03 4 .OB-02 7.4E-03 1. HI-02 6. GE-03 1.9E-02 8.4B-03

unit

Absorbed dose activity administered 15 year 1.2E-02 2.7E-01 S . OE-02 6.1E-03 E.OE-03 1.2E-02 l.OB-02 1.6E-02 2. SE-02 8.4E-03 8.43-03 1.6E-02 9.6%03 5.3E-02 a. 1313-03 1.3E-02 0.4B-03 2.3E-02 I. OB-02 10 year 1,0E-02 4.OE-01 7.9E-02 9.7B-03 1.3E-02 1.0E-02 1.6E-02 2. SE-02 3.6B-02 1.3&02 1.3E-02 2.3B-02 1. SE-02 II. BE-02 1.4E-02 2.1E-02 1.3E-02 3.7E-02 1. SE-02

(mGy/MBqf 5 year 2.0E-02 6.1E-01 1.3E-01 1. SE-02 1.9E-02 2.83-02 2.6E-02 3.7E-02 5.3E-02 2.1E-02 2.OB-02 3.6E-02 2.3E-02 1.8E-01 2.1E-02 3.3E-02 2.OE-02 5.73-02 2.4E-02 1 year 5.2E-02

1 .lE+OO
3.0%01 3.OE-02 3.63-02 5.2E-02 4.6E-02 6.3E-02 9.7E-02 3.9B-02 3.9E-02 6.33-02 4.4E-02 3. W-01 4.1E-02 6.2E-02 3.6E-02 9.9E-02 4.4E-02

* * *

Kidneys
Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other Effective tissue

dose equivalent Wv/lIBq)

2.7B-02

3.4B-02

5.2B-02

8.6B-02

1.7B-01

RADIATION

DOSE TO PATIENTS

FROM RADIOPHARMACEUTICALS

F 9 FDG

2-FLUORO-ZDEOXY-D-GLUCOSE 18F Biokinetic Model

(FDG)

18FDG is a glucose analogue used in the investigation of myocardial and cerebral glucose metabolism. Following intravenous administration, most of the radiopharmaceutical is rapidly cleared from the circulation with a half-life of less than 1 min, as it mixes within a large distribution space, although there are longer-term components with half-lives of up to 1.5 hr. The substance is taken up predominantly by the myocardium and brain. There is evidence from investigations on dogs (Gallagher et al., 1977) of concentration in other organs, especially spleen, liver and kidneys, but significant uptake in these organs has not been observed in human studies (Phelps et al., 1978). Approximately 20% of the administered 18F is excreted in urine within the first 2 hr (Jones et al., 1982). From the average urine data of Jones et al. (1982) it can be deduced that the total body retention of *FDG may be described for dosimetry purposes by a multiexponential function with half-times of 12 min (0.075), 1.5 hr (0.225) and co (0.70). Fractions of 0.04 and 0.06 are taken up by myocardium and brain, respectively, with an uptake half-time of 8 min and retained for a time which is long in relation to the radioactive half-life of *F. The residual activity in the total body is assumed to be uniformly distributed amongst all tissues other than brain and heart. A fraction of 0.3 is assumed to be eliminated by the renal system with half-times of 12 min (0.25) and 1.5 hr (0.75) according to the kidney-bladder model. References
Gallagher, B. M., Ansari, A., Atkins, H., Casella, V., Christman, D. R., Fowler, J. S., Ido, T., MacGregor, R. R., Som, P., Wan, C. N., Wolf, A. P., Kuhl, D. E. and Reivich, M. (1977). Radiopharmaceuticals XXVII: F-1abelled Z-deoxy-2-fluoro-D-glucose metabolism in vivo: Tissue distribution and imaging studies in animals. J. Nucl. Med. 18, 99&996. Jones, S. C., Alavi, A., Christman, D., Montanez, I., Wolf, A. P. and Reivich, M. (1982). The radiation dosimetry of 2-F-18 fluoro-2-deoxy-D-glucose in man. J. Nucl. Med. 23, 613-617. Phelps, M. E., Hoffman, E. J., Selin, C., Huang, S. C., Robinson, G., MacDonald, N., Schelbert, H. and Kuhl, D. E. (1978). Investigation of *F 2-fluoro-2-deoxyglucose for the measure of myocardial glucose metabolism. J. Nucl. Med. 19, 1311-1319.

Biokinetic Data
Organ (S) Total body (excluding bladder contents) Brain Heart wall Kidneys Bladder contents F, 1.0 T 12 min 1.5 hr 30 8 min io 8 min ;o a 0.075 0.225 0.70 -1.0 1.0 -1.0 1.0 %lAo 2.13 hr

0.06 0.04 0.30 0.30

8.9 min 5.9 min 1.45 min 19 min

75

F 9 FDG

BIOKINETIC MODELS AND DATA

2-FLUORO-2-DEOXY-D-GLUCOSE (FDG)
18F 109.77 minutes

per Organ Adult Adrenals Bladder wall Bone surfaces Brain Breast GI-tract Stomach wall Small intest ULI wall LLI wall Heart Kidneys Liver Lungs Ovaries Pancreas Red marrow Soleen Testes Thyroid Uterus Other tissue 1.4E-02 1.7E-01 l.OE-02 2.6E-02 l.lE-02 1.2E-02 1.3E-02 1.3E-02 1.6E-02 6.5E-02 2.1E-02 1.2E-02 l. lE-02 1.5E-02 i .2E-02 l. lE-02 1.2E-02 1.5E-02 9.7E-03 2.OE-02 l. lE-02

unit

Absorbed dose activity administered 15 year 1.5E-02 2.1E-01 1.2E-02 2.7E-02 l. lE-02 1.4E-02 1.7E-02 1.5E-02 1.8E-02 8.OE-02 2.5E-02 1.4E-02 1.3E-02 2.OE-02 1.6E-02 1.4E-02 1.4E-02 1.6E-02 1.2E-02 2.6E-02 1.3E-02 10 year 2.3E-02 3.1E-01 1.9E-02 2.9E-02 1.7E-02 2.1E-02 2.6E-02 2.4E-02 2.9E-02 1.2E-01 3.6E-02 2.2E-02 2.OE-02 3.OE-02 2.4E-02 2.1E-02 2.2E-02 2.6E-02 2.OE-02 4.1E-02 2.1E-02

(mGy/MBq) 5 year 3.6E-02 4.8E-01 3 .OE-02 3.3E-02 2.7E-02 3.4E-02 4.OE-02 3.8E-02 4.4E-02 2.OE-01 5.3E-02 3.5E-02 3.2E-02 4.6E-02 3.8E-02 3.1E-02 3.4E-02 4.1E-02 3.3E-02 6.3E-02 3.2E-02 1 year 6.5E-02 8.9E-01 5.6E-02 4.6E-02 5.2E-02 6.2E-02 7.43-02 6.93-02 7.6E-02 3.5E-01 9.4E-02 6.43-02 6.OE-02 8.2E-02 7.OE-02 5.6E-02 6.3E-02 7.6E-02 6.2E-02 l. lE-01 6.1E-02

* *

* * *

Effective dose equivalent Wv/llBcl)

2.7&02

3.2B-02

4.7E-02

7.3E-02

1.3B-01

76

RADIATION

DOSE TO PATIENTS

FROM RADIOPHARMACEUTICALS

Na I1 Ion

SODIUM
Na 24Na Biokinetic Model The metabolic model given in ICRP Publication 30 (ICRP, 1980) is adopted here, with a small modification regarding the long-term retention in bone. A fraction of 0.3 is assumed to be translocated to the skeleton, and the remainder is assumed to be uniformly distributed throughout all other organs and tissues of the body. Of sodium deposited in the skeleton, 0.3% is assumed to be retained with a very long half-life of 1100 d (Vennart, 1963; Henningsen et al., 1982). The rest of the activity in bone, as well as all activity in other tissues, is assumed to be excreted with a half-life of 10 d (ICRP, 1980; Henningsen et al., 1982). This half-life may vary considerably with the intake of sodium. Following oral administration, complete absorption from the stomach with a half-time of uptake of 21 min is assumed. References
(1980). Limitsfor Intakes ofRadionuclides by Workers, ICRP Publication 30: Part 2. Pergamon, Oxford. Henningsen, N. C., Ohlsson, O., Mattsson, S. and Nosslin, B. (1982). Whole body measurements of sodium turn-over in offspring of patients with sustained essential hypertension. Eur. J. Nucl. Med. 7, 225-228. Vennart, J. (1963) External counting. In: Diagnosis and Treatment ofRadioactive Poisoning, STI/PUB 65 (IAEA, 1963). pp. 3-22. International Atomic Energy Agency, Vienna, Austria.
ICRP

Biokinetic Data

Organ (S) (1) Intravenous administration Bone

Ps 0.3

22Na

s4Na

Remaining tissues 0.7 (2) Oral administration (f, = 1.Q Stomach 1.0 Bone 0.3 Remaining tissues 0.7

10d 1lOOd 10d 21 min 21 min 10d IlOOd 21 min 10d

0.997 0.003 1.0

1.o

4.93 d 10.0 d 30.0 min 4.93 d

6.09 hr 14.3 hr 29.3 min 5.95 hr

- 1.0 0.997 0.003 -1.0 1.0

10.0 d

14.0 hr

77

Na 11 Ion

BIOKINETIC MODELS AND DATA

Intravenous

SODIUM
or oral

administration

22Na

2.602

years

per Organ Adult * Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Bed marrow Spleen Testes Thyroid Uterus Other tissue

unit

Absorbed dose activity administered 15 year 3.7E+OO 2.7B+OO 6.4E+OO 2.1E+OO 2. EE+OO 3.3E+OO 3.1E+OO 3.1E+OO 3.1E+OO 3.OE+OO 2.9E+OO 3.4E+OO 3.3E+OO 4.9E+OO 3.OE+OO 2.6E+OO 3.OE+OO 3.3E+OO 2.8E+OO 10 year 5.5EtOO 4.1&+00 9. BE+00 3.2E+OO 3.9EtOO 5. OEtOO 4.7E+OO 4.8EtOO 4.7EtOO 4. SE+00 4.3EtOO 5.1EtOO 5.OEtOO 7.4EtOO 4.5EtOO 3.8E+OO 4.6BtOO 4.9EtOO 4.3EtOO

(mGy/HBq) 5 year 8.4EtOO 7 * 2EtOO 1.6BtOl 5.OB+OO 6.3EtOO 7.6EtOO 7.2EtOO 7.5EtOO 7.3EtOO 6.9E+OO 6.6EtOO 7.7EtOO 7.6EtOO 1.4EtOl 7. OEtOO 5.9EtOO 7.2E+OO 7. SE+00 6.6EtOO 1 year 1.5EtOl

3. ?E+OO 2.6E+OO 5. a+00 2.1E+OO 2.1E+OO 2. ?E+OO 2.6B+OO 2. EE+OO 2.6E+OO 2. SE+00 2.3E+OO 2.6E+OO 2. SE+00 4.1E+OO 2. SE+00 2.5E+OO 2.3EiOO 2.6E+OO 2.4E+OO

1.lE+Ol
3.4EtOl 9.3EtOO

* k * *

1.1EtOl
1.4EtOl 1.3E+Ol 1.3E+Ol 1.4EtOl 1.3EtOl 1.2BtOl 1.4BtOl 1.4EtOl 2.7BtOl 1.3EtOl

1. let01
1.3EtOl 1.3BtOl 1.2BtOl

Effective dose equivalent (mBv/IIBq)

2.8B+OO

3.3B+oO

4.9BtOO

8 . OB+OO

1.5B+Ol

78

RADIATION

DOSE TO PATIENTS FROM RADIOPHARMACEUTICALS

Na
11 10n

SODIUM 24Na
Organ Adult * * Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other Effective tissue 3.4E-01 2.8E-01 6.6E-01 2.4E-01 2.4E-01 2.8E-01 2.7E-01 3.1E-01 2.6E-01 2.6E-01 2.4E-01 3.1E-01 3.2E-01 6.6E-01 2.4E-01 2.7E-01 2.4E-01 2.9E-01 2.5E-01 15 year 3.7E-01 2.9E-01 8.1E-01 2*4E-01 3.2E-01 3.4&01 3.3E-01 3.2E-01 3.3E-01 3.1E-01 3.OE-01 3.5E-01 3.5E-01 8.6E-01 3.2E-01 2.8E-01 3.1E-01 3.4E-01 3.OE-01 10 year 5.6E-01 4.5E-01 1.3EtOO 3.7E-01 4.6E-01 5.3E-01 5.2E-01 5.1E-01 5.OE-01 4.9E-01 4.5E-01 5.3&01 5.3E-01 1.4E+OO 4.9E-01 4.2E-01 4.9E-01 5.2E-01 4.6E-01 5 year 8.7E-01 7.8E-01 2.1E+OO 5.8E-01 7.5E-01 8.OE-01 7.8E-01 8.1E-01 7.8%01 7.5E-01 7.1E-01 8.1E-01 8.X-01 2.7E+OO 7.6E-01 6,5E-01 7.7&01 8.OE-01 7.2E-01 1 year 1.6E+OO 1.3E+OO 4.5E+OO 15.00 hours per unit Absorbed dose activity administered (mGy/MBq)

1. lE+OO
1.3EtOO 1.5E+OO 1.4E+OO 1.4E+OO 1.5E+OO 1.4EtOO 1.3E+OO 1.5E+OO 1.5E+OO 5.4EtOO 1.4E+OO 1.2E+OO 1.4E+OO 1.5E+OO 1.3EtOO

* *

dose equivalent (mSv/W)

3.4E-01

3.9E-01

6.1E-01

1. OR+00

1.9B+OO

Oral Organ * Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Adult 3.5E-01 2.7E-01 6.5E-01 2.4E-01 6.6E-01 2.9E-01 2.7E-01 3.1E-01 2.7E-01 2.6E-01 2.4E-01 3.1E-01 3.6E-01 6.5E-01 2.6E-01 2.6E-01 2.3E-01 2.9E-01 2.5E-01

administration 15 year 3.7E-01 2.9%01 8.OE-01 2.4E-01 8.5E-01 3.5E-01 3.4E-01 3.2E-01 3.3E-01 3.2E-01 3.OE-01 3.5E-01 3.9E-01 8.4E-01 3.4E-01 2.7E-01 3. IE-01 3.4E-01 3.OE-01 10 year 5.7E-01 4.4E-01 1.3E+OO 3.7E-01 1.2E+OO 5.3E-01 5.3E-01 5.1E-01 5.1E-01 4.9E-01 4.6E-01 5.3E-01 5.9E-01 1.4E+OO 5.2E-01 4.1E-01 4.8E-01 5.2E-01 4.6E-01 5 year 8.8E-01 7.7E-01 1.9B+OO 5.8E-01 2.OE+OO 8.1E-01 7.9E-01 8.1E-01 7.9E-01 7.6E-01 7.1E-01 8.1E-01 8.9E-01 2. OEcOO 8.OE-01 6.5E-01 7*6E-01 8.OE-01 7,1E-01 1 year 1.6B+OO 1.3E+OO 4.2E+OO l.lE+OO 3.8E+OO 1.5E+OO 1.4E+OO 1.4E+OO 1.5E+OO 1.4E+OO 1.3E+OO 1.5E+OO 1.6E+OO 4.OE+OO 1.5E+OO 1.2E+OO 1.4E+OO 1.4E+OO 1.3E+OO

* * *

Red marrow Spleen Testes Thyroid Uterus Other tissue

Effective dose equivalent (=Sv/lres)

3.6E-01

4.2E-01

6. SE-01

l.OE+oO

1.9E+OO

79

RADIATION

DOSE TO PATIENTS

FROM RADIOPHARMACEUTICALS

Mg
12 Ion

MAGNESIUM
Mg Biokinetic Model The total body retention of magnesium in humans after intravenous administration was measured by Kniffen et al. (1970) and Roessler (1972). Their results suggest a two-term function with half-times of approximately 12 hr (0.10) and 25 d (0.90). A long-term component, which may be derived from balance considerations for stable magnesium, is not considered for *Mg, which has a physical half-life of 20.91 hr According to ICRP Publication23 (ICRP, 1975), 0.55 of the total body content ofmagnesium is localized in the skeleton. The same value was reported by Shils (1973) and is adopted here. It is assumed that the daughter of *Mg, i.e. 28A1(half-life = 2.3 min), is in equilibrium with *Mg and follows the same kinetics. References
ICRP (1975). Report ojthe Task Group on Reference Man, ICRP Publication 23. Pergamon, Oxford. Kniffen, J. C., Roessler, C. E., Roessler, G. S., Dunavant, B. G. and Quick, D. T. (1970). Whole-body counter determination of Mg retention in humans. In: Radioaktiue Isotope in Klinik und Forschung, Vol. 9, pp. 231-232. (Fellinger, K. and Hiifer, R. eds) Urban and Schwarzenberg, Miinchen. Roessler, G. M. S. (1972). Whole-body retention and excretion of magnesium in humans. Ph.D. Thesis, University of Florida, Mf-order No. 73965. Shils, M. E. (1973). Magnesium, Chapter 6, Part B. In: Modern Nutrition in Health and Disease-Dietotherapy, 5th edn. (Goodhart, R. S. and Shils, M. E. eds) Lea and Febiger, Philadelphia.

Biokinetic Data

Organ (S) Total body Bone

Fs 1.0 0.55

T 12 hr 25 d 25 d

a 0.10 0.90 1.0

=Mg (= 28A1) 1.14d 16.0 hr

&/A,

81

MS
12 Ion

BIOKINETICMODELSANDDATA

MAGNESIUM

Z8t4g

20.91 hours
Absorbed dose per unit activityadministered hGy/mq)

Organ
Adult * Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue 15 year 10 year 5 year 1 year

4.1E-01 3.0&-01 5.4E+OO 3.1E-01 2.8E-01 3.2E-01 3.1E-01 3.4E-01 3.2.b01 3.OE-01 3.0)s01 3.2E-01 3.3.b01 3.3EtOO 3.OE-01 2.8E-01 3.1&01 3.1E-01 3.2&01 8.3E-01

4.8&01 7.4E-01 1.2E+OO 2.3E+OO 3.4E-01 5.5)s01 9.6E-01 1.7E+OO 7.OE+OO l.lE+Ol 2.OE+Ol 4.7e+oi 3.1E-01 5.OE-01 8.2E-01 1.6E+oo 3.?E-01 4.OE-01 3.8E-01 4.OE-01 4.OE-01 3.7E-01 3.8E-01 4.1E-01 4.1E-01 3.7EtOO 3.8E-01 3.4E-01 3.9E-01 3.8E-01 5.7E-01 9.3E-01 6.3&01 9.9B-01 6.2E-01 9.6E-01 6.3&01 l.OE+OO 1.7E+OO 1.9E+OO l.EE+OO 2.OE+OO

* * *

6.4E-01 l.OE+OO 2.OEtOO 5.9E-01 9.4E-01 1.8EtOO 6.OE-01 9.7%01 1.9E+OO 6.4E-01 l.OE+OO 1.9E+OO 6.4E-01 l.oe+oo 1.9E+OO 6.3E+OO 1.4E+Ol 2.9E+Ol 6.1E-01 9.7E-01 1.9EtOO 5.3E-01 8.5E-01 1.7E+OO 6.1&01 9.7s01 l.EE+OO 6.OE-01 9.6E-01 l.EE+OO 9.8&01 1.9E+OO

3.9E-01 6.2E-01 9.8B-01 1.6B+OO

Effective dose equivalent (mSv/HBq)

3.OB+OO 6.4BtOO

82

RADIATION

DOSE TO PATIENTS

FROM RADIOPHARMACEUTICALS

PHOSPHATE
32p 33p

Biokinetic Model For phosphate, the metabolic model from ZCRP Publication 30 (ICRP, 1979) is adopted. A fraction of 0.30 of the injected activity is assumed to go to mineral bone and to be permanently retained, and 0.70 is assumed to be distributed in soft tissues. Activity deposited in soft tissues is assumed to be excreted with half-times of 12 hr (0.2) 2 d (0.2) and 19 d (0.6). Reference
ICRP

(1979). Limitsfor

Intakes ofhdionuclides

by Workers, ICRP Publication 30: Part 1. Pergamon, Oxford.

Biokinetic Data

Organ (S) Bone Remaining tissues

Fs 0.3 0.7

T cc 12 hr 2d 19d

a 1.0 0.20 0.20 0.60

32P 6.18 d 5.40 d

j3P ll.Od 7.05 d

83

BIOKINETIC MODELS AND DATA

PHOSPHATE
32P
Organ Adult * * Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue 15 year 9.2E-01 9.2E-01 1.4E+Ol 9.2&01 9.2E-01 9.2E-01 9.2E-01 9.2E-01 9.2E-01 9.2E-01 9.2B-01 9.2E-01 9.2E-01 1. SE+01 9.2E-01 9.2E-01 9.2E-01 9.2E-01 9.2E-01 10 year 1.6B+OO 1.6E+OO 2.3EtOl 1.6BtOO 1.6EtOO 1.6EtOO 1.6EtOO 1.6E+OO 1.6E+OO 1.6E+OO 1.6EtOO 1.6EtOO 1.6BtOO 2.6EtOl 1.6EtOO 1.6EtOO 1.6EtOO 1.6EtOO 1.6EtOO 5 year 2.6EtOO 2.6EtOO 4.OE+Ol 2.6E+OO 2.6E+OO 2.6E+OO 2.6BtOO 2.6EtOO 2.6EtOO 2.6EtOO 2.6EtOO 2.6BtOO 2.6B+OO 5.8E+Ol 2.6E+OO 2.6E+OO 2.6EtOO 2.6EtOO 2.6EtOO 1 year 5.4B+OO 5.4EtOO 9.6E+Ol 5.4EtOO 5.4B+OO 5.4E+OO 5.4EtOO 5.4E+OO 5.4EtOO 5.4Etoo 5.4EtOO 5.4EtOO 5.4E+OO 1.2Et02 5.4BtOO 5.4B+OO 5.4B+OO 5.4EtOO 5.4EtOO

14.29 days
per unit Absorbed dose activity administered (mGy/MBq)

?.4B-01
7.4E-01

1. lB+Ol
9.2B-01

* * *

?.4E-01
7.4B-01

?.4B-01 ?.4E-01 ?.4B-01

7.4B-01 7.4B-01 7.4E-01

?.4E-01

1. lE+Ol
?.4E-01 ?.4E-01 7.4E-01 ?.4B-01

?.4E-01

Effective dose equivalent (mSv/n8q)

2.2B+OO

3.oBtOO

5.1B+OO

l.OB+Ol 2.2BtOl

33P Organ

25.4

days Adult 15 year 1.3E-01 1.3E-01 2. JEtOO 1.3&01 1.3E-01 1.3E-01 1.3E-01 1.3E-01 1.3E-01 1.3E-01 1.3E-01 1.3E-01 1.3E-01 2.1E+OO 1.3E-01 1.3E-01 1.3E-01 1.3E-01 1.3E-01 10 year 2.3E-01 2.3E-01 4,4E+OO 2.3E-01 2.3B-01 2.3E-01 2.3E-01 2.3E-01 2.3E-01 2.3E-01 2.3E-01 2.3E-01 2,3E-01 3.5E+OO 2.3E-01 2.3E-01 2.3E-01 2.3E-01 2.3B-01 1 year 7. JE-01 7. JE-01 1.9EtOl 7. JE-01 7. JE-01 7. JE-01

5 year
3.8E-01 3.8E-01 J.JEt00 3.8E-01 3. EE-01 3. EE-01 3.8E-01 3.8E-01 3.8E-01 3.8E-01 3.8E-01 3.8E-01 3. EE-01 E.OE+OO 3. EE-01 3.8E-01 3.8E-01 3. BE-01 3. BE-01

* *

* * *

Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other Effective tissue

l. lE-01 l.lE-01 2 .OEtOO 1.3E-01 l. lE-01 l. lE-01 l. lE-01 l.lE-01 l.lE-01 l. lB-01 l. lB-01 l. lE-01 l. lE-01 1.5EtOO l.lE-01 l.lE-01 l.lE-01 l.lE-01 l. lE-01

7 .JE-01

7. JE-01 7. JE-01 7. JE-01 7. JE-01 7. JE-01 7. JE-01 1. JE+Ol 7. JE-01 7. JR-01 7. JE-01 7. JE-01 7. JE-01

dose equivalent (=Sv/rn)

3.3B-01

4.4B-01

7. SB-01

1.5E+oo

3.2BtOO

84

RADIATION

DOSE TO PATIENTS

FROM RADIOPHARMACEUTICALS

s
16 Sulphate

SULPHATE
3sS

Biokinetic Model For sulphate, the metabolic model from ZCRP Publication 30 (ICRP, 1980) is adopted. The distribution in the body is assumed to be uniform and the activity is excreted with half-times of 6 hr (OX), 20 d (0.15) and 2000 d (0.05). Reference
ICRP

(1980). Limitsfor Intakes

ofRadionuclides by

Workers,

ICRP

Publication 30: Part 2. Pergamon, Oxford.

Biokinetic Data
Organ (S) Total body Fs 1.0 T 6.0 hr 20 d 5.5 yr a 0.80 0.15 0.05 &IA, 9.85 d

85

S 16 Sulphate

BIOKINETIC MODELS AND DATA

SULPHATE
35s 07.44

days
Absorbed dose activity administered 15 year l.ZE-01 l.ZE-01 l.ZE-01 l. ZE-01 1.2E-01 l.ZE-01 l.ZE-01 l.ZE-01 l. ZE-01 l.ZE-01 l.ZE-01 1. ze-01 l .ZE-01 l.ZE-01 l. ZE-01 l.ZE-01 l.ZE-01 l.ZE-01 l. ZE-01 10 year Z.OE-01 Z.OE-01 Z .OE-01 Z.OE-01 Z.OE-01 2 .OE-01 Z .OE-01 Z.OE-01 Z.OE-01 2 .OE-01 Z.OE-01 Z.OE-01 Z.OE-01 Z.OE-01 Z.OE-01 Z.OE-01 2 .OE-01 2 .OE-01 Z.OE-01

per Organ Adult * * Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas 9.51-02 9. SE-02 9. SE-02 l.ZE-01 9. SE-02 9. SE-02 9. SE-02 9.53-02 9. 9. 9. 9. 9. SE-02 SB-02 SE-02 SE-02 SE-02

unit

(mGy/MBq) 5 year 3.4E-01 3.4E-01 3.4E-01 3.4E-01 3.4E-01 3.4%01 3.4E-01 3.4E-01 3.4E-01 3.4E-01 3.4E-01 3.4E-01 3.4E-01 3.4E-01 3.4E-01 3.4E-01 3.4E-01 3.4E-01 3.4&01 1 year 6.8E-01 6.8E-01 6.8E-01 6.8E-01 6.8B-01 6. EE-01 6. EE-01 6.8E-01 6.8E-01 6.8E-01 6.8E-01 6.8E-01 6.8E-01 6.8E-01 6.8E-01 6.8E-01 6.8E-01 6.8E-01 6.&J-01

* * *

Red marrow Spleen Testes

Thyroid Uterus

9. SE-02 9.53-02 9. SE-02 9. SE-02 9.53-02 9. SE-02

Other

tissue

Bffective dose equivalent (=Rv/llBq)

9,8B-02

l . ZB-01

Z . OB-01

3.4B-01

6. BE-01

86

RADIATION

DOSE TO PATIENTS FROM RADIOPHARMACEUTICALS

Cl 17 Chloride

CHLORIDE
34mC1Wl Wl

Biokinetic Model In accordance with ZCRP Publication 30 (ICRP, 1980), a uniform total body distribution and biological half-life of 10 d are assumed. Chlorine-34m is in equilibrium with its radioactive daughter Cl (half-life 1.53s) which is produced in 47% of the decays. Reference
ICRP (1980). Limitsfor Intake ofRadionuclides by Workers,

ICRP Publication 30: Part 2. Pergamon, Oxford.

Biokinetic Data

AS/A0
Organ (S) Total body FS 1.0 T 10d a 1.0 34mC1 3 34C1 46 min 22 min 3W 14.4 d VI 53.8 min

CHLORIDE

34mc1
organ

32.0

minutes
per unit Absorbed dose activity administered

(mGy/MBq) 1 year

Adult * Adrenals * Bladderwall Bone surfaces Breast GI-tract Stomachwall * Small intest ULI wall * LLI wall Kidneys Liver Lungs ovaries * Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue Effective dose equivalent (mSv/HBq) 7.93-03 7.5E-03 6.53-03 1.6E-02 7.IE-03 7.7E-03 7.5E-03 8.33-03 7.1E-03 7.1E-03 6.53-03 7.9B-03 8.53-03 6.9E-03 6.93-03 7.1B-03 6.73-03 7.93-03 6.53-03 8.6B-03

15 year 1.9E-02 1.8E-02 1.8E-02 1.6E-02 1.8E-02 1.9E-02 1.9E-02 1.8E-02 l.BE-02 1.8E-02 1.7E-02 1.9E-02 1.9E-02 1.8E-02 1.8E-02 1.7B-02 l.EE-02 1.9E-02 1.7E-02

10 year 3.OE-02 2.93-02 2.93-02 2.53-02 2.93-02 3.1E-02 3.OE-02 3.OE-02 2.9E-02 2.93-02 2.83-02 3.1E-02 3.1E-02 2.8E-02 2.93-02 2.7E-02 2.93-02 3.1E-02 2.83-02

5 year

4.83-02 9.43-02 4.83-02 9.OE-02 4.73-02 9.2E-02 4.1E-02 8.2E-02 4.73-02 4.93-02 4.9B-02 4.83-02 4.83-02 4.83-02 4.5E-02 5.OB-02 4.9E-02 9.lE-02 9.63-02 9.33-02 9.2E-02 9.2E-02 9.23-02 8.8B-02 9.6E-02 9.63-02

8.73-02 4.x-02 4.73-02 9.23-02 4.43-02 8.73-02 4.8E-02 9.33-02 5.OE-02 9.63-02 4.51-02 8.8B-02 9.OE-02

1.8B-02 2.9B-02 4.6E-02

87

Cl 17 Chloride

BIOKINETIC MODELS AND DATA

CHLORIDE
36c1 3.01E+05 years per Organ Adult * * Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue 7.8E-01 7. EE-01 7.8E-01 9,6E-01 7. EE-01 7. EE-01 7. EE-01 7.8E-01 7. EE-01 7. EE-01 7.8E-01 7.8%01 7.8E-01 7. EE-01 7.8E-01 7.8E-01 7.8E-01 7. E&01 7. EE-01 15 year 9.6E-01 10 year 1.6EtOO 1.6EtOO 1.6E+OO 1.6EtOO 1.6EtOO 1.6EtOO 1.6EtOO 1.6E+OO 1.6EtOO 1.6EtOO 1.6EtOO 1.6E+OO 1.6EtOO 5 year 2. EE+OO 2.8EtOO 2. EE+OO 2.8EtOO 2.8EtOO 2. EE+OO 2.8EtOO 2. EE+OO 2.8EtOO 2.8EtOO 2.8EtOO 2.8EtOO 2.8RtOO 2. El?,+00 2. EE+OO 2.8BtOO 2.8EtOO 2.8EtOO 2.8EtOO 1 year 5.6EtOO 5.6EtOO 5.6EtOO 5.6B+OO unit Absorbed dose activity administered (mGy/MBq)

9.6E-01 9.6L01 9.6E-01 9.6L01 9.6E-01 9.6E-01 9.6&01 9.6&01

9.6E-01 9.6&01 9.6E-01 9.6E-01

* * *

5.6EtOO 5.6E+OO
5.6EtOO 5.6EtOO 5.6EtOO 5.6E+OO 5.6EtOO 5.6EtOO 5.6EtOO 5.6EtOO 5.6E+OO

9.6&01 9.6E-01 9.6E-01 9.6E-01 9.6&01 9.6E-01 9.6E-01

1.6EtOO
1.6EtOO 1.6EtOO 1.6EtOO 1.6EtOO 1.6EtOO

5.6EtOO 5.6EtOO 5.6EtOO 5.6EtOO

5.6BtOO

Bffective dose equivalent Wv/nBq)

8.0%01

1.6B+OO

2.8&00

38c1 Organ

37.21

minutes

Adult * Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Snleen Tbs tes Thyroid Uterus Other tissue 1.6E-02 1.5E-02 1.5E-02 1.7E-02 1.5E-02 1.6E-02 1.5E-02 1.6E-02 1.5E-02 1.5E-02 1.4E-02 1.6E-02 1.7E-02 1.5E-02 1.5E-02 1.5E-02 1. SE-02 1.6E-02 1.5E-02

15 year

10 year 3.1E-02 3.OE-02 2.9E-02 2. EE-02 3.OE-02 3.2B-02 3.1E-02 3.1E-02 3.1E-02 3.1E-02 2.9E-02 3 *2E-02 3,2E-02 3.OE-02 3.1E-02 2.9E-02 3.OE-02 3.2E-02 2.9E-02

5 year 5.1E-02 5.1E-02 4.8E-02 4.6E-02 5.OE-02 5.1E-02 5.1%02 5.1E-02 5.OE-02 5.0%02 4. EE-02 5.1%02 5.1%02 4. EE-02 5.OE-02 4. EE-02 5.OE-02 5.2E-02 4. EE-02

1 year l.OE-01 9. EE-02 9.5E-02 9.2E-02 9.83-02 l .OE-01 9.9E-02 9. BE-02 9.9E-02 9.9&02 9.6E-02 l . OE-01 l.OE-01 9.5E-02 9.9E-02 9.63-02 9.9E-02 l .OE-01 9.6E-02

1.9E-02 l.EE-02
1. EE-02 1.7E-02 1.9E-02 1.9E-02 1.9E-02 1. EB-02 1. EE-02 1. EE-02 1. EE-02 1.9E-02 1.9E-02 1. BE-02 1.9E-02 1. EE-02 1. EE-02 1.9E-02 1.8%02

* * *

Bffective dose equivalent WV/m)

1.6E-02

l.BE-02

3 .OB-02

4.9E-02

9.7R-02

88

RADIATION

DOSE TO PATIENTS

FROM RADIOPHARMACEUTICALS

K 19 Ion

POTASSIUM (Ultrashort-lived)
38K Biokinetic Model Intravenously administered potassium is immediately taken up in all organs (except the brain) and tissues in proportion to their blood flow (Sapirstein, 1958). Later a slow redistribution occurs by exchange with body potassium, so that the distribution after a few hours becomes similar to that of stable potassium in the body. In view of the short physical half-life of 38K the following model corresponds to the first phase ofpotassium kinetics only and is based on the relative blood flow as a proportion of cardiac output (Appendix Section A.2; Spector, 1956). Following intravenous injection, 38K in blood passes through the lungs with a mean transit time of about 10 s and rapidly transfers from blood to tissues. Subsequently, the distribution remains constant for a period which is long compared with the physical half-life. In addition to the initial circulation of 38K through the lungs, it is assumed that the lungs also subsequently receive a proportion, by relative tissue weights, of the 38K in the remainder of the body tissues for which blood flows are not defined, and that the biological retention of this proportion (nutritional flow) is constant. Although the brain receives 14% of the cardiac output, 38K is not transferred across the blood-brain barrier and this fraction of the tracer is assumed to recirculate to the remainder of the body. Blood flows to organs drained by the portal blood are not all uniquely defined, so the summed cumulated activity of some tissues (stomach, intestines) is assumed to be shared in proportions estimated from the data of Kearfott (1982) based on studies in rats (Gehring and Hammond, 1967). References
Gehring, P. J. and Hammond, P. B. (1967). The interrelationship between thallium and potassium in animals. J. Pftarmuc. Exp. Ther. 155, 187-201. Kearfott, K. J. (1982). Radiation absorbed dose estimates for positron emission tomography (PET): K-38, Rb-81, Rb-82, and G-130. J. Nucl. Med. 23, 1128-l 132. Sapirstein, L. A. (1958). Regional blood flow by fractional distribution of indicators. Am. J. Physiol. 193, 161-168. Spector, W. S. (1956). Handbook ofBiological Data, W. B. Saunders, Philadelphia.

89

K 19 Ion

BIOKINETIC MODELS AND DATA

Biokinetic Data
Organ (S) Total body Adrenals Cortical bone Trabecular bone Heart wall Kidneys Liver Lungs Initial flow Nutritional flow Total Muscle Pancreas Red marrow Spleen Thyroid GI-tract wall Stomach SI ULI LLI Fs 1.0 0.012 0.04 0.01 0.04 0.23 0.058
1.0

T
co a,

a
1.0

&IA, ll.Omin 7.8s 26.1 s 6.5 s 26.1 s 2.5 min 37.8 s 9.93 s 2.77 12.7 s 1.77 min 11.1 s 32.6 s 22.8 s 20.8 s 15.0 s

a, co co co a,

1.0 1.0 1.0 1.0 1.0 1.0

0.163 0.017 0.05 0.035 0.032 0.023 0.099 0.032 0.025

al

co m m co m co a! m

1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0

1.07min
20.8 s 16.3 s

POTASSIUM (Ultrashort-lived)
38K

7.636 minutes
per Organ Adult 15 year 1.6E-01 2.4B-03 2.1E-03 2.OE-03 3.%-02 3.1E-02 3.2E-02 3.OE-02 2.5E-02 1.4E-01 9.3E-03 6.1E-03 4.53-03 2.9E-02 3.OE-03 1.98-02 1.7E-03 3.5%01 3.7%03 2.7E-03 10 year 2.3E-01 3.8%03 3.2E-03 3.3E-03 4.9E-02 5.4E-02 5.8E-02 5.3E-02 3.9E-02 1.9E-01 1.4%02 8.8E-03 6.9E-03 5.8E-02 4.2E-03 3.OE-02 2.7E-03 5.4B-01 6.OE-03 4.3E-03 5 year 3.1e-01 6.OE-03 4. ?E-03 4.8E-03 8.4%02 8.9E-02 9.5E-02 8.9E-02 6.3E-02 2.9E-01 2.1E-02 1.4E-02 1 .OE-02 7.4E-02 5.7E-03 4.6&02 4.2E-03 1.2E+OO 9.0%03 6.9E-03 1 year 4.6E-01 l. lE-02 9.3E-03 9.1E-03 l.BE-01 1.7E-01 1.8E-01 1.8E-01 l. lE-01 5.2E-01 3.9E-02 2.6E-02 1.9E-02 1.6E-01 9.5E-03 8.2%02 8.1E-03 2.3E+OO 1.6E-02 1.3E-02 unit Absorbed dose activity administered

(mGy/HBq)

* * * *

Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Heart Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue

1.2E-01
2.2E-03 1.9E-03 2.3E-03 2.8E-02 2.4E-02 2.8B-02 2.68-02 2.OE-02

l. lE-01 7.3E-03
4.2E-03 3.7E-03 2.OE-02 2.7E-03 1.4E-02 l.?E-03 2.2E-01 3.OE-03 2.2E-03

Effective dose equivalent Wv/llBg)

2. ?B-02

3.6E-02

5. SE-02

9.4E-02

1.7E-01

90

RADIATIONDOSE TO PATIENTS FROM RADIOPHARMACEUTICALS

K 19 IOil

POTASSIUM
42~ 43K

Biokinetic Model Intravenously administered potassium is immediately taken up in all organs and tissues (except the brain) in proportion to their blood flow (Sapirstein, 1958). Later, a slow redistribution occurs, by exchange with body potassium, so that, after a few hours, the distribution in the body becomes similar to that of stable potassium. Thus, for 42K and 43K, the model is based mainly on biodistribution data for naturally occurring 40K (Forbes and Lewis, 1956; ICRP, 1959; Oberhausen, 1963; Kaul et al., 1974). Organs and tissues listed in the biokinetic data are those exhibiting concentration by more than a factor of 1.5 larger than that corresponding to uniform distribution in the body. From balance considerations, a total-body biological half-time of 30 d may be derived. This half-time is adopted here, in accordance with ICRP Publication 30 (ICRP, 1980). Following oral administration, the half-time in the stomach is taken to be 21 min and complete absorption is assumed. References
Forbes, G. B. and Lewis, A. M. (1956). Total sodium, potassium and chloride in adult man. J. Clin. Znoest. 35,596-60@ ICRP (1959). Report of Committee II on Permissible Dose for Internal Radiation, ICRP Publication 2. Pergamon, Oxford. ICRP (1980). Limitsfor Intakes of Radionuclides by Workers, ICRP Publication 30: Part 2. Pergamon, Oxford. Kaul, A., Oberhausen, E., Roedler, H. D. and Werner, E. (1974). Interne Strahlenexposition durch 40K. In: Die nottirliche Strahlenexposition des Menschen. (Aurand, K. et al., eds) Georg Thieme Verlag, Stuttgart. Leggett, R. W. and Williams, L. R. (1986). A mode1 for the kinetics ofpotassium in healthy humans. Phys. Med. Biol. 31, 23-42. Oberhausen, E. (1963). Die Altersabhiingigkeit des Kalium- und Cesium-137-Gehaltes des Menschen. Biophysik l/Z, 135-142. Sapirstein, L. A. (1958). Regional blood flow by fractional distribution of indicators. Am. J. Physiol. 193, 161-168.

Biokinetic Data for Potassium Radionuclides (except JBK)

&IA,
Organ (S) (1) Intravenous administration Total body Liver Muscle Red marrow Spleen (2) Oral administration Stomach Liver Muscle Red marrow Spleen Remaining tissues Fs 1.0 0.04 0.65 0.05 0.004 1.0 0.04 0.65 0.05 0.004 0.256 T a 42K. 43K

30 d 30 d 30 d 30d 30d 21 min 30 d 30 d 30d 30 d 30 d

1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0

17.6 hr 42.2 min 11.4 hr 52.8 min 4.2 min 29.2 min 41.1 min 11.1 hr 51.5 min 4.1 min 4.43 hr

1.30d 1.24 hr 20.2 hr 1.55 hr 7.4 min 29.5 min 1.22 hr 19.9 hr 1.53 hr 1.3 min 7.97 hr

91

K 19 Ion

BIOKINETIC

MODELS

AND DATA

POTASSIUM
42K 12.36 hours Absorbeddose per unit activityadministered (mGy/BBq) Organ Adult * Adrenals Bladderwall Bone surfaces Breast GI-tract Stomachwall Small intest ULI wall * LLI wall Kidneys Liver Lungs Ovaries * Pancreas * * Red marrow Spleen Testes Thyroid Uterus Other tissue Effective dose equivalent (mSv/BBq) l.ZE-01 l.lE-01 3.OE-01 1.3E-01 l.lE-01 l.lE-01 l.lE-01 l.lE-01 l.lE-01 3.4E-01 l.lE-01 l.ZE-01 l.lE-01 5.OE-01 3.4E-01 l.lE-01 l.lE-01 l.lE-01 3.5E-01 1.9B-01 15 year l.ZE-01 l.lE-01 4.1E-01 l.lE-01 l.lE-01 l.lE-01 l.lE-01 l.lE-01 10 year 5 year 1 year 1.8B-01 2.6E-01 5.4E-01 1.7&01 2.6B-01 5.3E-01 6.9E-01 1.3B+OO 2.7E+OO 1.7E-01 2.5E-01 5.1E-01 1.7E-01 1. aB-01 1.8E-01 1.8E-01 2.6B-01 2.6E-01 2.6E-01 2.6E-01 5.33-01 5.3B-01 5.3E-01 5.3E-01

l.lE-01 1.8E-01 4.4E-01 6.8E-01 l.lE-01 1.7E-01 l.ZE-01 1.8B-01 l.ZE-01 1.8E-01

2.6B-01 5.3E-01 l.OE+OO Z.lE+OO 2.5E-01 5.2E-01 2.7E-01 5.4B-01 2.7E-01 5.4E-01 4,9E+OO 2.3E+OO 5.3E-01 5.4B-01 5.4E-01 1.9E+OO 1.3B+OO

7.OE-01 l.ZE+OO 2.3E+OO 4.9E-01 7.8E-01 l.ZE+OO l.lE-01 1.7E-01 2.6E-01 l.lE-01 1.8E-01 2.6E-01 l.ZE-01 1.8E-01 2.7E-01 3.1E-01 2.3B-01 5.3E-01 3.8B-01 9.3E-01 6.4B-01

Oral administration
Organ

Adult 1.2E-01 l.lE-01 2.9E-01 1.3E-01 a.oB-01 l.lE-01 l.lE-01 l.lE-01 1.1%01 3.3E-01 1.1%01 l.lE-01 l.lE-01 4.9E-01 3.3E-01 l.lE-01 l.lE-01 l.lE-01 3.4B-01 2.3B-01

15 year

10 year

5 year

1 year

* Adrenals Bladderwall Bone surfaces Breast GI-tract * Stomachwall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries * Pancreas * * Red marrow Spleen Testes Thyroid Uterus Other tissue Bffective dose equivalent (=Bv/BB@

l.lE-01 1.8E-01 2.6E-01 5.3E-01 l.lE-01 1.7B-01 2.6E-01 5.2E-01 4.OE-01 6.7E-01 l.ZB+OO 2.6B+OO l.lE-01 1.6E-01 2.4E-01 5.OB-01 l.OE+OO 1.5E+OO l.lE-01 1.7B-01 l.lE-01 1.7E-01 l.lE-01 1.7&01 l.lE-01 1.7E-01 4.3E-01 6.7E-01 l.lE-01 1.7E-01 l.lE-01 1.8E-01 l.ZE-01 1.8E-01 6.9E-01 l.ZE+OO 4.8E-01 7.6E-01 l.lE-01 1.7%01 l.lE-01 1.7E-01 l.lE-01 1.8E-01 3.OE-01 5.2B-01 2.8B-01 4.5B-01 2.6E+OO 2.6B-01 2.6E-01 2.6E-01 2.6E-01 l.OE+OO 2.5E-01 2.6E-01 2.7E-01 Z.ZE+OO l.ZB+OO 2.5E-01 2.6B-01 2.6B-01 9.1&01 7.7B-01 5.4E+OO 5.3E-01 5.2E-01 5.2B-01 5.2E-01 Z.OE+OO 5.1E-01 5.3E-01 5.4E-01 4.8E+OO 2.3E+OO 5.1E-01 5.3E-01 5.3B-01 1.9B+OO 1.6B+oo

92

RADIATION

DOSE TO PATIENTS FROM RADIOPHARMACEUTICALS

K 19 Ion

POTASSIUM 43u
Organ Adult * Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Soleen Tktes Thyroid Uterus Other Bffective tissue 1.5E-01 1.4E-01 1.9E-01 l.ZE-01 1.3E-01 1.4E-01 1.4E-01 1.5E-01 1.4E-01 2.5E-01 1.2E-01 1.5E-01 1.5E-01 2.9E-01 2.4E-01 1.2E-01 1.2E-01 1.5E-01 2.2E-01 15 year 1.7E-01 1.5E-01 2.4E-01 1 .OE-01 1.5E-01 1.6E-01 1.6E-01 1.6E-01 1.6E-01 3.1%01 1.4E-01 1.8E-01 1.8E-01 3.8E-01 3.2E-01 1.4E-01 1.5E-01 1.7E-01 2.1E-01 10 year 2.5E-01 2.3E-01 3.9E-01 1.6E-01 2.1E-01 2.4E-01 2.3E-01 2.4E-01 2.3E-01 4.6E-01 2.OE-01 2.7E-01 2.6E-01 6.2E-01 4.9E-01 2.OE-01 2.4E-01 2.7E-01 3.4E-01 5 year 3.7E-01 3.6E-01 6.7%01 2.4E-01 3.2E-01 3.6E-01 3.5E-01 3.6E-01 3.4E-01 6.8E-01 3.1E-01 4.OE-01 3.9E-01 1 year 6.6B-01 6.2%01 1.4E+OO 4.5E-01 5.9E-01 6.5&01 6.3E-01 6.4E-01 6. X-01 1.3E+OO 5.73-01 7.1E-01 7.OE-01 2.2E+OO 1.4E+OO 5.7E-01 7.OE-01 7.1E-01 22.6 hours per unit Absorbed dose activity administered (mGy/MBq)

* *

* *

1. lE+OO
7.6E-01 3.1E-01 3.8E-01 4.OE-01 5.6E-01

1. 1EtOO

dose equivalent (=Sv/llBq)

1.7B-01

2.OB-01

3.OB-01

4.8B-01

9.OB-01

Oral Organ * Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Adult 1.5E-01 1.4E-01 1.9%01 1.2E-01 3.3E-01 1.4E-01 1.4E-01 1.4E-01 1.4E-01 2.4E-01 1.2E-01 1.5E-01 1.6E-01 2.9E-01 2.4E-01 1.2E-01 1.2E-01 1.5E-01 2.1E-01

administration 15 year 1.8&01 1.5E-01 2.4B-01 l .OE-01 4 * lE-01 1.6E-01 1.6E-01 1.6E-01 1.6E-01 3. IE-01 1.4E-01 1.7E-01 1.9E-01 3.8E-01 3.3E-01 1.3E-01 1.5E-01 1.7E-01 2.1E-01 10 year 2.6E-01 2.3E-01 3.9E-01 1.6E-01 5.8E-01 2.4E-01 2.3E-01 2.4E-01 2.3E-01 4.6E-01 2.OE-01 2.6E-01 2.8E-01 6. IE-01 5.OE-01 2.OE-01 2.4E-01 2.7E-01 3.4E-01 5 year 3.7E-01 3.5E-01 6.7E-01 2.4E-01 9.6E-01 3.6E-01 3.6E-01 3.6E-01 3.4E-01 6.8E-01 3.1E-01 3.9E-01 4. IE-01 1 year 6,7E-01 6.1E-01 1.4E+OO 4.5E-01 1.9E+OO 6.5E-01 6.4E-01 6.3E-01 6.1E-01 1.3E+OO 5.7&01 7.OE-01 7.4E-01 2.2E+OO 1.4E+OO 5.6E-01 6.9E-01 7.1E-01 1. lE+OO

Red marrow Spleen Testes Thyroid Uterus Other tissue Effective dose equivalent (mSvA4Bq)

1. lE+OO 7.7E-01 3.1E-01 3.7E-01 4.OE-01

5.6&01

1.8B-01

2.1B-01

3.2B-01

5.1B-01

9.7E-01

JAICRP

18:1-4-D*

93

RADIATIONDOSE TO PATIENTS FROM RADIOPHARMACEUTICALS

Ca

20 Ion

CALCIUM
45Ca 47Ca Biokinetic Models Radioisotopes of calcium are assumed to be distributed and retained in the body in accordance with the model developed by the Task Group on Alkaline Earth Metabolism in Adult Man (ICRP, 1972) and values of the time integrals of retention functions have been taken from that publication. The ingrowth and dosimetry of 4Sc, the radioactive daughter of 47Ca, has been taken into account, but at the time of administration the 47Ca is assumed to be free from 47Sc. 47Sc formed after administration of 47Ca is assumed to have the same distribution and retention as its parent nuclide. If the administered 47Ca is contaminated with known quantities of 47Sc, the additional effective dose equivalent can be calculated from the data given at the bottom of the dosimetry table for 47Ca. According to the ICRP model, a fraction of 0.85 of the administered calcium is initially distributed in soft tissue, from which it is largely removed with a half-life of about 1 d, although a fraction of about 0.15 is retained for a much longer period. The calcium initially lost from soft tissue is mostly taken up by the skeleton which reaches a maximum content of 0.6 of the administered calcium after 3 d, this being fairly equally divided between cortical and trabecular bone. After an initial loss of about one third of the bone content over 30 d, the remainder (0.4 of the administered calcium) is retained for a long time. In accordance with the ICRP criteria concerning the radioactive half-lives of bone-seeking radionuclides (ICRP, 1979), 45Ca is assumed to be distributed throughout the volume of mineral bone and 47Ca is assumed to be distributed over bone surfaces at all times following their deposition in the skeleton. A urinary to faecal excretion ratio of 2 : 1 is assumed for intravenously administered calcium. The cumulated activities for cortical and trabecular bone given in the biokinetic data tables have been used also for children of all ages. The fractional absorption of orally administered calcium is taken to be 0.5 and this material is assumed to behave identically to intravenously injected calcium. For orally administered calcium, the standard GI-tract model was used (Appendix, Section A.3). References
Harrison, G. E., Carr, T. E. F. and Sutton, A. (1967). Distribution of radioactive calcium, strontium, barium and radium following intravenous injection into a healthy man. In?. J. Rad. Biol. 13, 235-247. ICRP (1972). Alkaline Earth Metabolism in Adult Man, ICRP Publication 20. Pergamon, Oxford. ICRP (1979). Limitsfir Intakes ofRadionuclides by Workers, ICRP Publication 30: Part 1. Pergamon, Oxford.

95

Ca
20 Ion

BIOKINETIC MODELS AND DATA

Biokinetic Data

UAO
Organ (S) (1) Intravenous administration Total body Cortical bone Trabecular bone Bladder contents (2) Oral administration (f, =0.5) Total body (excluding contents of GI tract and bladder) Cortical bone Trabecular bone G&tract contents Stomach SI ULI LLI Bladder contents Wa 47Ca 47sc

1lOd 53.1 d 45.9 d 36 min 55.2 d 26.9 d 23.0 d 1 hr 2.3 hr 7.6 hr 14 hr 18 min

5.1 d 1.7d 1.6d 15 min 2.51 d 20.0 hr 19.1 hr 1 hr 2.1 hr 6.3 hr 10hr 1.7 min

5.1 d 1.7d 1.6d 15 min 2.51 d 20.0 hr 19.1 hr 0.5 min 3.3 min 41 min 2.9 hr

96

RADIATION

DOSE TO PATIENTS FROM RADIOPHARMACEUTICALS

Ca 20 10n

CALCIUM
45Ca 163 days Per Organ Adult * * Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue 1.6B-01 1.6&01 1.8E+Ol Z .OE-01 1.6E-01 1.6E-01 1.6E-01 1.6E-01 1.6E-01 1.6E-01 1.6E-01 1.6E-01 1.6E-01 l.ZE+Ol 1.6E-01 1.6E-01 1.6E-01 1.6E-01 1.6E-01 15 year Z.OE-01 Z.OE-01 2.3E+Ol Z .OE-01 2 .OE-01 Z .OE-01 2. DE-01 Z .OE-01 2 .OE-01 Z .OE-01 Z.OE-01 Z.OE-01 Z .OE-01 1.7E+Ol Z.OE-01 Z . OE-01 Z .OE-01 Z.OE-01 Z.OE-01 10 year 3.4E-01 3.4%01 3.8E+Ol 3.4E-01 3.4E-01 3.4E-01 3.4E-01 3.4E-01 3.4E-01 3.4E-01 3.4E-01 3.4E-01 3.4E-01 2.8E+Ol 3.4E-01 3.4E-01 3.4E-01 3.4E-01 3.4E-01 5 year 5.6E-01 5.6E-01 6.4E+Ol 5.6E-01 5.6E-01 5.6E-01 5.6E-01 5.6E-01 5.6E-01 5.6E-01 5.6E-01 5.6E-01 5.6E-01 5.4E+Ol 5.6!3-01 5.6E-01 5.6E-01 5.6E-01 5.6E-01 1 year unit Absorbed dose activity administered (mGy/MBq)

l.ZE+OO
1.2E+oG 1. SE+02 1. ZE+OO 1.2E+OO 1.2E+OO 1.2E+OO 1 . ZE+OO 1.2B+OO 1 . ZE+OO 1.2E+OO 1.2E+OO l.ZE+OZ 1. ZE+OO 1.2E+OO 1.2E+OO

* * *

1 . ZE+OO

1 . ZE+OO
l.ZE+OO

Effective dose equivalent (mSv/TW)

2.1B+oo

2.8E+oo

4.8B+tJO

8.9E+OO

1.91+01

Oral Organ * Adrenals Bladder Adult 8.3E-02 8.3E-02 8.8E+OO l.OB-01 1.3E-01 l.OE-01 8.1E-01 2.3E+OO 8.3E-02 8.3E-02 8.3E-02 8.3E-02 8.3E-02 5.8E+OO 8.33-02 8.3E-02 8,3E-02 8.3E-02 8.3E-02

administration 15 year 1. oe-01 l.OE-01 l.lE+Ol l.OE-01 10 year 5 year 1 year 6.OE-01 6.OE-01 ?.7E+Ol 6.OE-01 9.2E-01 8.OE-01 6.2E+OO 1.7E+Ol 6.OE-01 6.OE-01 6.OE-01 6.OE-01 6.OE-01 5.8E+Ol 6.OE-01 6.OE-01 6.OE-01 6.OE-01 6.OE-01

wall

1.8E-01
1.8%01 1.9EtOl 1.8E-01 2.6E-01 2.4E-01 1,8E+OO 5.1E+OO 1.8E-01

Bone surfaces
* Breast GI-tract Stomach wall Small intest ULI vail LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue

2.9E-01 2.9E-01 3.2BtOl 2.9E-01 4.5E-01 4.OB-01 3.1E+OO 8.7EtOO 2.9E-01 2.9E-01 2.9E-01 2.9E-01 2.9E-01

*
* *

1.7E-01 1.3E-01 l.OE+OO 2.9E+OO l.OE-01

l.OE-01 l.OE-01 l.OE-01 1 .OE-01 8.3E+OO l.OE-01 l.OE-01 l .OE-01

1.8E-01 1.8E-01 1.8E-01 1.8E-01

1.4E+Ol 2.7EtOl l.BE-01 2.9E-01 1.8E-01 2.9E-01 1.8E-01 2.9E-01 l.OE-01 1.8E-01 2.9E-01 l.OE-01 1.8%01 2.9E-01 2.8B+oo 5.1B+88

Bffective dose equivalent Wv/llBq)

1.2B+t38

1.7B+O8

1 .lB+Ol

97

BIOKINETIC MODELS AND DATA

CALCIUM
47Ca
organ * * Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrov Spleen Testes Thyroid Uterus Other tissue

4.53 days
per unit Adult 7.6E-01 5.8E-01 1.3EcOl 6.6E-01 4.2E-01 Absorbed dose activity administered 1Y year 10 year 1,2E+OO
1 . OE+OO

(mGy/HBq) 1 year 3.6E+OO 3.1E+OO 1. lE+OZ 2.6E+OO 2.6E+OO 2.9E+OO 2. ?E+OO 3.OE+OO 3.1E+OO 2.8E+OO 2.9E+OO 2.9E+OO 3.OE+OO 4.2E+Ol 2.9E+OO 2.5EtOO 2.7B+OO 2.8B+OO 2.9E+OO

5 year 1.9E+OO 1.7E+OO 6.7EiOl 1*2E+OO 1.4E+OO 1. SE+00 l.SE+OO 1.6E+OO 1.6E+OO 1.4E+OO 1. SE+00 1. SE+00 1. SE+00 Z.OE+Ol 1. SE+00 1.3E+OO 1. SE+00 1.5B+OO 1. SE+00

7.?E-01
6.6E-01 1.7B+Ol

4.6E-01
5.6E-01 6.1E-01 5.8E-01 6.3E-01 6.2E-01 5.7E-01 6.OE-01 6.4E-01 6.3E-01 6.4E+OO 5.8E-01 5.23-01 6. N-01 5.9E-01 6.2E-01

2.8B+Ol 7. SE-01 8.7&01 9.5E-01 9 *5E-01 9 *8E-01 9.8E-01 8.9E-01 9.3E-01 9.8E-01 9.8E-01 1. lE+Ol 9.. 2E-01 8.0%01 9.6E-01 9.2E-01 9.6E-01

5.OE-01
4. BE-01 5.4%01 5.2E-01 6.6E-01 4.8E-01 S.lE-01 5.2E-01 5 . OE+OO 4.6E-01 4.5E-01 4.?E-01 5.OE-01 5.1E-01

* *

Effective dose equivalent (mSv/nBq)

1.4B+OO

1.83+00

2.9B+OO

5.OE+OO

l.lB+Ol

ose equivalent 47Sc (3.351 d) 9.1E-01

(mSv/HBq of 1.2E+OO

the impurity) 1.9E+OO 3.1E+OO 6.1E+OO

Oral administration
Organ Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid uterus Other tissue Adult 15 year 4.3E-01 4.9E-01 8.5E+OO 2.6E-01 9.5B-01 1.4B+OO 6. BE+00 1.2B+Ol 3.9B-01 3.6E-01 3.1E-01 9.4E-01 6.OE-01 3.3E+OO 3. SE-01 3.2E-01 3.1B-01 5.7B-01 3.8E-01 2*3E+oO 10 year 6. SE-01 ?.8E-01 1.6B+Ol 6,OE-01 1.6E+OO 2.4B+OO 8.6B+OO 2.1B+Ol 6.2B-01 5.6E-01 6.9E-01 1.6B+OO 6,3E-01 5.5B+OO 5 year 1 . OE+OO 1.2E+OO 2.3B+Ol 6.4E-01 z+g 1:6B:Ol 3.4B+Ol 9.?B-01 E.9B-01 7. QE-01 2.1B+OO 9.9B-01 l.OB+Ol

1 year
2.OE+OO 2.3E+OO 5.5B+Ol 1.3B+OO 4.6E+OO 6. Q&00 2.7E+Ol 6. ?B+Ol 1.8B+OO 1. ?E+OO 1,5E+OO 3. ?E+OO 1.9B+OO 2.1E+Ol 1.7B+OO 1.5g+oO 1.3BtOO 2.6E+OO 1. ?E+OO 1.3E+Ol

4.OE-01 6.3L01 6.6E+OO 2.6E-01 7.3E-01 1.2B+OO 3.9B+OO 9.6B+OO 3.3E-01 2.8B-01
2.5B-01 ? . OB-01 3.31-01

* * * *

2.6E+OO 2.9L01 2.7B-01 2.6E-01 6.5B-01 3.1B-01 1.6B+OO

5.6E-01 5.OB-01 4.?B-01 9.OB-01 5.8E-01

3.9B+oo

9.OE-01 8.3e-01 ?.4B-01 1.4E+OO 9.1B-01 6.5~+00

Bffective

dose equivalent Wv/lrecl)

ose equivalent 47Sc (3.351 d) 5.6E-01

(mSv/HBq of 7.3B-01

the impurity) 1.3E+OO Z.lE+OO 4.2E+OO

98

RADIATION

DOSE TO PATIENTS FROM RADIOPHARMACEUTICALS

SC 21 Markers

SCANDIUM-LABELLED

NON-ABSORBABLE 46sc47sc
Biokinetic Model

MARKERS

Scandium compounds can be used as non-absorbable markers in studies of the gastrointestinal tract. For dosimetry a modified ICRP model of the gastrointestinal tract is used, as described in Appendix Section A.3. References
Ditchburn, R. K., Smith, A. H. and Hayter, C. J. (1974). The assessement of fat absorption in man utilizing single stools or incomplete faecal collections after oral administration of radioactive triolein with an unabsorbed radioactive marker. ht. J. App. Rad. Isotopes 25, 167-176. Pearson, J. D. (1966). Use ofC?-labelled haemoglobin and SC as inert faecal markers. Int. J. Appl. Radiat. 17,13-16. Ogg, C. S., Pearson, J. D. and Veal], N. (1968). A method for measuring the gastro-intestinal absorption of 47Ca using SC as an inert marker. Ch. Sci. 34, 327-332.

Biokinetic Data

Organ (S) (1) Oral administration of fluids C&tract contents Stomach SI ULI LLI (2) Oral administration of solids GI-tract contents Stomach SI ULI LLI

Fs

46sc

47sc

1.0 1.0 1.0 1.0

33.0 min 3.99 hr 12.9 hr 23.7 hr

32.8 min 3.85 hr 11.3 hr 17.3 hr

1.0 1.0 1.0 1.0

2.10 hr 3.99 hr 12.9 hr 23.6 hr

2.06 hr 3.80 hr 11.1 hr 17.1 hr

99

SC
21 Markers

BIOKINETIC MODELS AND DATA

SC-LABELLED NON-ABSORBABLE MARKERS

Oral 46Sc 83.83 days per Organ Adult Adrenals _ Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue 1.3E-01 6.1E-01 1.4E-01 3.6E-02 5.4E-01 2.3E+OO 4.5E+OO l.lE+Ul 2. RE-01 1.9E-01 4.4E-02 2.OE+OO 2.3E-01 4.OE-01 2.1E-01 1.8E-01 6.7E-03 8.5E-01 2.5E-01 15 year 1.7E-01 7.7E-01 2 .OE-01 3.6E-02 6.8E-01 2.2EtOO 5.6E+OO 1.3E+Ol 3.2E-01 2.3E-01 5.7E-02 2.8E+OO 2.8E-01 4.6E-01 2.3E-01 2.8E-01 8.6E-03 1.2E+OO 3.OE-01 10 year 2.5E-01 1.3E+OO 2.9E-01 8.OE-02 1. lE+OU 3.4E+OO 9,. 2E+OO 2.1E+Ul 5.OE-01 4.3E-01 9.8E-02 3.9E+OO 4. 8E-01 5.9E-01 3.9E-01 4.7E-01 2 .OE-02 1.9E+OO 4.5E-01 5 year 4.5E-01 1.8E+OO 4.3E-01 1.3E-01 1.7E+OO 5.1E+OO 1.4E+Ol 3.3E+Ol ?.9E-01 7.3E-01 1.6E-01 5.7E+OO 7.7E-01 7.4E-01 6.3E-01 8.4E-01 3.8E-02 2.9E+OO 6.8E-01 1 year 7.9E-01 3.5E+OO 8.8E-01 2.7E-01 2.9E+OO 8.4E+OO 2.6E+Ol 6.2E+Ol 1.3E+OO 1.3E+OO 3.6E-01 9.7E+OO 1.3E+OO 8.9E-01 1. lE+OO 1.4E+OO 9.6E-02 4.9E+OO l.ZE+OO unit Absorbed dose activity administered (mGy/MBq) administration of fluids

* * * *

Effective dose equivalent (mSv/Mlq)

1.4E+Oo

1.8E+OO

2.8E+oO

4.4E+OO

7.8E+oo

Oral Organ Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Adult 1.4E-01 6.1E-01 1.4E-01 4,3E-02

administration 15 year 1.9E-01 7.7E-01 2.OE-01

of

solids 5 year 4.9E-01 1.8E+OO 4.4E-01 1.5E-01 3. OEtOO 5.2E+OO 1.4E+Ol 3.3E+Ol 8.3E-01 7.9E-01 1.9E-01 5.7E+OO 9.6E-01 7.5E-01 7.4E-01 8.4E-01 4.2E-02 2.9E+OO 7.OE-01 1 year 8.5E-01 3.5E+OO 9.1E-01 3.1E-01 5.4E+OO 8.4E+OO 2.6E+Ol 6.2EtOl 1.3E+OO 1.4E+OO 4.OE-01 9.7E+OO 1.6E+OO 9.1E-01 1.3E+OO 1.4E+OO l.OE-01 4.9E+OO 1 . ZE+OO

10 year 2.8E-01 1.3E+OO 3.OE-01

4.3E-02 9.23-02 1.3E+OO 2.2E+OO 5.7E+OO 1.3E+Ol 3.5E-01 2.5E-01 6.9E-02 2.8EiOO 3,8E-01 4.6E-01 2.9E-01 2.8E-01 9.81-03 1.2E+OO 1.9E+OO 3.5E+OO 9.3E+OO 2.1E+Ol 5.3E-01 4.5E-01 1.2E-01 3.9E+OO 6.3E-01

* * * *

1.OE+OO
2.3E+OO 4.5E+OO 1 .OE+Ol 2.9E-01 2.OE-01 5.51-02 2.OE+OO 3.3E-01 4.OE-01 2.6E-01 1.8E-01 7.7E-03 8.6E-01 2.5E-01

Spleen Testes Thyroid Uterus Other

tissue

6*OE-01 4.7E-01 4.7E-01 2.2E-02 1.9E+OO 3.1E-01 4.6E-01 1.8B+OO 2.9e+oo

Effective dose equivalent (mSv/HBq)

1.5E+OO

4.4B+oo

8.OB+OO

100

RADIATION

DOSE TO PATIENTS FROM RADIOPHARMACEUTICALS

SC 21 Markers

SC-LABELLED NON-ABSORBABLE MARKERS 47sc

Organ Adult Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue 5.9E-03 3.5E-02 9.83-03 9.9E-04 1.2E-01 5.4E-01 2.4E+OO 5.9E+OO 1.4%02 9.1E-03 1.2E-03 1 .OE-01 1.2E-02 2.9E-02 9.5E-03 8.6E-03 5.9E-05 5.1E-02 1.2E-02 15 year 8.2E-03 4.2E-02 1,2E-02 9.9E-04 1.7E-01 6.9E-01 3.2E+OO 7.7E+OO 1.7E-02 1.2E-02 2.1E-03 1.3E-01 1.7E-02 3.5E-02 1.2E-02 1.2E-02 1.3E-04 6.6E-02 1.4E-02 10 year 1.4E-02 6.4E-02 1.7E-02 2. SE-03 2.4E-01 l.,2EtOO 5.7EtOO 1.3EtOl 2.7E-02 2.3E-02 3.9E-03 2.OE-01 2.7E-02 4.5E-02 2.OE-02 2.2E-02 4.5E-04 l .OE-01 2.1E-02 5 year 2.4E-02 9.5B-02 2. SE-02 5.3E-03 4.2E-01 2. OEtOO 9. SE+00 2.3E+Ol 4.1E-02 3.9E-02 7.2E-03 2.8E-01 4.33-02 5.2E-02 3.2E-02 3.4B-02 l . OB-03 1.6B-01 3.2E-02 1 year 4.2E-02 1.6B-01 4.8B-02 l.OE-02 8.3E-01 3.9EtOO 1.9EtOl 4.5EtOl 6.4B-02 7.0&02 1.5E-02 4.5E-01 7.8E-02 6.1E-02 5.6E-02 6.4E-02 3.5B-03 2.5E-01 5.5B-02

Oral administration
per unit

of

fluids

3.351

days Absorbed dose activity administered (mGy/MBq)

* *

*
*

Effective dose equivalent Wv/nes)

5.6E-01

7.3B-01

1.3BtOO

2.1Btoo

4.2BtOO

Oral administration
Organ Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue Adult 7.1E-03 3.43-02 9.9E-03 1.3E-03 4.1E-01 5.3E-01 2.4EtOO 5.8E+OO 1.5E-02 9.6E-03 1.7E-03 l.OE-01 1.7E-02 3.OE-02 1.3E-02 8. SE-03 ?.2E-05 5.OE-02 1.2E-02 15 year 9.5E-03 4.2B-02 1.2B-02 1.3E-03 5.5E-01 6.9E-01 3.1EtOO 7.6EtOO 1.9E-02 1.3E-02 2.8E-03 1.3E-01 2.3E-IJ2 3.5E-02 1.6E-02 1.2E-02 1.6B-04 6.6E-02 1.5E-02

of

solids 5 year 2.6B-02 9.4B-02 2.6B-02 6.3B-03 1.4B+OO 2.OE+OO 9.3BtOO 2.2BtOl 4.3B-02 4.2B-02 8.7E-03 2.8B-01 5.4E-02 5.3B-02 3.8B-02 3.4E-02 1.2B-03 1. SE-01 3.3E-02 1 year 4.6B-02 1.6B-01 4.9B-02 1.2E-02 2.8B+OO 3.8BtOO 1.9BtOl 4. SE+01 6.7B-02 7.5B-02 1.8E-02 4.5E-01 9. SE-02 6.2E-02 6.5E-02 6.4E-02 3.93-03 2.5B-01 5.6B-02

10 year 1.6B-02 6.4B-02 1.8B-02 3.1B-03 8.OE-01 1.2EtOO 5.6E+OO 1.3EtOl 2.8B-02 2.5B-02 4.9E-03 1.9E-01 3.6E-02 4.5E-02 2.5E-02 2.2E-02 5.1%04 l .OE-01 2.2E-02

* * * *

Effective dose equivalent (aSv/llBq)

5.7B-01

7.4B-01

1.3B+CQ

2.2B+00

4.3B+OO

101

RADIATION DOSE TO PATIENTS FROM RADIOPHARMACEUTICALS

Cr

24

CHROMIUM (III) CHLORIDE

Cr Biokinetic Model When injected intravenously, trivalent chromium chloride is firmly bound by plasma proteins. From measurements in humans (Lim, 1978), the following whole-body retention halflives were derived: 8 hr (0.3), 10 d (0.3) and 160 d (0.4). From total-body scans and compartmental analysis by the same author, fractional distributions of 0.25 for the liver and 0.025 for the spleen with an uptake half-time of 6 d and an elimination half-time of 160 d are assumed. Reference
Lim, T. H. (1978). Kinetic Model Building Using Advanced Nuclear Medicine Techniques--The Kinetics of Chromium (III) in the Human Body, Report LBL 7473. Lawrence Berkeley Laboratory, University of California. (June 1978).

Biokinetic Data
Organ (S) Total body FS 1.0 T 8 hr 10d 160d 6d 160d 6d 160d a 0.3 0.3 0.4 -1.0 1.0 -1.0 1.0 %A 16.9 d

Liver Spleen

0.25 0.025

7.0 d 16.8 hr

103

Cr
24 Chloride

BIOKINETIC MODELS AND DATA

CHROMIUM (III) CHLORIDE

51C, 27.704 days

per Organ Adult * Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest IJLI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other Bffective tissue 9.7E-02 3.7E-02 4.2B-02 4.43-02 6.6&02 5.6B-02 6.3E-02 3.9B-02 0.3E-02 5. SE-01 5.8E-02 4.OE-02 l .OB-01 4.9E-02 4.3B-01 3.1E-02 3 * lB-02 4.3E-02 4.2E-02

unit

activity

Absorbed dose administered 10 year 1. EE-01 7.3E-02 7.4E-02 6.9E-02 1.3E-01 l. lE-01 1.3B-01 7,7E-02 1. SE-01 1. OE+OO l. lE-01 E.EE-02 2 .OE-01 8.7E-02 9.3E-01 5.6B-02 6.7E-02 8. EE-02 7. iE-02

(mGy/MBq)

15 year 1.2B-01 4.7E-02 S.OE-02 4.4E-02 a. lE-02 6.8B-02 7.7B-02 4.7E-02 l.OE-01 6.9B-01 7.6E-02 5. SE-02 1.3E-01 6.1E-02 6.1E-01 3.6E-02 4.1E-02 5.4E-02 5.1E-02

5 year 2.5E-01 1.2E-01 l . lB-01 l. lE-01 2.OE-01 l.EE-01 2.1E-01 1.2E-01 2.2E-01 1. SE+00 1.7E-01 1.4&01 3.OE-01 1.2B-01 1.4E+OO 8.9E-02 l. lE-01 1.4E-01 1.2E-01

1 year 4.1E-01 2.1E-01 2.1E-01 2.1E-01 3.7E-01 3.2E-01 3.7E-01 2.2E-01 3.6&01 2.7B+OO 2.9E-01 2.6E-01 5.2E-01 2.1E-01 2.6E+OO 1.7E-01 2.OE-01 2.5E-01 2.2E-01

* *

* *

dose equivalent Wv/rres)

l.lE-01

1.4L01

2.13-01

3.

m-01

5. SB-01

104

RADIATION

DOSE TO PATIENTS

FROM RADIOPHARMACEUTICALS

Cr 24 EDTA

CHROMIUM EDTA
51Cr Biokinetic Models Intravenous administration of chromium ethylene diaminetetraacetic acid (Cr-EDTA) results in initial distribution in the extracellular fluid and the substance is excreted exclusively by the renal system according to the models for GFR substances and the kidney-bladder (see Appendix Sections A.6 and AS, respectively). In the normal case, total body retention is described by a double exponential function with half-times of 100 min (0.99) and 7 d (0.01). The fraction excreted by the kidneys equals 1.Oand the renal transit time is 5 min. For the abnormal case, it is assumed that the retention half-time of the major component is 1000 min and that the renal transit time is increased to 20 min. 51Cr-EDTA administered orally is absorbed in the normal case only minimally (i.e. about l-5%) from the GI tract. In conditions of abnormal gut permeability, absorption of this substance is significantly increased (Bjarnason et al., 1983) followed by rapid clearance of the absorbed fraction from extracellular fluid by glomerular filtration. The proportion of the administered activity appearing in the urine is an indication of the degree of permeability of the gut wall. For absorbed dose calculations, the GI tract model (Appendix Section A.3) was applied. In cases with increased gut permeability the absorbed activity is more rapidly excreted than is the activity remaining in the intestines. Thus, absorbed doses in the abnormal cases are lower than in the normal case and, for this reason, no separate absorbed dose values are presented for these cases. References
Bjamason, I., Peters, T. J. and Veal& N. (1983). A persistent defect in intestinal permeability in coeliac disease demonstrated by a 51Cr-Iabelled EDTA absorption test. Lancet i, 323-325. Briichner-Mortensen, J., Giese, J. and Rossing, N. (1969). Renal inulin clearance versus total plasma clearance of Cr-EDTA. J. Lab. Clin. Invest. 23, 301-305. Chantler, C., Garnett, E. S., Parsons, V. and Veal& N. (1969). Glomerular filtration rate measurement in man by the single injection method using srCr-EDTA. Clin. Sci. 37, 169-180. OReiiIy, P. H., Shields, R. A. and Testa, H. J. (1979). Nuclear Medicine in Urology and Nephrology. Butterworths, London.

105

Cr
24 EDTA

BIOKINETIC MODELS AND DATA

Biokinetic Data
Organ (S) (1) Intravenous administration Normal renal function Total body (excluding bladder contents) Kidneys Bladder contents Abnormal renal function Total body (excluding bladder contents) Kidneys Bladder contents (2) Oral administration (f, =0) GI-tract contents Stomach SI ULI LLI a KJA,

1.0 1.0 1.0 1.0 1.0 1.0

1.67 hr 7d

0.99 0.01

4.31 hr 6.2 min 2.15 hr

16.7 hr 7d

0.99 0.01

1.05 d 26.2 min 1.74 hr

1.0 1.0 1.0 1.0

1.00 hr 3.98 hr 12.8 hr 23.0 hr

CH&OMIUM
51Cr 27.704 days per Organ Adult 15 year 9.1E-04 3.2E-02 8.2E-04 5.6E-04 0.4E-04 1.4E-03 1.2E-03 2.1E-03 2.2E-03 a. 3E-04 7.2B-04 2 .OE-03 9.4E-04 l .OE-03 0.6E-04 1.6E-03 7.3E-04 3.4E-03 9.5E-04 unit

EDTA
(mGy/MBq) 5 year 2.2E-03 7 .OE-02 1.9E-03 1.3E-03 2.1E-03 3.3B-03 3.OE-03 4.5E-03 4.6E-03 2.1E-03 1.7&03 4.5&03 2.3E-03 2.1E-03 2.OE-03 4.2E-03 1.9E-03 7.9E-03 2.2E-03 1 year 4.OE-03 1.3E-01 3.5E-03 2.6E-03 3.63-03 5. aP+03 5.1E-03 7.6E-03 E.lE-03 3.83-03 3.2E-03 7.6E-03 4.1E-03 3.5E-03 3. BE-03 7.03-03 3.5E-03 1.3B-02 4.1E-03

Absorbed dose activity administered 10 year 1.4E-03 4.6E-02 1.2E-03 0.3E-04 1.3E-03 2.1E-03 1.9E-03 3.OE-03 3.2E-03 1.3E-03 l.lE-03 3.OE-03 1.5B-03 1.5E-03 1.3E-03 2. EE-03 1.2E-03 5.3E-03 1.5E-03

Adrenals Bladder wall

Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other Effective tissue

a. lB-04 2. x-02 ? . OE-04 5.6E-04 ?.3E-04 l. lE-03 l.OE-03 1.6E-03 1. SE-03 6.83-04 5.7E-04 1.6E-03 7.0E-04 a. 7E-04 ?.2E-04 1,2E-03 5.3E-04 2. SE-03 S.OE-04

* * * *

dose equivalent (mSv/tlLtq)

Bladder wall contributes

2.3E-03

3.1E-03

4.6E-03

7 .OB-03

1.3B-02

to

60.0

X of

the

effective

dose

equivalent.

106

RADIATION

DOSE TO PATIENTS FROM RADIOPHARMACEUTICALS

CI 24 EDTA

CHROMIUM
%r 27.704 days Abnormal per Organ * * Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Soleen Testes Thyroid Uterus Other tissue Adult 4.5E-03 2.1.E-02 3.6E-03 3.2E-03 4.1E-03 4. x-03 4.3E-03 4.6E-03 8.3E-03 3.8E-03 3.33-03 4.6E-03 4.3E-03 4.OE-03 4.OE-03 3.7E-03 3.1E-03 5.8E-03 3.4E-03 unit renal

EDTA
function (mGy/MBq) 5 year 1.2E-02 6.4E-02 9.8E-03 7.6E-03 l. lE-02 1.3E-02 l.ZE-02 1.3E-02 2.1E-02 l. lE-02 9.7E-03 1.4E-02 1.2E-02 l .OE-02 l.lE-02 l. lE-02 l. lE-02 1.7E-02 9.9B-03 1 year 2.1E-02 1.2E-01 1.8E-02 1.4E-02 1.9E-02 2.3E-02 2.1E-02 2.3E-02 3.6E-02 2.OE-02 1.8E-02 2.5E-02 2.2E-02 1.8E-02 2.OE-02 2.1E-02 2.OE-02 2.9E-02 1. BE-02

Absorbed dose activity administered 15 year 5.OE-03 2.9E-02 1.2E-03 3.2E-03 4.7E-03 5.5E-03 5.2E-03 5.7E-03 1 .OE-02 4.63-03 4.2E-03 6.OE-03 5.2E-03 4.8E-03 4.8E-03 4.6E-03 4.3E-03 7.1E-03 4.1E-03 10 year 7.7E-03 4.2E-02 6.4E-03 4.83-03 7.2E-03 8.4E-03 7.7E-03 8.8E-03 1.4E-02 7.2E-03 6.3E-03 9.1E-03 8.1E-03 7.1E-03 7.3E-03 7.2E-03 6.8E-03 l, lE-02 6.3E-03

*
* *

Effective dose equivalent (q sv/nBq)

5.2&03

6.5E-03

9.7E-03

1.5B-02

2.7%02

Oral Organ Adult Adrenals Bladder wall Bane surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue 2.OE-03 1.2E-02 2.7E-03 4.2E-04 1.4.E-02 4.7E-02 l.lE-01 2.7E-01 4.6E-03 3. IE-03 5.6E-04 3.9E-02 4.5E-03 8.1E-03 3.3E-03 3.4E-03 6.1E-05 1.6E-02 4.1E-03

administration 15 year 2.8E-03 1.4E-02 3.3E-03 4.2E-04 2.OE-02 6.1E-02 1,6E-01 4.OE-01 5.7E-03 3.93-03 7.9E-04 4.7&02 5.6E-03 9.2E-03 4.OE-03 4.2E-03 7.6E-05 2,1E-02 5.OE-03 10 year 4.7E-03 2.3E-02 4.6E-03 l.lE-03 2.8E-02 9.7&02 2.7E-01 6.7E-01 8.8E-03 7.4E-03 1.5E-03 7 .OB-02 9.OE-03 1.2E-02 6.9E-03 8.2E-03 2.3B-04 3.4E-02 7.4E-03 5 year 7.9E-03 3.3E-02 6.8E-03 2.OB-03 4.78-02 1.5E-01 4.4B-01 1 year 1.4B-02 5.6E-02 1.3B-02 4 .OE-03 8.7E-02 2.6E-01 8.3E-01 2.1E+OO

*
* * *

1. lE+OO
1.3B-02 1.3E-02 2.5B-03 1 .OE-01 1.4E-02 1.4E-02 l. lB-02 1.2E-02 5.3E-04 5.1%02 l. lB-02

2.1&02 2.3E-02 5.53-03 1.7E-01 2.53-02 1.6E-02 1.9B-02 2.4E-02 1.4E-03 8.4B-02 2.OE-02 2.3B-01

Effective dose equivalent (mSv/nes)

3.4E-02

4.7B-02

7.7E-02

1.2%01

107

RADIATION

DOSE TO PATIENTS

FROM RADIOPHARMACEUTICALS

Cr 24 Platelets

CHROMIUM-LABELLED

PI;PcTELETS (THROMBOCYTES)
Biokinetic Model

The same model is used as for l1 In-labelled thrombocytes (see p. 253), with the exception of the excretion half-times which, by analogy with the models for chromium-labelled red cells and leukocytes and for ionic chromium, are assumed to be 10 d (90%) and 160 d (10%). Biokinetic Data
Organ (S) Blood Liver FS 1.0 0.30 T 0 4d 0 4d 10d 160d 4d 10d 160d 0 4d 10d 160d 4d 10d 160d a 0.40 0.60 -0.33 -0.67 0.90 0.10 -1.0 0.90 0.10 -0.86 -0.14 0.90 0.10 -1.0 0.90 0.10 &IA, 3.03 d 3.56 d

Red marrow

0.25

2.83 d

Spleen

0.35

4.45 d

Remaining tissues

0.10

1.13 d

Cr-LABELLED
% 27.704 days

PLATELETS
per unit activity 15 year 1.4E-01 2.5E-02 6.1E-01 3.OE-02 l.lE-01 5.3E-02 5.5E-02 3.93-02 1.2E-01 1.4E-01 3. EE-01 9.5E-02 4.2E-02 2 .OE-01 2.6E-01 3. JE+OO 1. JE-02 3.1E-02 3.6E-02 4.1E-02

(THROMBOCYTES)
dose (mGy/MBq) 5 year 2.9E-01 6.4E-02 1. JE+OO 1 year 4.8%01 l. lB-01 4.OB+OO 1.4E-01 3. BE-01 2.2B-01 2.4B-01 1.4E-01 4.4E-01 4.8E-01 1.5B+OO 4.OE-01 1.6E-01 6. SE-01 1.5E+OO 1.6B+Ol 7. JE-02 1.5B-01 1.4B-01 1.6%01 administered 10 year

Absorbed organ Adult * Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Sn~all intest ULI wall LLI wall Heart Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid uterus Other tissue l.lE-01 1. SE-02 9.0&02 3.OE-02 9.6B-02 4.4E-02 4.5E-02 3.2E-02 9.6E-02 l.lE-01 3.OE-01

2.1E-01 4.2E-02 9.9E-01 5.2E-02 1.6E-01 8,3E-02 8.9B-02 6.OE-02 1. JE-01 2.1E-01 5. JE-01 1.4E-01 6.3E-02 3.0&01 4.2E-01 5.6E+OO 2.6E-02 4. BE-02 5.5E-02 5.9E-02

8.2E-02

2.3E-01 1.3E-01 1.4E-01 8. JE-02 2.6E-01 3.1E-01 8.2E-01 2.2E-01 9.4E-02 4.3E-01

* *

7.2E-02
3.2E-02 1 .gE-01 1.9E-01 2.6E+OO 1.3E-02 2.2E-02 2. BE-02 3.43-02

* *

7.4E-01
8.6E+OO 4.08-02 7. JE-02 8.2E-02 8.9E-02

Effective dose equivalent WV/W)

2.4B-01

3.5E-01

5.3E-01

8.2B-01

1.5B+oO

109

RADIATION

DOSE TO PATIENTS

FROM RADIOPHARMACEUTICALS

Cr 24 RBC

CHROMIUM-LABELLED
iCr

ERYTHROCYTES

Biokinetic Model Normal erythrocytes have a mean life span of 120 d. Since erythrocytes of all age-classes are labelled simultaneously, the mean remaining lifetime for the labelled cells is 60 d. The decrease of activity in erythrocytes, because of cell death, is a linear process, at a rate corresponding to 0.9% of the initial amount per day. In order to keep to the standard form for biokinetic data, this is approximated as an exponential process with a half-life of 42 d. During its residence in the circulation, the activity is considered to be distributed in organs according to their relative blood volumes. Dying cells are taken up in spleen, liver and bone marrow with a distribution of 70%, 25% and 5%, respectively. Chromium is also eluted from the living cell at a rate of 1.0% per day, corresponding to a half-time of 70 d. The released chromium is assumed to be distributed according to the model used for ionic chromium (III), and is, therefore, taken up in liver (25%), spleen (2.5%) and in other tissues (72.5%) with a uniform distribution. In the normal case, about 42% of the activity disappears from the blood by elution, and 58% by death of cells. The combined effect is that in all 42% is taken up by the spleen, 25% by the liver, 4% by the bone marrow and 29% is taken up in other tissues with a uniform distribution. Most studies on the disappearance of chromium from the site of uptake have been performed on the spleen after injection of denatured red cells. The measurements have been performed over only a short time and have shown great variation, with a mean half-life of about 10 d. On the other hand, long term studies by Lim (1978) have shown that after injection of ionic chromium there is also a fraction with a half-life of about 160 d. Although no such long term retention has been demonstrated after injection of red blood cells, the model used here includes a 10% component with this half-life, whereas the rest (900/) is assumed to be eliminated with a half-life of 10 d. These values are assumed to be the same in all organs and tissues. In pathological states, the mean lifetime of intact red cells can be more or less shortened. The worst case would correspond to immediate uptake of all labelled cells, giving the same biokinetic model as for denatured red cells. Variations in absorbed dose in different clinical conditions have been reported by Roth et al. (1986).

References
Belcher, E. H. and Hughes Jones, N. C. (1960). The mathematical analysis of iCr deposition in organs following the injection of slCr-labelled red cells. Clin. Sci. 19, 657663. Hughes Jones, N. C. and Szur, L. (1957). Determination of the sites of red-cell destruction using iCr-labelled cells. Br. J. Haematol. 3, 320-331. ICRU (1979). Methods ofAssessment of Absorbed Dose in Clinical Use ofRadionuclides, ICRU Report 32. International Commission on Radiation Units, Washington, DC. Lim, T. H. (1978). Kinetic Model Building Using Advanced Nuclear Medicine Techniques--The Kinetics of Chromium (Ill) in the Human Body, Report LBL 7473. Lawrence Berkeley Laboratory, University of California. Roth, P., Werner, E., Henrichs, K., Elsasser, U. and Kaul, A. (1986). Variations in absorbed dose from Cr: Investigations with labelled erythrocytes. In: Fourth Int. Radiopharmaceutical Dosimetry Symposium, Oak Ridge 1985, Oak Ridge Assoc. Univ. CONF-851113, pp. 6733680. Oak Ridge National Laboratories, Oak Ridge, Tennessee. Schloesser, L. L., Korst, D. R., Clatanoff, D. V. and &hilling, R. F. (1957). Radioactivity over the spleen and liver following the transfusion of chromium si-labelled erythrocytes in hemolytic anemia. J. Clin. Inoest. 36, 1470-148s.

111

Cr 24 RBC

BIOKINETIC MODELS AND DATA

BiokineticData
Organ (S) Blood Spleen FS 1.00 0.42 T 42 d 70d 42 d 70d 10d 16Od 42d 70d 10d 160d 42 d 70 d 10 d 16Od 70 d 10 d 16Od a 0.58 0.42 -0.97 -0.03 0.90 0.10 -0.58 -0.42 0.90 0.10 -0.70 -0.30 0.90 0.10 -1.00 0.90 0.10 U% 26.1 d 2.15 d

Liver

0.25

1.14d

Red marrow

0.40

4.53 hr

Remaining tissues

0.29

1.07 d

Cr-LABELLED ERYTHROCYTES
51C,

27.704

days Absorbed dose activity administered

15 year 2.7B-01 9.7E-02 2.5E-01 l.OE-01 1.6E-01 1*2E-01 1.2E-01 1 .OE-01 6.1B-01 2.6E-01 2.9E-01 4.1E-01 l. lB-01 2.2E-01 1.7E-01 2.1B+OO 7.7B-02 1.6E-01 l. lB-01 l.OE-01 10 year 4.2B-01 1.4B-01 4.OE-01 1.7E-01 2.4&01 1. EE-01 1.7B-01 1.6E-01 9.1B-01 4.1E-01 4.6B-01 6.5E-01 1.6E-01 3.4B-01 2.6E-01 3.3E+OO l.lE-01 2.6&01 1.6E-01 1.5E-01

per unit
Organ Adult * Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Heart Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue

(mGy/MBq) 5 year 6.5E-01 2.2E-01 6.2&-01 2,6E-01 3.5B-01 2. EB-01 2. EB-01 2.3E-01 1.4E+OO 6.4E-01 6.9B-01 1 year 1.2E+OO 3.7E-01 1.3B+OO 4.6E-01 6.0%01 S.OE-01 4.9E-01 4.2%01 2.4E+OO 1.2E+OO 1.3E+OO 2.OE+OO 4.5&01 8.5E-01 7.6E-01 9.3E+OO 3.3B-01 7.9E-01 4.5E-01 4.2B-01

2.2E-01 ?.5B-02 l. lE-01 9.9B-02 1.4E-01 9.5&02 9. u-02 8.1E-02 5.1E-01 2.2E-01 2. bE-01 3.2E-01 8.2&02 1.9E-01 1.4B-01 1.6E+OO 6.3E-02 1.2E-01 8.5B-02 8.5B-02 2.6B-01

* * *

1. OB+OO
2.5&01 5.OE-01 4.1B-01 5.1E+OO 1.7B-01 4.2%01 2.5E-01 2.3B-01

Bffective dose equivalent (=Bv/nas)

3.3B-01

5.2B-01

8.01-01

1.5B+OO

112

RADIATION DOSE TO PATIENTS FROM RADIOPHARMACEUTICALS

Cr 24 RBC denatured

CHROMIUM-LABELLED

DENATURED
51Cr Biokinetic Model

ERYTHROCYTES

Erythrocytes can be intentionally damaged by heat or by chemical means. After injection into blood, such denatured cells are rapidly taken up by tissues, predominantly in the spleen. This technique is, therefore, used in spleen studies. After injection, most of the cells (900/,) disappear from the blood with a half-time of a few minutes. For dosimetric purposes, immediate uptake of this fraction is assumed. Published values for fractional spleen uptake are in the range 0.42-l .OO and a typical value of 0.75 has been selected. A fractional uptake of 0.15 has been assumed for liver. The remaining 10% is assumed to leave the blood with a half-time of 3 hr and to result in a uniform distribution in other tissues. After uptake in the various organs and tissues, the chromium is set free. Several studies have been performed, especially by measurement over the spleen, to estimate the disappearance half-time. The results show a wide distribution, with a range of 4.59.5% per day and a mean value of 7.6% per day, corresponding to a half-time of about 10 d. These studies have usually covered only a short time after injection and long-term studies have not been reported. Since it is known that injected ionic chromium (III) has a long-term component of retention, with a half-life of 160 d, such a component has also been included in this model, where it has been taken to apply to 10% of the uptake in each organ or tissue. References
Atkins, H. L., Goldman, A. G., Fairchild, R. G., Oster, Z. H., Som, P., Richards, P., Meinken, G. E and Srivastava, S. C. (1980). Splenic sequestration of ggmTclabelled, heat-treated red blood cells. Radiology 136,501-503. Lim, T. H. (1978). Kinetic Model Building Using Advanced Nuclear Medicine Techniques--The Kinetics of Chromium (III) in the Human Body, Report LBL 7473. Lawrence Berkeley Laboratory, University of California. Smith, P. H. S. (1974). Tc labelled erythrocytes for spleen scanning. ht. J. Appl. Radiat. Isot. 25, 137-139. Spinelli-Ressi, F. (1964). In: Medical Radioisotope Scanning, Vol. II, pp. 355-369. International Atomic Energy Agency, Vienna. Williams, E. D., Ahuja, S., Szur, L., Lewis, S. M. and Glass, H. I. (1972). Rate of loss of Cr from the spleen. J. Nucl. Med. 13,686687.

Biokinetic Data
Organ (S) Blood Spleen Liver Remaining tissues Fs 1.0 0.75 0.15 0.10 T 0 3 hr 10d 160d 10d 160d 3 hr 10d 160d a 0.90 0.10 0.90 0.10 0.90 0.10 -1.00 0.90 0.10 AslAo 25.9 min 9.71 d 1.94d 1.29 d

113

Cr 24 RBC denatured

BIOKINETIC MODELS AND DATA

Cr-LABELLED DENATURED ERYTHROCYTES

51C,
27.704 days

per Organ Adult Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Heart Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other Effective tissue l. lE-01 8.OE-03 Z.OE-02 1.9E-02 1.5E-01 3.1E-02 3.1E-02 1.6E-02 4.2E-02 1.5E-01 1.7E-01 4.4E-02 1.8E-02 3. DE-01 2. BE-02 5.6E+OO 5.73-03 6.6J3-03 1.3E-02 2.9E-02

unit

Absorbed dose activity administered 15 year 1.4E-01 l.ZB-02 2.5E-02 1.9E-02 1.7E-01 4.OE-02 4.1E-02 Z. lE-02 5.5E-02 1.8E-01 Z. lE-01 5.8E-02 Z. lE-02 3.2E-01 3.83-02 7.9E+OO 6.6E-03 9.8E-03 1.8E-02 3.5E-02 10 year 2.3E-01 Z . lE-02 3.7B-02 3.5E-02 2.5E-01 6.6E-02 6.9E-02 3.7E-02 8.2E-02 2.7E-01 3.2E-01 8.63-02 3.5E-02 4.8E-01 5.26-02 l.ZB+Ol l. ZE-02 1.7E-02 3.2E-02 5.1E-02

(mGy/MBq) 5 year 3.2E-01 3.6E-02 5.6B-02 6.2.8-02 3.3E-01 l.lE-01 l. lE-01 6.1E-02 l. ZE-01 3.9E-01 4.6E-01 1.3E-01 6.1E-02 6.7E-01 7.0%02 1.8E+Ol 1.8B-02 2.8E-02 5.1E-02 7.7B-02 1 year S.ZE-01 6.9E-02 l.lE-01 9.7E-02 5.lE-01 1.9E-01 Z.OE-01 l.OE-01 Z.OE-01 6.OE-01 8.4E-01 2.3%01 l. lE-01

* *

* *

1. OE+OO
l. lB-01 3.3E+Ol 4.2B-02 5.6E-02 l.OE-01 1.4E-01

dose equivalent WWllBq)

4.0&01

5.4B-01

8.3E-01

1.3B+oO

2.3&00

114

RADIATION DOSE TO PATIENTS FROM RADIOPHARMACEUTICALS

Cr 24
WBC

CHROMIUM-LABELLED WHITE BLOOD CELLS (LEUK5?zYTES)

Biokinetic Model The same model is used as for indium-labelled leukocytes (see p. 255), with the exception of the excretion half-times which, by analogy with the models for chromium-labelled red cells and platelets and for ionic chromium, are assumed to be 10 d (90%) and 160 d (10%). Reference
McMilian, R. and Scott, J. L. (1968). Leukocyte labeling with 5Chromium. I. Technique and results in normal subjects. Blood 32, 738-754.

Biokinetic Data
Organ (S) Blood Liver Fs 1.0 0.20 T 0 7 hr 0 7 hr 10d 160d 0 7 hr 10 d 16Od 0 7 hr 10d 160d 0 7 hr 10d 160d a 0.60 0.40 -0.60 -0.40 0.90 0.10 -0.60 -0.40 0.90 0.10 -0.60 -0.40 0.90 0.10 -0.60 -0.40 0.90 0.10 &&I 4.00 hr 2.58 d

Red marrow

0.30

3.87 d

Spleen

0.25

3.23 d

Remaining tissues

0.25

3.23 d

115

Cr
24 WBC

BIOKINETIC MODELS AND DATA

Cr-LABELLED WHITE BLOOD CELLS (LEUKOCYTES)

51Cr 27.704 days

per Organ Adult * Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Heart Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue

unit

Absorbed dose activity administered 15 year l.OE-01 2.6E-02 10 year 1. SE-01 4.4E-02 1.3E+OO 4.1E-02 1.3E-01 7. JE-02 6.3B-02

(mGy/BBq) 5 year 2.1E-01 6.4E-02 2.2E+OO 6. SE-02 1. BE-01 l. lE-01 1.2E-01 8. JE-02 l .OE-01 1 year 3.4E-01 l .lB-01 5.2EtOO l.lE-01 2.9E-01 1.9E-01 2.1E-01 1.4B-01 1.7E-01 3.4E-01

J . EE-02
1.9%02 l. lE-01 2. SE-02

7.9E-01

2. SE-02 8.6E-02 S . OE-02 S . OE-02 4.2E-02 4.9E-02 l .OE-01 2. JR01 5.3&02 4.43-02 1. SE-01 3.2E-01 2,6E+OO 1.0E-02 2.4E-02 3.83-02 3.63-02

J.4&02

4.3B-02 4.1E-02 3.5&02 4.0&02 0.4E-02 2.1R-01 4.OE-02 3.4E-02 1.3E-01 2.3B-01 1.9B+OO 1.4B-02 1. ?E-02 3.OB-02 3.OE-02

7.9E-02 7.2E-02

* *

1. SE-01 4.OE-01

7.6E-02
6. SE-02 2.2E-01 5.2E-01 4.OE+OO 2. BE-02 3.6E-02 5.6E-02 5.3E-02

2.2%01 5. m-01
l. lE-01 9.3B-02 3.2E-01 9.4E-01 6.2E+OO 4.3E-02 5. JE-02

1. OE+OO
2.0%01 1. SE-01 S. lE-01 1.9EtOO

* *

1. 1EtOl
8.OE-02 l.OE-01 1.4E-01 1.4E-01

8.2E-02

E.OE-02
6.7E-01

Effective dose equivalent (mSv/ll8q)

1.9g-01

2.8B-01

4.3E-01

1.3B+oO

116

RADIATIONDOSE TO PATIENTS FROM RADIOPHARMACEUTICALS

Cr 24
Markers

CHROMIUM-LABELLED

NON-ABSORBABLE
51Cr

MARKERS

Biokinetic Model Compounds of trivalent chromium are used as non-absorbable markers in studies of the gastrointestinal tract. For dosimetry a modified ICRP model for the gastrointestinal tract is used, as described in Appendix Section A.3. References
Donaldson, R. M. Jr and Barreras, R. F. (1966). Intestinal absorption of trace quantities of chromium. J. Lab. Clin.
Med. 68,484-493.

Griffith, G. H., Owen, G. M., Kirkman, S. and Shields, R. (1966). Measurement of rate of gastric emptying using Chromium-Q. Lancet i, 124+1245. Hansky, J. and Connell, A. M. (1962). Measurement of gastrointestinal transit using radioactive chromium. Gut 3, 187-188.

Biokinetic Data
Organ (S) (1) Oral administration of fluids GI-tract contents Stomach SI ULI LLI (2) Oral administration of solids GI-tract contents Stomach SI ULI LLI

r;,
1.0 1.0 1.0 1.0

~,/A,

33.0 min 3.98 hr 12.8 hr 23.0 hr

1.0 1.0 1.0 1.0

2.10 hr 3.97 hr 12.7 hr 23.0 hr

117

CI
24 Markers

BIOKINETIC MODELS AND DATA

Cr-LABELLED NON-ABSORBABLE MARKERS

51C,
Organ Adult Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue 1.9E-03 l. lE-02 2.6E-03 3.9E-04 l . lE-02 4.X-02 l.lE-01 2.7E-01 4.5E-03 3. N-03 S.lE-04 3.9E-02 4.OE-03 8.OE-03 3.OE-03 3.4E-03 5.7E-05 1.6E-02 4.1E-03 15 year 2.7E-03 1.4E-02 3.2E-03 3.9E-04 1.5E-02 6.1E-02 1.6E-01 4.OE-01 5.6E-03 3.8E-03 7.3E-04 4.7E-02 5.1E-03 9.1E-03 3.73-03 4.2E-03 7. WI-05 2.1E-02 4.9E-03 10 year 4.5R-03 2.3E-02 4.6E-03 l .OE-03 2 lE-02 9.6E-02 2.7E-01 6.7E-01 8.7E-03 7.2B-03 1.4E-03 7 .OE-02 8.2E-03 1.2E-02 6.5E-03 8.2E-03 2.2E-04 3.4E-02 7.4E-03 5 year 7.7R-03 3.3R-02 6.8E-03 1.9E-03 3.5E-02 1.5%01 4.4E-01 1 year 1.4E-02 5.6E-02 1.3E-02 3. BE-03 6.4E-02 2.6E-01 8.3E-01 2.1E+OO 2.OE-02 2.3E-02 5.3E-03 1.7E-01 2.4E-02 1.6E-02 1.8E-02 2.4E-02 1.3E-03 8.4E-02 1.9E-02 27.704 days Oral per administration unit of fluids (mGy/BRq) Absorbed dose activity administered

* * * *

1. lE+OO
1.3E-02 1.2E-02 2.4R-03 1.0%01 1.3E-02 1.4E-02 l . OE-02 1.2&02 5.1B-04 5.1E-02 l. lE-02

Effective dose equivalent Wv/llBq)

3.4E-02

4.?R-02

7.7B-02

1.2R-01

Z-31-01

Oral Organ Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Soleen Testes Thyroid Uterus Other tissue Adult 2.1E-03 1.2E-02 2.78-03 5.OE-04 2.3E-02 4.7E-02 l.lE-01 2.7E-01 4.83-03 3.2E-03 6.8E-04 3.93-02 5.7E-03 8,1E-03 4.OE-03 3.43-03 7,OE-05 1.6E-02 4.2E-03

administration 15 year 3.1E-03 1.4E-02 3.3E-03 5.OE-04 3.2E-02 6.1E-02 1.6%01 4.OE-01 5.9E-03 4.OE-03 9.2E-04 4.73-02 6.9E-03 9.2E-03 4.81-03 4,2E-03 8.7E-05 2.1E-02 5.1E-03

of

solids 5 year 8.5E-03 3.3%02 6.93-03 2.3E-03 7.6E-02 1.5E-01 4.3E-01 1 year 1.5E-02 5.6B-02 1.3E-02 4.4E-03 1.4&01 2.6E-01 8.3E-01 2.1E+OO 2.1E-02 2.4E-02 6.OE-03 1.7E-01 2.91-02 1.7E-02 Z.lE-02 2.4E-02 1.5E-03 8.41-02 2 .OB-02

10 year 5.1E-03 2.3E-02 4.7E-03 1.2E-03 4.6E-02 9.73-02 2.7E-01 6.7E-01 9.2E-03 7.7E-03 1.7E-03 7 .OE-02 l.lE-02 1.2E-02 7,9E-03 8.2E-03 2.4E-04 3.4E-02 7.6E-03

* * * *

1. lE+OO
1.4E-02 1.3E-02 2.8E-03 1 .OE-01 1.7E-02 1.4E-02 1.2E-02 1.2E-02 5.7E-04 5.1E-02 l . lE-02

Effective dose equivalent (mSv/Wq)

3.4E-02

4.8B-02

7.8B-02

1.2E-01

2.3B-01

118

RADIATION DOSE TO PATIENTS FROM RADIOPHARMACEUTICALS

Fe 26 Ion

IRON
52Fe s5Fe 5gFe Biokinetic Model This model is based on the biokinetic data for normal subjects in MIRD Dose Estimate Report No. 11 (Robertson et al., 1983). The model is shown in Fig. 1.
r ___-__-* ______ -__-,

Fig. 1.

Arrows indicate flows and the dashed line between compartments 3 and 6 indicates delayed feedback due to the 120 d life of circulating red blood cells. The fractional flow rates between compartments are listed below. Rate Rate (fraction (fraction Flow Flow per day) per day) 1.4 l-2 3+1 0.33 l-r3 2.0 3-4 0.024 1+5 4+3 6.0 0.0018 0.91 2-l 546 0.70 In relating the compartments to different organs and tissues, the MIRD model has been modified with regard to the distribution of blood (plasma and RBC). This has been found necessary to derive an adequate calculation of effective dose equivalent. In the MIRD model, doses to some organs with a high blood content are underestimated, since the blood outside liver, spleen and bone marrow is assumed to be uniformly distributed throughout the residual body. This is especially so for lungs, which have a weighting factor, in the calculation of H,, that is large in comparison with other organs and tissues. This modification leads to the distribution of compartments between organs and tissues given in Table 1. The MIRD publication also gives models for three abnormal states, namely primary haemochromatosis, pernicious anaemia in relapse, and iron-deficiency anaemia. The absorbed doses estimated using these models differ very little from the normal case, with the exception of primary haemochromatosis, in which the dose to liver, spleen and red marrow is above or around a factor of two higher in the case of 55Fe and 5gFe. This results in increases in H, of 75 and 21%, respectively. The variation of absorbed doses in different diseases has also been studied by Roth et al. (1986). When Fe is used, some 52mMn is inevitably also administered, and a model for this radionuclide is, therefore, needed. Instantaneous uptake in organs is assumed, with a distribution as determined by Atkins et al. (1979): i.e. liver 0.3, kidney 0.08, small intestine 0.158, upper large intestine 0.052, lower large intestine 0.04, heart 0.03, pancreas 0.03, lungs 0.03, ovaries and testes 0.0003, and remaining tissues 0.28. According to Mahoney et al. (1968), the activity is retained in these organs and tissues with half-lives of 4 d (0.3) and 38 d (0.7). The 119

Fe 26 Ion

BIOKINETIC

MODELS AND DATA

Table 1. Fractional distribution of compartments Compartment 1. 2. 3. 4. 5. 6. Plasma Extracellular fluid Rapid uptake Slow uptake Red marrow Red blood cells Liver 0.03 0.33 Spleen 0.15 Red marrow 0.02 1.00 0.30 1.00 Blood 1.00 1.00 Residual 0.95 0.22 -

effective dose equivalent, from administered 52mMn, calculated from this model, is given below. The absorbed dose from 52mMn produced after the time of administration of 52Fe is included in the absorbed dose values for 52Fe. In the case of oral administration of iron, a fractional absorption of 0.10 is assumed. In iron deficiency, this fraction may increase, up to a value of 0.5. References
(1) Adopted model Atkins, H. L., Som, P., Fairchild, R. G., Hui, J., Schachner, E., Goldman, A. and Ku, T. (1979). Myocardial positron tomography with Manganese-52m. Radiology 133,769-714. Mahoney, J. P. and Small, W. J. (1969). Studies on manganese III. The biological half-life of radio-manganese in man and factors which affect this half-life. J. Clin. Inoest. 47, 643653. Robertson, R. R., Price, R. R., Budinger, T. F., Fairbanks, V. F. and Pollycove, M. (1983). Radiation absorbed doses from Iron-52. Iron-55 and Iron-59 used to study ferrokinetics. MIRD Dose Estimate Report No. 11. J. Nucl. Med. 24, 339-348. Roth, P., Werner, E., Henrichs, K., Elsasser, U. and Kaul, A. (1986). Variations in absorbed doses from sgFe in different diseases. In: Fourth ht. Radiopharmaceutical ~oosirnetry Symposium, Oak Ridge 198, Oak Ridge Assoc. Univ. CONF-851113, pp. 31&318. Oak Ridge National Laboratories, Oak Ridge, Tennessee. (2) Fetal dosimetry Dyer, N. C. and Brill, A. B. (1972). Maternal-fetal transport of iron and iodine in human subjects. Adv. hp. Med. Biol.
27.351-366.

Biokinetic Data

Organ (S) (1) Intravenous administration Total body Blood Liver Spleen Red marrow (2) Oral administration Total body Blood Liver Spleen Red marrow GI-tract contents Stomach SI ULI LLI

52Fe and 52mMn

55Fe
3.9 yr

Fe 65 d 59 d 17hr 7.6 hr 3.8d 8.1 d 5.9 d 1.7 hr 46 min 9.1 hr 1.0 hr 3.6 hr 12 hr 21 hr

12 hr 2.2 hr 2.4 min 52 s 8.6 hr 11 hr 9.4 min 10.2 s 3.7 s 37 min 0.92 hr 2.6 hr 4.0 hr 2.4 hr

12 hr 2.2 hr 2.4 min 52 s 8.6 hr 11 hr 9.4 min 10.2 s 3.7 s 37 min 1.6 min 6.4 min 10.5 min 6.5 min

3.2 yr 84d 38d 93 d 144d 120d 8.4d 3.8 d 9.3 d 1.0 hr 3.6 hr 12 hr 22 hr

120

RADIATION

DOSE TO PATIENTS FROM RADIOPHARMACEUTICALS

Fe 26 Ion

IRON
52Fe 8.275 hours

per Organ Adult * Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach vall Small intest ULI wall LLI wall Heart Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other Effective 1 .OB+oo tissue 2.9E-01 l.lE-01 3.1E+OO l.ZE-01 l.ZE-01 1.9E-01 1.7E-01 2 .OE-01 4.1E-01 2.573-01 1.7E-01 3. HI-01 Z. lE-01 1.7E-01 6.1E+OO 3.5E-01 7.6E-02 1.5E-01 1.6%01 l.ZE-01

unit

Absorbed dose activity administered 15 year 3,6E-01 1.3E-01 3. SE+00 l.ZE-01 1.4E-01 Z.ZE-01 1.9E-01 2.5E-01 4.8E-01 3.OE-01 Z.OE-01 3.9E-01 2.5E-01 2.OE-01 6.7E+OO 4.5E-01 l .OE-01 1.9E-01 Z.OE-01 1.5E-01 10 year 5.2E-01 2.2&01 5.8E+OO 1.9E-01 2.1E-01 3.1E-01 2.7%01 3.5E-01 7.3E-01 4.5E-01 3. IE-01 6.1E-01 3.4E-01 2.8E-01 l.lE+Ol 7.1E-01 1.6&01 2.8E-01 2.7E-01 2.3E-01

(mGy/MBq) 5 year 7.6E-01 3.OE-01 l.lE+Ol Z.EE-01 3.3E-01 4.2E-01 3.9E-01 4.3&01 1. lE+OO 6.7E-01 4.7E-01 9.6E-01 4.5E-01 4.OE-01 2. 1 year 1.3E+OO 5.1E-01 2.3E+Ol 5.OE-01 5.2E-01 6.4E-01 6.3E-01 6.6E-01 2 .OE+OO

* * *

1 .lE+OO
B.5E-01 1.9E+OO 6.8E-01 6.7E-01 4.5E+Ol 2.1E+OO 4.4E-01 a. 4E-01 5.8E-01 6.OE-01

lE+Ol

1. lE+OO
2.4E-01 4.5E-01 3.8E-01 3.4E-01

1 .lB+oo

1.9B+oo

3.4E+OO

7.OE+oo

Wose 52m Mn (21.1

equivalent min) 3.3E-02

(mSv/MBq of 4.3E-02

the

impurity) l .ZE-01 2.3E-01

8.OE-02

121

Fe 26 Ion

BIOKINETIC MODELS AND DATA

IRON
Oral administration

=2Pe

8.275

hours

Organ

per Adult

unit

Absorbed dose activity administered 15 year 2. SB-01 2. E&01 3.4E-01 2.OB-01 6.1%01 9. SE-01 2.2E+OO 2.OEtOO l.lE-01 2.7E-01 9. EE-02 2.3E-01 4.7E-01 2.9E-01 6.1E-01 1.2E-01 2.2E-01 2.2E-01 3.6E-01 2.3&01 10 year 4.OB-01 4.5E-01 5.6E-01 3.2E-01 E.EB-01 1.6E+OO 3.8E+OO 3. SE+00 1.7E-01 4.3E-01 1. EE-01 3.6E-01 7.2E-01 4. SE-01 9.9&01 1.9E-01 3.6B-01 3.6B-01 5. BE-01 3.7E-01

(mGy/BEq) 5 year 6. SB-01 7.4E-01 9.7E-01 5.2E-01 1. SE+00 2. SE+00 6.2E+OO 5. EE+OO 2.6&01 6.7B-01 3.2E-01 5.9B-01 1. 1EtOO 7.1B-01 1.7E+oa 3.OE-01 S.EB-01 5.9E-01 9.1E-01 6.OE-01 1 year 1.2EtOO 1.3B+OO 2.OB+OO 1. OB+OO 2.8E+OO 4.7E+oO 1.2E+Ol l.lE+Ol 4.4B-01 1.3E+OO 5.9E-01

* * * *

Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Heart Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue

2.OB-01 2.3B-01 2 *9E-01 2.0&-01 4.8B-01 7.6E-01 1. El?.+00 1.6E+OO 9.43-02 2.2E-01 8. SE-02 1. EE-01 3.7E-01 2.3%01 5.2B-01 l. lE-01 l.EB-01 1.7B-01 2. EE-01 1.9B-01

1. lB+OO
2.OB+OO 1.3BtOO 3.5E+OO 6.OE-01

1.lB+OO 1 . lB+OO
1. ?E+OO 1.2B+OO

Bffective dose equivalent Wv/llBq)

4.9B-01

7.1B-01

1.2B+OU

1_9B+OO

3.8E+OO

%Z%%ose 52mMn (21.1

equivalent min) 5.53-02

(mSv/KBq

of

the

impurity) l.EE-01 3.6E-01

7.2E-02

l. lE-01

122

RADIATION

DOSE TO PATIENTS FROM RADIOPHARMACEUTICALS

Fc 26 Ion

IRON 55Pe
Organ
Adult 15 year 5.4E+OO 1.3E+OO l.lE+Ol 1.3E+OO 1.3E+OO 10 year 9.1E+OO 2.1E+OO 2.1E+Ol 2.1E+OO 2.1E+OO 2.1E.+oo 2.1E+OO 2.1E+OO 2.6E+Ol 0. EE+OO 1.3E+Ol 2.1E+Ol 2.1E+OO 2.1E+OO 5 year 1.5E+Ol 3.5E+OO 3.9E+Ol 3.5E+OO 3.5E+OO 3.5E+OO 3.5E+OO 3.5E+OO 4.3E+Ol 1.5E+Ol 2.1E+Ol 3 *6E+Ol 3.5E+OO 3.5EtOO 3.5E+Ol 9.6E+Ol 3. SE+00 1.2E+Ol 3.5EcOO 3.5E+OO 1 year 3.1E+Ol ?.2E+OO 8.2E+Ol ?.2E+OO ?.2E+OO 7.2EtOO ?.2E+OO ?.2E+OO 7.9EtOl 3.OE+Ol 4.2E+Ol ?.3E+Ol ?.2E+OO ?.2E+OO ?.3E+Ol 1.9E+02 ?.2E+OO 2.4E+Ol ?.2E+OO 7.2EtOO 4.2E+OO 1 .OE+OO 3. ?E+OO 1.3EtOO 2.7 years Per unit Absorbed dose

activity

administered

(mGy/MBq)

* Adrenals Bladderwall
Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Heart Kidneys Liver Lungs Ovaries Pancreas Red marrow Soleen Testes Thyroid Uterus Other tissue

1.OE+OO 1.OE+OO 1.OE+OO 1.OE+OO

1.3E+Ol 4.2E+OO 6.3EtOO 9.5E+OO

1.3E+OO
1.3EtOO

* * *

1.3E+OO 1.6E+Ol 5.2E+OO 7.8EtOO

1.3E+Ol 1.3E+OO 1.3E+OO

1. lE+OO
1. OEtOO 6.8E+OO 2.6E+Ol

1. OE+OO
3.4E+OO 1. lE+OO

1. lE+Ol 3.6E+Ol 1.3E+OO 4.1E+OO 1.3E+OO

1.3E+OO

1.8EtOl
5.9E+Ol 2.1E+OO 7 .OE+OO 2.1E+OO 2.1E+OO

1.OE+OO
5.9B+OU

Effective dose equivalent (=Bv/llBq)

E.OE+OO

1.3E+Ol

2.3E+Ol

4.6E+Ol

Oral Organ * Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Heart Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue Adult 4.2&01 l*OE-01 3. ?E-01 1.3E-01 ?. lE-02 6.6E-03 1.3E-01 2. ?E-01 1.3EtOO 4.2E-01 6.3E-01 9.5E-01 l.lE-01 l.lE-01 6.8E-01 2.6EtOO l. lE-01 3.4%01 l. lE-01 l. lE-01

administration 15 year 5.4E-01 1.3E-01 l.lE+OO 1.3E-01 7. ?E-02 -1.9E-02 l.EE-01 4.OE-01 1.6E+OO 5.2E-01 ?.8E-01 1.3E+OO 1.3E-01 1.3E-01 10 year 9.1E-01 2.2&01 2.1E+OO 2.2&01 1.2E-01 -2.71-02 3.2E-01 ?.lE-01 2.6E+OO 5 year 1.5E+OO 1 year 3.1E+OO 7.4%01 8.2E+OO ?.4E-01 4.2E-01 -9.8E-02

3.6E-01 3.9E+OO 3.6E-01 2.1E-01 -4.2E-02 5.2E-01 1.2E+OO 4.3E+OO

1. SE+00 2.1E+OO 3.6E+OO 3.6E-01 3.6E-01 3.5E+OO 9.6E+OO 3.6E-01 1.2E+OO 3.6E-01 3.6%01

1. lE+OO
2.4E+OO ?.9E+OO 3.OE+OO 4.2EtOO ?.3E+OO ?.4E-01 ?.4E-01 ?.3E+OO 1.9E+Ol ?.4B-01 2.4B+OO ?.4E-01 ?.4E-01

* * *

l3.8E-01 1.3E+OO 2.1E+OO 2.2E-01 2.2E-01 l.BE+OO 5.9E+OO 2.2&01 ?.OE-01 2.2E-01 2.2E-01 1.3B+OO

1. lE+OO
3.6E+OO 1.3E-01 4.1E-01 1.3E-01 1.3E-01

Effective dose equivalent (=Bv/ltBq)

5.9%01

8.1B-01

2.3E+oO

4.6B+Oo

123

Fe 26 Ion

BIOKINETIC MODELS AND DATA

IRON 5gPe
Organ Adult * Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Heart Kidneys Liver Lungs Ovaries Pancreas Red marrow Soleen Testes Thyroid Uterus Other tissue 15 year 1.6E+Ol 6. OEtOO l.lEtOl 7.5EtOO 8.9E+OO 8 . lE+OO 7.9EtOO 7 .OEtOO 3.8EtOl 1.5EtOl 1.4E+Ol 2.5EtOl 7.9E+OO l.lE+Ol 1.7E+Ol 3.2EtOl 5.6E+OO 1. OEtOl 7.7E+OO 6.9E+OO 10 year 2.5E+Ol 9.1E+OO 1. Elk01 1.2EtOl 1.3E+Ol 1.2EtOl 1.2EtOl 5 year 3.9EtOl 1.6E+Ol 3.lEtOl 1.9EtOl 2.OEtOl 1. BE+01 1.8EtOl 1.6E+Ol 0.8E+Ol 3.7E+Ol 3.5E+Ol 6.2E+Ol 1.7E+Ol 2.5E+Ol 4.3B+Ol 7.8EtOl 1 year 7.1E+Ol 2.5EtOl 6. OEtOl 3.3EtOl 3.4E+Ol 3.2EtOl 3.2EtOl 2.7EtOl 1.5E+02 6.7E+Ol 6.2EtOl 1.2Et02 3.OEtOl 4.5E+Ol 8.3E+Ol 1.4Et02 2.2EtOl 44.529 days per unit Absorbed dose activity administered (mGy/MBq)

1.4E+Ol
6.OE+OO 1.3E+Ol ?.3E+OO 7.1E+OO 6.7EtOO 6,4E+OO 6.4EtOO 3.2B+Ol 1.3EtOl 1.2EtOl 1.9EtOl 5.8E+OO %.5E+OO 1.3EtOl 2.6EtOl 5.OE+OO 8.3Et00 6.6E+OO 5.9E+OO

1. lE+Ol
5.8E+Ol 2.4EtOl 2.3EtOl 3.9EtOl 1.2EtOl 1.7EtOl 2.6EtOl 5.OEtOl 8.1EtOO 1.7&+01 l.lBtOl 1. OEtOl

* * *

1.2E+Ol
2.7E+01 1.7E+Ol 1.6E+Ol

5.OBtOl
3.OE+Ol 2.9E+Ol

Effective dose equivalent Wv/n&l)

1.3E+Ol

1.5EtOl

2.4BtOl

3.7EtOl

6.8EtOl

Oral Organ Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Heart Kidneys Liver Lungs Ovaries Pancreas * Red marrow Spleen Testes Thyroid Uterus Other tissue Adult 1.5E+OO 9.2E-01 1.4EtOO 7.6B-01

administration 15 year 1.7EtOO 10 year 2.6BtOO 1.6EtOO 2.OE+OO 1.3EtOO 1.9E+OO 3.4EtOO 7.5EtOO 1.7EtOl 5.9E+OO 2.6E+OO 2.5gtoo 3.9E+OO 3.1E+OO 1.9EtOO 2.9EtOO 5.2E+OO 5 year 1 year 7.5&+00 4.3EtOO 6.4EtOO 3.5%.00 5.3EtOO 8.8EtOO 2.2E+Ol 5.1EtOl 1.5EtOl 7.4E+OO 6.9EtOO

4.1gtoo
2.5EtOO 3.3E+OO 2.OB+OO 3.1EtOO 5.1EtOO 1.2E+Ol 2.7E+Ol 8.9EtOO 4.1E+OO 3. BE+00 6.3EtOO 4.5E+OO 3. OEtOO 4.7EtOO 8.1E+OO 1.7E+OO 2.7E+OO 3.1EtOO 1.9E+OO

1. O&O0
1.2E+OO 7.9E-01 1.3EtOO 2.2E+OO 4.5EtOO l.OE+Ol 3.9EtOO 1.7E+OO 1.6E+OO 2.5E+OO 2,1E+OO 1.3EtOO

1. OE+OO
1.8EtOO 3.7EtOO 8.2E+OO 3.2EtOO 1*4E+OO 1.3EtOO 2.OE+OO 1.6E+OO 9.7E-01 1.5EtOO 2.7EtOO 6.OE-01 8.4E-01

*
* *

1.2E+Ol
7.9EtOO 5.2E+OO 8.8EtUO 1.5E+Ol

1.9EtOO
3.3E+OO 7.1E-01

1.lE+OO
1.7E+OO 2.1E+OO

1. lE+OO
1.3EtOO 8.4E-01

3.OE+OO 5.1E+OO
5.5EtOO 3.5EtOO

1.lE+OO
7.3E-01

1.3E+OO

Effective dose equivalent (mSv/nBq)

2.oBtoO

2.5EtOO 4.OE+OO

6.2B+UO

1 .lE+Ol

124

RADIATION DOSE TO PATIENTS FROM RADIOPHARMACEUTICALS

CO

27 Bleomycin

COBALT-LABELLED BLEOMYCIN 57co

Biokinetic Model The data of Beekhuis and Niewig (1984), which are based on measurements in 58 patients, are adopted here. Most of the injected activity is rapidly excreted in the urine, according to the kidney-bladder model. A fraction of approximately 0.10 is taken up in the kidneys and released with half-times of 1.8 hr (0.82) and 40 hr (0.18). A fraction of 0.008 is retained in the liver with a half-time of 35 d. The activity outside these organs is assumed to be distributed uniformly throughout the remainder of the body. Reference
Beekhuis, H. and Niewig, 0. E. (1984). Radiation absorbed doses from Co-57- and Co-55 bleomycin. J. Nucl. Med. 25,
478-485.

Biokinetic Data
Organ (S) Kidneys (uptake) Liver Kidneys (excretion) Bladder content Remaining tissues Fs 0.097 0.008 1.0 1.0 0.895 T 1.8 hr 40 hr 40d a 0.82 0.18 1.0 &IA, 1.21 hr 9.65 hr 4.96 min 1.82 hr 2.63 d

10 hr 2d 60d

0.87 0.10 0.03

JAICRQ 18: 1-r-e

125

co
27 Bleomycin

BIOKINETIC MODELS AND DATA

Co-LABELLED BLEOMYCIN =co

270.9 days

per Organ Adult * * Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other Effective tissue 5.OE-02 l. lE-01 4.7E-02 3.4E-02 4.1E-02 4.7E-02 4.8R-02 4.2E-02 l.lE-01 1.5E-01 3.9E-02 4.4E-02 5. HI-02 5.5E-02 4.1E-02 3.1%02 2.6E-02 5.1%02 3.5E-02

unit

Absorbed dose activity administered 15 year 6.6E-02 1.6E-01 5.6E-02 3.4&02 5.63-02 5.7E-02 6.OE-02 5. SE-02 1.3E-01 1.9E-01 5.OE-02 5.6E-02 6.7E-02 6.7E-02 5.OE-02 4.OE-02 4.3E-02 6.1B-02 4.2E-02 10 year 9.9E-02 2.3E-01 8.43-02 5.OE-02 9,OE-02 0.9E-02 9.1E-02 8.7E-02 1.8E-01 2 .a~-01 7.3E-02 8.7E-02 l . OE-01 9.7E-02 7.03-02 6.2E-02 6.9&02 9. SE-02 6.4E-02

(mGy/MBq) 5 year 1.4&01 3.4E-01 1.3E-01 8.1E-02 1.3E-01 1.4E-01 1.5E-01 1.3E-01 2.7E-01 4.OE-01 l.lE-01 1.3E-01 1.5E-01 1.4E-01 l.ZE-01 9.8E-02 l. lE-01 1.4%01 9.9E-02 1 year 2.5E-01 6.4&01 2.4E-01 1.5&01 2.3E-01 2.4E-01 2.5E-01 2.4E-01 4.6E-01 7.3E-01 Z .OE-01 2.4E-01 2.7E-01 2.4E-01 2.2B-01 l.BE-01 Z . OE-01 2.5E-01 1. BE-01

* *

dose equivalent (aSv/nBq)

5.6%02

7.1&02

1 .OE-01

1.6B-01

2.8E-01

126

RADIATION DOSE TO PATIENTS FROM RADIOPHARMACEUTICALS

CO

21 B 12

VITAMIN B,, 57co Yo

Biokinetic Model: Intravenous Injection With No Carrier Vitamin B,, About two thirds of intravenously administered vitamin B,, is concentrated in the liver, where it is retained for a long time. Of the residue, which is initially distributed in the extracellular fluid, a small fraction is eliminated rapidly, but the majority is retained for a long period. Total body retention is described by a 2-exponential function with half-lives of 1.Od (0.1) and 500 d (0.9). A fraction of 0.6 is taken up by the liver and retained with a half-life of 500 d. The remaining fraction of 0.4 is distributed throughout the rest of the body and eliminated with half-times of 1.0 d (0.25) and 500 d (0.75). References
(1) Adopted model
Amin, S., Spinks, T., Ranicar, A., Short, M. D. and Hoffbrand, A. V. (1980). Long-term clearance of (s7Co) cyanocobalamin in vegans and pernicious anaemia. Clin. Sci. 58,101-103. Heyssel, R. M., Bozian, R. C., Darby, W. J. and Meneely, G. R. (1965). Turnover of 60Co-labeled vitamin B,, in patients with pernicious anaemia. In: Radioactivity in Man, Second Symposium, pp. 331-342. (Meneely, G. R. and Linde, S. M. eds) Charles C. Thomas, Springfield, Illinois. McEwan, A. C. (1974). Patient Radiation Doses from Radiopharmaceuticals, Report of the National Radiation Laboratory, NRL 1974/3. Department of Health, Christchurch, New Zealand. Powsner, E. R. and Raeside, D. E. (1971). Diagnostic Nuclear Medicine, p. 456. Grune and Stratton, New York. Reizenstein, P., Ek, G. and Matthews, C. M. E. (1966). Vitamin B,, kinetics in man. Implications on total-body-B,,-determinations, human requirements, and normal and pathological cellular B,, uptake. Whys.Med.
Biol. 11, 295-306. (2) Transfer to the fetus

Luhby, A. L., Cooperman, J. M., Donnenfeld, A. M., Herrers, J. M., Teller, D. N. and Wenig, J. B. (1958). Observations on the transfer of vitamin B,, from mother to fetus and newborn. AMA J. Dis. Child. 96, 532-533.

Biokinetic Data: Intravenous Injection With No Carrier Vitamin B,,

&IA, Organ (S) Total body Liver Fs 1.0 0.6 T l.Od 500d 500d a 0.1 0.9 1.0 s7co 228 d 152 d 5sco 80.7 d 53.7 d

127

CO

BIOKINETIC MODELS AND DATA

27 B11

VITAMIN BU
Intravenous =7co 270.9 days Per Organ Adult * Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue 5.4EtOO 1*3E+oO 2.5E+OO 2.1EtOO 2.9E+OO 2.9EtOO 3.7&00 1.4E+OO 5.OE+OO 5.1EiOl 3. SE+00 1.7E+OO 5. bE+OO 3.2EtOO 2.OEtOO 9.7E-01 9.4E-01 1.8E+OO 2.OE+OO 15 year 10 year 1.2E+Ol 3.OE+OO 4. SE+00 3.4.8&O 7.3E+OO 6.1E+OO 8.OB+OO 3.2E+OO 8.8E+OO 9,4B+Ol 6.5%+00 3.9E+OO l.ZE+Ol 5.9E+OO 4.6EtOO 1.9E+OO 2. SE+00 3.8EtOO 3.6E+OO 5 year 1.5BtOl 5.4E+OO 6.8E+OO 5.4E+OO 1.2B+Ol 9.9B+OO 1.4EiOl 5.2E+OO 1.2EtOl 1,4E+02 1 year 2.4E+Ol 9.7E+OO 1.3E+Ol l.OE+Ol 2.lE+Ol 1.7EtOl 2.3IztOl unit injection with no carrier

Absorbed dose activity adminirtered

fmGy/HBq)

8*lE+OO
1.9BiOO 3.1E+OO 2 * lE+OO 4.3E+OO 3.5E+OO 4.6E+OO 1.9E+OO 5.8E+OO 6.4E+Ol 4. ?E+OO 2.3E+OO 7.9B+OO 4.2Etoo 2.8E+OO 1.2B+OO 1.5E+OO 2.2E+OO 2.4EtOO

* * *

1.OE+Ol

9.4E+oo
6.3E+OO 1.8E+Ol 8,OE+OO 7.3E+OO 3.2B+OO 4.2BtOO 6.3EtOO 5.5E+OO

1.9EtOl 2. SE+02 1.63+01 1.2B+Ol 3.OE+Ol 1.3E+Ol 1.3E+Ol 6.1B+OO 7 .?B+OO 1.2E+Ol 1. OEtOl

Effective dose equivalent (aSv/W)

5.8BtoO

7.3B+OO

l.lB+Ol

1.6B+Ol

Z.SB+Ol

=aco
Organ *

70.80

days

Adult Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Bed marrov Spleen Testes Thyroid Uterus Other tissue 1.4E+Ol 3.3EtOO 3.7E+OO 5.3EtOO 7. OEtOO 6.4EtOO 8.4EtOO 3.4B+OO l.l&+Ol 7.7E+Ol 7.8E+OO 3.2EtOO 1.3B+Ol 4.7EiOO 5.OE+OO 2.9EtOO 2.6E+OO 3.8EtOO 4.7E+OO

15

year

10 year 2.7EtOl 5.9E+OO 6.7EtOO 8.7E+OO 1. SB+Ol 1.4BtOl 1.8B+Ol 6.lEtOO 2. OEtOl 1.4E+02 1.5E+Ol 8.7EtOO 2,7E+Ol 8.5EtOO 1. OE+Ol 4.1E+OO 5.3E+OO 8.5E+OO 8.2E+OO

5 year
3.6B+Ol

1 year 5.7E+Ol 1.7E+Ol 1.9E+Ol 2.5EtOl 5.3E+Ol 3.9B+Ol 5.3B+Ol 1.8E+Ol 4,5B+Ol 3.2B+02 3.8BtOl 2.6E+Ol 7.1E+Ol 1.9E+Ol 2.9EtOl 1.2E+Ol 1.6EtOl 2.5EtOl 2.3E+Ol

1.9EtOl
3.6B+OO 4.5EtOO 5.3E+OO 8.7E+OO 7.8E+OO 1 .OE+Ol 3.7EtOO 1.3E+Ol 9.5B+Ol l.OE+Ol S.lE+OO 1.7EtOl 6. OEtOO 6.5E+OO 2 :6E+OO 3.3E+OO 5.2E+OO 5.6E+OO

1. lE+Ol 1*OB+Ol
1.4E+Ol 2.6E+Ol 2.2EtOl 3.OEtOl

* * *

1. OE+Ol
3.OE+Ol 1.9E+02 2.2B+Ol 1.4E+Ol 4.2B+Ol 1.2EiOl 1.6EtOl 6.78+00 8.8E+OO 1.4B+Ol 1.3E+Ol

Bffective dose equivalent (mSv/ne4)

1.lE+Ol

1.3BtOl

2.OB+Ol

2.9B+Ol

4.9B+Ol

128

RADIATION

DOSE TO PATIENTS

FROM RADIOPHARMACEUTICALS

CO 27 B 12

VITAMIN B,, s7co s8co

Biokinetic Model: Intravenous Injection With Carrier Vitamin B,, for GFR Studies Following the parenteral administration of unlabelled vitamin B,, to saturate plasma and tissue binding sites, the intravenous administration of labelled vitamin leads to rapid elimination of most of the radiopharmaceutical by glomerular filtration. A small residue becomes bound and is retained for a long time. The total body retention is described by a 2-exponential function with half-lives of 100 min (0.90) and 500 d (0.10). A fraction of 0.05 is taken up by the liver and retained with a half-time of 500 d. A second fraction of 0.05 is assumed to be uniformly distributed throughout all other organs and tissues, and retained with a half-time of 500 d. The fraction of 0.9 which is retained inthe body with a half-life of 100 min is assumed to be excreted via the kidneys according to the standard kidney-bladder model (Appendix Section A.5). References
Boddy, K. and Adams, J. F. (1968). Excretion ofcobalamins and coenzyme B,, following massive parenteral doses. Am. J. Clin. Nutr. 21, 651666. Nelp, W. B., Wagner, H. N. and Reba, R. C. (1964). Renal excretion of vitamin B12 and its use in measurement of glomerular filtration rate in man. J. Lab. Clin. h&d. 63, 480-491. Weeke E. (1968). Co-cyanocobalamin in the determination of the glomerular filtration rate. Scan. J. C/in. Lab. rrlve;t. 21, 139-144.

Biokinetic Data: Intravenous Injection With Carrier Vitamin B,, for GFR Studies

Organ (S) Total body (excluding bladder contents) Liver Remaining tissues Kidneys Bladder contents

Fs 1.0 0.05 0.05 0.90 0.90

T 100 min 5OOd 500d 500d

a 0.9 0.1 1.0 1.0

CO 25.5 d 12.7 d 12.7 d 1.4 hr 1.95 hr

ssco 9.04 d 4.48 d 4.48 d 33 min 1.95 hr

129

co
21 B 12

BIOKINETIC MODELS AND DATA

VITAMIN Bn
Intravenous 57co 270.9 days per unit injection with carrier

Absorbed dose activity administered 15 year 8.OE-01 3.7E-01 4.OE-01 2.6E-01 4.8E-01 4.3E-01 5.2E-01 2.9E-01 6.OE-01 5.4E+OO 5.OE-01 3.3E-01 7.9E-01 5.x?,-01 3.5E-01 2.OE-01 2.4E-01 3.3E-01 3.OE-01 10 year 1.2E+OO 5.5E-01 5.8B-01 4.OE-01 8.1E-01 7.2E-01 8.6J.k 4.9E-01 8.9E-01 8.OE+OO 7.OE-01 5.4E-01 1.2E+OO 7.2E-01 5.7E-01 3.1E-01 4.0&01 5.4E-01 4.5E-01

(mGy/MBq) 5 year 1.6E+OO 8. E-01 8.9E-01 6.5E-01 1.3E+OO 1 year 2. SE+00 1.6E+OO 1.7E+OO 1.2B+OO 2.2E+OO 2.OE+OO 2.4E+OO 1.4E+OO 1.9E+OO 2.1E+Ol 1.8E+OO 1.5E+OO 3.OE+OO 1.6EtOO 1.6E+OO 9.7E-01 1.2E+OO 1.6B+OO 1.3E+OO

Organ
* Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue

Adult 5.5E-01 2.6E-01 3.3E-01 2.6%01 3.4E-01 3.5E-01 4.2E-01 2.2E-01 5.1E-01 4.3E+OO 3.8E-01 2.5E-01 5.6E-01 4.OE-01 2.7E-01 1.6E-01 1.5E-01 2.7E-01 2.5E-01

* * *

1. lE+OO
1.4E+OO 7.4E-01 1.3E+OO 1. lE+Ol 1. OE+OO 8.5E-01 1.8E+OO 1. OEtOO 8.9E-01 5.1E-01 6.5E-01 8.6E-01 7.OE-01

Effective dose equivalent (mSv/llBq)

5.8B-01

7.3E-01

1.lB+OO

1.6B+oO

2.9B+OO

58~0

70.80

days

Organ
* Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wal.1 Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue

Adult 1.4EtOO 7.9E-01 4.9E-01 6.OE-01 7.8E-01 7.7E-01 9.3E-01 5.3E-01 1. lE+OO 6.5E+OO 8.2E-01 4.6E-01 1.3E+OO 5.8E-01 6.2E-01 4.7E-01 4.OE-01 6.1E-01 5.7E-01

15 year 1.8E+OO 8.9E-01 5. BE-01 6.OE-01 9.6E-01 9.3E-01 l,lE+OO 5.68-01 1.3E+OO 8.OE+OO l.lE+OO 7.2E-01 1. E+OO 7.2E-01 7.8E-01 4. SE-01 5.OE-01 7.6E-01 6.7E-01

10 year 2.6B+OO 1.3E+OO 8.5E-01 9.5E-01 1.6E+OO 1.5E+OO 1.9E+GO 9.1&01 2.OE+OO

5 year 3.6E+OO 2.2B+OO 1.3B+OO 1.5E+OO 2.7EtOO 2.5E+OO 3.1E+OO 1.5E+OO 3.OE+OO 1.6E+Ol 2.3E+OO 1.8E+OO 4.1E+OO 1.4E+OO 1.9E+00

1 year 5.?E+OO 3.5E+OO 2.4E+OO 2.7E+OO 5.3E+OO 4.3E+OO 5.4E+OO 2.5B+OO 4. I?.+00 2.7E+Ol 4.OE+OO 3.3E+OO 6.9E+OO 2.3E+OO 3.3E+OO 2.OE+OO 2.3E+OO 3.3E+OO 2.8E+OO

* * *

1. lE+Ol
1.5E+OO 1.2E+OO 2.6Ei.00

1. OE+OO
i. 2E+OO 6.8E-01 8.OE-01 1.2E+OO 9.9E-01

1. lE+OO
1.3E+OO 1.9E+OO 1.5E+OO

Effective dose equivalent (mSv/nes)

1 .lB+OO

1.3B+OO

2.OB+oo

2.9B+OO

5.OB+OO

130

RADIATION DOSE TO PATIENTS FROM RADIOPHARMACEUTICALS

CO

21 B12

VITAMIN B,, s7co s8co

Biokinetic Model: Oral Administration Without Flushing Labelled vitamin B,, is administered orally in small quantities (0.5 pg) without later injection of a flushing dose of vitamin, in order to estimate the fraction absorbed from the gastrointestinal tract by means of whole-body counting, or by measurement of faecal excretion or plasma concentration of labelled vitamin. In the normal case, about two thirds of the administered vitamin is absorbed at the terminal ileum and retained in the body in the same way as labelled vitamin B,, administered intravenously without additional carrier. Thus, in the model adopted, a fraction bf 0.7 of the orally administered material is taken to be absorbed and retained in the body with half-times of 1 d (0.1) and 500 d (0.9). A fraction of0.6 of the absorbed vitamin is taken up by the liver and retained with a half-time of 500 d. The residual fraction of the absorbed vitamin is distributed throughout the body and eliminated with half-lives of 1 d (0.25) and 500 d (0.75). The ICRP GI-tract model has been modified to allow for the fact that absorption of vitamin B,, occurs at the distal end of the small intestine. References
Chanarin, I. (1974). The Megabblastic Anaemias, 2nd edn. Blackwell, Oxford. ICRP (1975). Report ofthe Task Group on Reference Man, ICRP Publication 23. Pergamon, Oxford.

Biokinetic Data: Oral Administration Without Flushing

Organ (S) Total body (excluding GI-tract contents) Liver GI-tract contents Stomach SI ULI LLI

Fs 0.7 0.42 1.0 1.0 0.3 0.3

T Id 5OOd 5OOd

a 0.1 0.9 1.0

Wo 160d 106d 1 hr 4.0 hr 3.9 hr 7.2 hr

=co 56.5 d 37.6 d 1 hr 4.0 hr 3.9 hr 7.1 hr

131

co
21 B 12

BIOKINETIC MODELS AND DATA

VITAMIN BU
Oral 57co 270.9 days per Organ Adult * Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue 3.8E+OO 9.5E-01 l.EE+OO 1.5E+OO 2 . OE+OO 2 .OEtOO 2.6BtOO 1.3EtOO 3.5EtOO 3.6EtOl 2.4E+OO 1.2EtOO 3.8EtOO 2.3E+OO 1.4B+OO 6.9E-01 6.6g-01 15 year 5.7EtOO 1.4E+OO 2.2EtOO 1.5E+OO 3. OBtoo 2.5E+OO 3.2E+OO 1.7EtOO 4.1EtOO 4.4EtOl 3.3B+OO 1.6E+OO 5.5EtOO 3.OEtOO 2 . OE+OO 8.6E-01 10 year 8.3E+OO 2.1EtOO 3.2E+OO 2.4E+OO 5.1E+OO 4.3E+OO 5.6&+00 2.9EtOO 6.2E+OO 6.6E+Ol 4.5EtOO 2.0E+OO 8.5EtOO 4.1BtOO 3.3E+OO 1.3EtOO 1.8EtOO 2.7EtOO 2.5E+OO 5 year l.lEtOl 3.8EtOO 4.8EtOO 3.0EtOO 0.3EtOO 7 .OEtOO 9.5EtOO 4.6EtOO 1 year 1.7EtOl 6.9EtOO 9.1EtOO 7.OE+OO 1.4E+Ol l.ZE+Ol 1.6E+Ol 9.OE+OO 1.4EtOl 1.7EtO2 l.1Bt01 a. 3BtOO unit Absorbed dose activity administered (mGy/MBq) administration without flushing

* * *

8.8EtOO
9.5EtOl 6.6B+OO 4.5E+OO 1.3EtOl 5.6E+OO 5.2EtOO 2 .ZE+OO 3. OBtOO 4.5E+OO 3.8E+OO

2. lE+Ol
8.9EtOO 8.9EtOO 4.3E+OO 5.5EtOO a. 3E+OO 7.1E+OO

1. lE+OO
1.6EtOO 1.7EtOO

1. ZE+OO
1.4EtOO

Effective dose equivalent WV/W)

4.ogtoO

5.2E+OO

7.7BtOO

1 .lE+Ol

2.OEtol

58co
Organ *

70.00

days

Adult Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Soleen Testes Thyroid Uterus Other tissue

15 year 1.3BtOl

10 year
1.9EtOl 4.3EtOO 4 * 7BtOO 6.1EtOO

5 year 2.5E+Ol 7.7EtOO 7.1EtOO 9.7E+OO 1.9E+Ol 1.6EtOl 2.2EtOl l.lEtOl 2 *lB+Ol 1.3Et02 1. SE+01

1 year 4.OEtOl 1.3EtOl 1.4E+Ol 1.7EtOl 3.7E+Ol 2. EE+Ol 3.9E+Ol 1.9EtOl 3.2EtOl 2. 2E+02 2.7EtOl 1.9EtOl 5.OEtOl 1.3EtOl 2.OEtOl 0.9EtOO

1.OE+Ol
2.4EtOO 2.6EtOO 3.7E+OO 4.9EtOO 4.7E+OO 6.3EtOO 3 *4EtOO 7.93+00 5.4BtOl 5.5EtOO 2.5EtOO

2.6B+OO 3.2E+OO 3.7EtOO 6.1E+OO

5.7E+OO 7,5E+OO 3.9EtOO

1 . OB+Ol
9.8EtOO 1.3E+Ol 6.4E+OO 1.4EtOl 9.5E+Ol

* * *

9.4EtOO
6.6EtOl 7.3EtOO 3.9E+OO 1.2EtOl 4.3EtOO 4.6EtOO

1. OE+Ol
6.6EtOO 1*9E+Ol 6.OE+OO 7.3EtOO 2.9E+OO 3.7E+OO 6.1gtOO 5. BE+00

1. l&01
2 *9BtOl 8.2E+OO

9.1BtOO
3.3E+OO 3.5EtOO Z.lE+OO 1. BE+00

1.1EtOl
4.8EtOO 6.2EtOO 1. OEtOl 0.9E+OO

1.9EtOO
2.3EtOO 3.8EtOO 3.9E+OO

1.lE+Ol
1.8EtOl 1.6E+Ol

2.8E+OO 3.3EtOO 7.5B+00

Effective dose equivalent (=Sv/nas)

9.3EtOO

1.4BtOl

Z.OBtOl

3.5BtOl

132

RADIATION

DOSE TO PATIENTS

FROM RADIOPHARMACEUTICALS

CO 27 B 12

VITAMIN B,, 57co wo

Biokinetic Model: Oral Administration with Flushing In the Schilling test, the parenteral administration of a flushing amount of unlabelled vitamin B, 2, 2 hr after oral administration of labelled vitamin (0.5 pg), saturates plasma and tissue binding sites and leads to the rapid elimination of one third of the absorbed radiopharmaceutical by glomerular filtration. The bulk of the residue is retained in liver and tissue binding sites for a long time. In the normal case, a fraction of 0.7 of the oral dose is absorbed at the terminal ileum and retained in the body with half-times of 100 min (0.34), 1 d (0.06) and 500 d (0.60). A fraction of 0.4 of the absorbed vitamin is taken up by the liver and retained with a half-time of 500 d. The remaining fraction of the absorbed vitamin, after initial distribution in the extracellular fluid, is partly excreted by glomerular filtration with a half-time of 100 min, according to the kidney-bladder model, the remainder being eliminated with half-times of 1 d and 500 d. The ICRP GI-tract model has been modified to allow for the fact that absorption of vitamin B,, occurs at the distal end of the small intestine. References
Callender, S. T. and Evans, J. R. (1955). The urinary excretion of labelled vitamin B,,. Clin. Sci. 14, 295-302. ICRP (1975). Report ofthe Task Group on Reference Man, ICRP Publication 23. Pergamon, Oxford.

Biokinetic Data: Oral Administration With Flushing

Organ (S) Total body (excluding bladder and GI contents) Liver Kidneys Bladder contents GI-tract contents Stomach SI ULI LLI

Fs 0.7

T 100 min Id 5OOd 5OOd

a 0.34 0.06 0.60 1.0

57co
106d

Yo 27.5 d

0.28 0.24 0.24 1.0 1.0 0.3 0.3

70.8 d 3.9 hr 30.6 min 1.0 hr 4.0 hr 3.9 hr 7.2 hr

25.0 d 1.4 hr 30.6 min 1.0 hr 4.0 hr 3.9 hr 7.1 hr

133

co
21 B II

BIOKINETIC MODELS AND DATA

VITAMIN Bu
Oral administration with flushing

57CO Organ *

270.9

days

per Adult 2 * 5E+OO 6.4E-01 1.2E+OO 9. BE-01 1.4B+OO 1.4E+OO 1.8E+OO 9.7E-01 2. cm00 2.4E+Ol 1.6E+OO 8.3E-01 2.6E+OO 1.5E+OO 9.7E-01 4.6E-01 4.4E-01 8.4E-01 9.5E-01

unit

Absorbed dose activity administered 15 year 3.8EtOO 9.2E-01 1.5E+OO 9.8E-01 2,OE+OO 1.7E+OO 2.2EtOO 1.3E+OO 2.7E+OO 3.OE+Ol 2 .ZE+OO 1. lE+OO 3.7E+OO 2,OE+OO 1.3E+OO 5.8E-01 7.2E-01 10 year 5.5E+OO 1.4E+OO 2.1E+OO 1.6E+OO 3.4E+OO 2.9EtOO 3.9EtOO 2.2EtOO 4.2E+OO 4.4E+Ol 3.OE+OO 1.9E+OO 5.7E+OO 2.8E+OO 2.2E+OO 9.OE-01 1.2EtOO 1.8E+OO 1.7E+OO

(mGy/MBq) 5 year 7.3EtOO 2.6E+OO 3.2E+OO 2.5EtOO 5.6EtOO 4.7EtOO 6.6E+OO 3.6E+OO 5.9E+OO 6.3EtOl 4,4E+OO 3.1E+OO 8.5EtOO 3.8E+OO 3.5EtOO 1.5EtOO 2. OEtOO 3. OEtOO 2.6EtOO 1 year

* * *

Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue

1. lE+Ol
4.6E+OO 6.1E+OO 4.7E+OO 9.7EtOO 8.1E+OO 1. 1EtOl 7.OE+OO 9.1E+OO 1.2E+02 7.7EtOO 5.6EcOO 1.4E+Ol 6.OE+OO 6.OE+OO 2.9E+OO 3.7E+OO 5.6E+OO 4.7E+OO

1. lE+OO

1. lE+OO
3.5E+OO

Effective dose equivalent Wv/l(Bq)

2.7E+OO

5.2BtOO

7.6EtOO

1.3B+Ol

sac0
Organ
*

70.80

days Adult 6.7EtOO 1.6EtOO 1*8E+OO 2.5BtOO 3,3E+OO 3.2E+OO 4.4EtOO 2.7E+OO 5.3EtOO 3.6E+Ol 3.6EtOO 1.8E+OO 6.1EtOO 2.2EtOO 2 * 4EtOO 1.4E+OO 1.2EtOO 1.9EtOO 2.2E+OO 15 year 8.8E+OO 1.8E+OO 2,lEtOO 2.5EtOO 4.x8+00 3.9EtOO 5.2E+OO 3,1E+OO

10 year 1.3B+Ol
2.9BtOO 3.1E+OO 4.1E+OO 6.9EtOO 6.7EtOO 9,2E+OO 5.1EtOO 9.5E+OO 6.3EtOl 6.9E+OO 4.6EtOO 1.3E+Ol 4.OB+OO 4.8EtOO 2.OE+OO 2.5B+OO 4.2E+OO 3.9EtOO

5 year
1.7B+Ol 5 *2E+OO 4.8B+OO 6. SE+00 1.23+01

1 year 2.7EtOl 8.5EtOO 9.1E+OO 1.2E+Ol 2. SE+01 1.9E+Ol 2.7EtOl 1.5E+Ol 2.1E+Ol 1.5E+02 1.8E+Ol 1.3E+Ol 3.3E+Ol 8.8B+OO 1.4B+Ol 6.OE+OO 7.5EtOO 1.2EtOl l.lEtOl

Adrenals Bladder

wall

* *
*

Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall
Kidneys Liver Lungs Ovaries Pancreas

1. lE+Ol
1.5E+Ol 8.4E+OO 1.4E+Ol 8.7E+Ol 1 .OE+Ol 7.3E+OO 2.OE+Ol 5.5E+OO 7.6B+OO 3.3E+OO 4.1E+OO 6. SE+00 6. OEtOO

6.3E+OO
4.4E+Ol 4.9E+OO 2.7E+00 8.OE+OO 2.9E+OO 3. OEtOO 1.3EtOO 1.5EtOO 2.6E+OO 2.6EtOO

Red marrow Spleen Testes Thyroid Uterus Other tissue

Bffective dose equivalent

WV/W)

S.lE+Oo

6.3B+OO

9.3E+OO

1.4B+Ol

2.3B+Ol

134

RADIATION

DOSE TO PATIENTS

FROM RADIOPHARMACEUTICALS

CU 29 Ion

COPPER 64cu 67cu

Biokinetic Model The distribution of copper in man was reviewed by Cartwright and Wintrobe (1964), Giinther et al. (1975), Osborn and Walshe (1967). The organs showing the highest activity concentrations of copper are liver, brain, kidneys and pancreas. For liver uptake, a mean fraction of 0.65 appears to be appropriate. It may vary over the range 0.25-0.72 in humans homozygous for Wilsons disease and over the range 0.70-0.90 for humans heterozygous for Wilsons disease. The fractional distributions for other organs are: brain 0.1 (Cartwright and Wintrobe, 1964; Underwood, 1977), kidneys 0.01 (Ryo et al., 1975; Underwood, 1977) and pancreas 0.002 (Ryo et al., 1975). Excretion measurements indicate a total-body biological half-life ranging from 7.7 to 11.3 d (Cartwright and Wintrobe, 1964; Wiseman, 1964). From balance considerations, a biological half-life of 14 d is calculated. Based on these data, a total body half-life of 10 d appears to be an appropriate estimate. For the metabolic models of Bernard (1973, 1978), up to 5-fold longer half-lives are reported. However, the half-life selected is of minor importance in absorbed dose calculations, because of the short physical half-lives of j4Cu and 67Cu (13 hr and 62 hr respectively). For the elimination of copper from the liver into plasma (synthesis of ceruloplasmin) and bile, the model of Chervu and Sternlieb (1975) is adopted, with half-lives of retention in the liver of 0.5 d (0.15), 1.5 d (0.33) and 10 d (0.52). References
Bernard, S. R. (1973). Dosimetric data for copper. In: He&h Physics Division Annual Progress Report, pp. 3&32. Oak Ridge National Laboratory (ORNL), Oak Ridge, Tennessee. Bernard, S. R. (1978). Metabolic model and dosimetric data for copper. Bull. Mathem. Biol. 40,265-269. Cartwright, G. E. and Wintrobe, H. M. (1964). Copper metabolism in normal subjects. Am. J. Clin. Nutr. 14,224-232. Chervu, L. R. and Sternlieb, I. (1974). Dosimetry of copper radionuclides. J. Nucl. Med. 15, 101l-1013. Giinther, K., Liissner, V., Liissner, J. and Biesold, D. (1975). The kinetics of copper uptake by the liver in Wilsons disease.--Studied by a whole-body counter and a double labelling technique. Eur. Net&. 13, 395-394. Osborn, S. B. and Walshe, J. M. (1967). Studies with radioactive copper (64~Cu and 67-Cu) in relation to the natural history of Wilsons disease. Lancet i, 346350. Ryo, U. Y., Ice, R. D., Jones, J. D. and Beierwaltes, W. H. (1975). Relative tissue distribution ofradioactivity in rats with endocrine autonomous breast carcinomas after 3H-, 99mTc- and 64Cu-Bleomycin. J. Nucl. Med. 16, 127-131. Underwood, E. J. (1977). Truce Elements in Human and Animal Nutrition, 4th edn., pp. 56108. Academic Press, London. Wiseman, G. (1964). Copper. In: AbsorptionfLom the Intestine, Chap. 13, pp. 271-272. Academic Press, London.

Biokinetic Data

Organ (S) Total body Brain Liver Kidneys Pancreas

Fs 1.0 0.1 0.65 0.01 0.002

T 10 d 10d 0.5 d 1.5d 10d 10d 10d

a 1.0 1.0 0.15 0.33 0.52 1.0 1.0

64cu 17.4 hr 1.74 hr 9.65 hr 10.4 min 2.1 min

6Cu 2.96 d 7.10 hr 1.35 d 42.6 min 8.5 min

135

CU
29 Ion

BIOKINETIC

MODELS

AND DATA

COPPER

64c
Organ

12.701

hours per Adult unit Absorbed dose activity administered 15 year 3.8E-02 1.4E-02 1.6E-02 l.lE-01 1.6E-02 Z . ZE-02 Z.OE-02 2.3E-02 1.4E-02 7.5E-02 6.OE-01 2.4E-02 1.6E-02 6.8E-02 1.8E-02 1.9E-02 l.ZE-02 1.4E-02 1.6E-02 1.7E-02 10 year 5.7B-02 2.3E-02 2.6E-02 l.ZE-01 2.6E-02 3.7E-02 3.5E-02 4.1E-02 2,3E-02 l. lE-01 9.4E-01 3.7E-02 2,8E-02 1.3E-01 2.8E-02 3.1&02 Z . OE-02 2.3E-02 2.7E-02 2.7E-02 (mGy/MBq) 5 year 8.2E-02 4.1E-02 4. IE-02 1.3E-01 4.4E-02 6.4E-02 5.8E-02 6.7E-02 4.1E-02 1.6E-01 1.4EtOO 5.7E-02 4.6E-02 1.8E-01 4.3E-02 5.OE-02 3.4E-02 3.9E-02 4. LE-02 4.4E-02 1 year 1.4E-01 ?.7E-02 8.2E-02 1.8E-01 8.7E-02 1.3E-01 l. lE-01 1.3E-01 8.OE-02 2.8E-01 2.7EtOO l. lE-01 9.1E-02 3.6E-01 8.2E-02 9.7E-02 6.93-02 7. BE-02 9.OE-02 8.6E-02

Adrenals Bladder wall Bone surfaces Brain Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue

3.0&02 l.ZE-02 1.3E-02 l. lE-01 1.6E-02 1.9E-02 1.7E-02 Z.OE-02 l. ZE-02 6.1E-02 4.8E-01 1.8&02 1. HI-02 4.8E-02 1.5E-02 1.5E-02 l. lE-02 l.ZE-02 l. ZE-02 1.4E-02

* *

Effective dose equivalent (mSv/nBq)

5.3B-02

6.6%02

l.OE-01

1.5B-01

2.8%01

67cu
Organ *

61.86

hours Adult 15 year l.ZE-01 7.33-02 8.3E-02 5.1E-01 7.OE-02 9.1E-02 8.6E-02 9.4E-02 7.2E-02 3.2E-01 2.3B+OO 9.3E-02 7.6E-02 2.7E-01 9,2E-02 8.OE-02 6.4E-02 7.OE-02 7.5E-02 7.5E-02 10 year 1.9E-01 l.ZE-01 1.3E-01 5.3E-01 l.ZE-01 1.6E-01 1.5E-01 1.6E-01 l.ZE-01 4 *6E-01 3.6EtOO 1.5E-01 1.3E-01 5.4E-01 1.4E-01 1.4E-01 l.lE-01 l.ZE-01 1.3E-01 l. ZE-01 5 year 2.9E-01 Z.lE-01 Z.ZE-01 5.7E-01 Z .OE-01 2.6E-01 2.5E-01 2.8E-01 Z. lE-01 6.8E-01 5.4EtOO 2.4E-01 Z. ZE-01 7.1E-01 2.3E-01 2.3E-01 1.8E-01 2 .OE-01 Z.ZE-01 Z. lB-01 1 year 5.4E-01 4.2E-01 4.4E-01 8.OE-01 4.1E-01 5.lE-01 4.9E-01 5.3E-01 4.2E-01 1.2EtOO l.lE+Ol 4.7E-01 4.4E-01 1.5E+OO 4.4E-01 4.5E-01 3.8E-01 4.1E-01 4.4E-01 4.2E-01

Adrenals Bladder wall Bone surfaces Brain Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue

9.4E-02 5.6E-02 6.83-02 5.OE-01 7 .OE-02 7.3E-02 7*OE-02 7,6E-02 5.7E-02 2.6E-01 1.8EtOO 7.2E-02 6.OE-02 1.8E-01 7.5E-02 6.4E-02 5.1E-02 5.4E-02 6.1E-02 6.1E-02

* *

Effective dose equivalent (mSv/klBq)

Z . ZB-01

2.7B-01

4.1B-01

6.1B-01

1.2BtOO

136

RADIATION

DOSE TO PATIENTS

FROM RADIOPHARMACEUTICALS

ZII 30 IOIl

ZINC
62Zn 65Zn 69mZn Biokinetic Model From long-term total body retention measurements of 65Zn in humans (Richmond et al., 1962; Spencer et al., 1965; Arvidsson et al., 1978), half-times of 15 d (0.2) and 400 d (0.8) may be derived. Organ measurements from autopsies (Siegel et al., 1961; Aamodt et al., 1979; Spencer et al., 1965) suggest the following distribution pattern: liver 0.7, bone 0.05, red bone marrow 0.05, kidneys 0.05. The total body retention function given above is assumed to be applicable also to kidneys and marrow. Autopsy measurements (Siegel et al., 1961) suggest a more rapid turnover in the liver, which is described here by modified intercepts of the components of the retention function. Rather than being excreted directly, zinc leaving the liver is assumed to be distributed throughout organs and tissues other than bone, liver, kidneys and red marrow. For 62Zn, the calculation includes only 62Cu formed in uivo, but for 69mZn where pre-injection separation of the daughter (j9Zn is not possible, equilibrium at the time of injection has been assumed.

References
Aamodt, R. L., Rumble, W. F., Johnston, G. S., Foster, D. and Henkin, R. I. (1979). Zinc metabolism in humans after oral and intravenous administration of Zn-69m. Am. J. Clin. Nutr. 32, 559-569. Arvidsson, B., Cederblad, A., Bjiim-Rasmussen, E. and Sandstriim, B. (1978). A radionuclide technique for studies of zinc absorption in man. Int. J. Nucl. Med. Eiol. 5, 104-109. Richmond, C. R., Furchner, J. E., Trafton, G. A. and Langham, W. H. (1962). Comparative metabolism of radionuclides in mammals-I. Uptake and retention of orally administered Zn-65 by four mammalian species.
Health Phys. 8, 481489.

Siegel, E., Graig, F. A., Crystal, M. M. and Siegel, E. P. (1961). Distribution ofZn 65 in the prostate and other organs of man. Br. J. Cancer 15,647X%4. Spencer, H., RosolT, B., Feldstein, A., Cohn, S. H. and Gusmano, E. (1965). Metabolism ofzinc 65 in man. Radiat. Res.
24,432445.

Biokinetic Data

Organ (S) Total body Bone Liver Kidneys Red marrow

F, 1.00 0.05 0.70 0.05 0.05

T 15d 400d 400 d 15d 400d 15d 400d 15d 400d

a 0.2 0.8 1.0 0.8 0.2 0.2 0.8 0.2 0.8

Zn 13.3 hr 40 min 9.30 hr 40 min 40 min

and

%u 13.0 hr 39 min 9.13 hr 39 min 39 min

65Zn 179d lld 42 d 9.0 d 9.0d

69mZn(= 6gZn) 19.7 hr 1.00 hr 13.8 hr 59 min 59 min

137

Zn

BIOKINETIC

MODELS

AND DATA

30
IOIl

ZINC 6%
9.26 hours Absorbeddose per unit activityadministered (mGy/MBq) Organ Adult * Adrenals Bladderwall Bone surfaces Breast GI-tract Stomachwall Small intest * ULI wall LLI wall * Kidneys * Liver
* Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue Effective dose equivalent Wv/lIBq)

15 year 2.5E-01 5.3E-02 4.3E-01 ?.3E-02 l.lE-01 l.OE-01 1.3E-01 6.OE-02 2.3E+OO 5.8E+OO 1.3E-01 7.1E-02 Z.lE-01

10 year 3.7E-01 9.28-02 7.2E-01 1.3%01

5 year

1 year

1.9E-01 4.58-02 1.8E-01 7.4E-02 9.1E-02 8.73-02 l.lE-01 S.lE-02 1.8E+OO 4.5E+OO l.OE-01 4.8E-02 1.7E-01 3.5E-01 7.73-02 3.8E-02 3.93-02 5.OE-02 6.7E-02 4.9E-01

5.2E-01 8.3E-01 1.6E-01 3.OE-01 1.3E+OO 2.9E+OO Z.OE-01 3.9E-01

2.0%01 3.4E-01 7.2E-01 1.8E-01 3.OE-01 5.5E-01 2.3E-01 3.6E-01 7.1E-01 l.OE-01 1.7E-01 3.2E-01 3.3E+OO 4.9E+OO 8.9E+OO 9.OE+OO 1.3E+Ol 2.6E+Ol Z.OE-01 2.9E-01 5.4E-01 1.2E-01 2.OE-01 3.9E-01 3.5E-01 5.4E-01 9.3E-01 4.5E+OO 4.8E-01 2.4E-01 2.7E-01 3.7E-01 3.7E-01

6.6E-01 l.lE+OO 2.2E+OO l.OE-01 1.7E-01 2.6E-01 4.3E-02 7.2E-02 l.ZE-01 5.OE-02 8.2E-02 1.4E-01 6.93-02 l.ZE-01 Z.OE-01 8.OE-02 1.2E-01 1.9E-01 6.6E-01

l.OB+OO 1.6E+OO 3.1B+oo

equivalent (mSv/MBq of the impurity) 62Cu (9.74 min) 4.33-03 5.53-03 8.73-03 1.3E-02 2.6E-02

138

RADIATION

DOSE TO PATIENTS FROM RADIOPHARMACEUTICALS

Zn
30 Ion

ZINC

65Z
Organ

243.9

days per Adult unit Absorbed dose activity administered 15 year 1.7E+Ol 6.7E+OO 1.2E+Ol 6.4EtOO l.OE+Ol 1. lEt01 1. lE+Ol 7.6E+OO 3.4E+Ol 4.2E+Ol 9.9E+OO 9.3E+OO 1.5E+Ol 10 year 2.6E+Ol l.OE+Ol 1. EE+Ol 9.6E+OO 1.5E;Ol 1.7E+Ol 1.8E+Ol 1.2E+Ol 4.8E+Ol 6.OE+Ol 1.4E+Ol 1.4E+Ol 2.3E+Ol 1.6E+Ol 1.6E+Ol 8.6E+OO l.lE+Ol 1.4E+Ol 5 (mGy/MBq)

year

1 year 6.OE+Ol 2.8E+Ol 5.8E+Ol 2.6E+Ol 4.4E+Ol 4.4E+Ol 4.6E+Ol 3.OE+Ol l.lE+OZ 1.4E+02 3.7E+Ol 3.7E+Ol 5.9E+Ol
3.9E+Ol 4.1E+Ol 2.3E+Ol 2.9E+Ol 3.6E+Ol 3.1E+Ol

* * *

Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue

1.5EtOl 6.8E+OO 7 * 2E+OO 6.4E+OO 8 .OE+OO 0,8E+OO 9.1E+OO 7,3E+OO 2.9E+Ol 3.5E+Ol 7.5E+OO 6.5E+OO l.lE+Ol 9.1EtOO 8.6E+OO 5.9E+OO 5.4E+OO 8.1EtOO 6.5E+OO

3.6E+Ol 1. BE+01
2.9E+Ol 1.5E+Ol 2,5E+Ol 2.5E+Ol 2.8E+Ol 1.9E+Ol 6.7E+Ol 8.3E+Ol 2.1E+Ol 2.1E+Ol 3.5E+Ol 2.3E+Ol 2.4E+Ol 1.3E+Ol 1.7E+Ol 2.1E+Ol 1.7E+Ol

1.lE+Ol 1. lE+Ol
5.9E+OO 6.7EtOO 9.OE+OO 7.7E+OO

1.lE+Ol

Effective dose equivalent

1. lB+Ol

1.3B+Ol 1.9B+Ol

2. EB+Ol

4.8B+Ol

(aSv/M)

69mZ
Organ

13.76

hours per Adult unit Absorbed dose activity administered 15 year l. lE-01 2.2E-02 1.6E-01 3.OE-02 5.OE-02 4.5E-02 5.5E-02 2.5E-02 8.6E-01 2.2E+OO 5. iE-02 3.OE-02 9.4E-02 2,5E-01 4.4E-02 1.7E-02 2.OE-02 2.98-02 3.4E-02 10 year 1.6E-01 3. BE-02 2.6E-01 5.3E-02 8.7E-02 7,7E-02 9. EE-02 4.1E-02 1.2E+OO 3.4E+OO 8.3E-02 5.2E-02 1.5E-01 4.2E-01 7.1E-02 2.9E-02 3,3E-02 4. EE-02 5.2E-02 (mGy/MBq) 5 year 2.2E-01 6.7E-02 4.7E-01 8.4E-02 1.5E-01 1.3E-01 1.6E-01 7.OE-02 l.EE+OO 5.1E+OO 1.3E-01 0.4E-02 2.3E-01 8.OE-01 l.lE-01 4. EE-02 5.6E-02 8.2E-02 E. lE-02 1 year 3.5E-01 1.2E-01 1 .OE+OO 1.6E-01 3.OE-01 2.3E-01 3.OE-01 1.3E-01 3.3E+OO 9.9E+OO 2.3E-01 1.6E-01 4.OE-01 1.7E+OO 2.OE-01 9.6E-02 l. lE-01 1.6E-01 1.5E-01

* * *

Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other Effective tissue

8.3E-02 1. &3E-02 4.4E-01 3.OE-02 3.9E-02 3.7E-02 4.73-02 2.1E-02 6.9E-01 1.7E+OO 4.2E-02 2.OE-02 7.3E-02 1.8E-01 3.2E-02 1.5E-02 1.6E-02 2.1E-02 2. .SE-02

dose equivalent (mSv/Ml3q)

2.1B-01

2.5E-01

3.9E-01

6.11-01

1 .ZE+OO

139

RADIATION

DOSE TO PATIENTS

FROM RADIOPHARMACEUTICALS

Ga 31 citrate

GALLIUM CITRATE
@jGa jGa 6sGa 72Ga Biokinetic Model The biokinetic model given in MIRD Dose Estimate Report No. 2 (1973), which is based on human data, is adopted here without change. For details, the reader is referred to that publication. In children the bone uptake is predominantly in the metaphyseal growth zones: this is discussed in Section 4 of General Considerations. The activity excreted via faeces (0.09) is assumed to have entered the bowel in the small intestine. The mean residence times in the gut are those of the standard GI-tract model (see Appendix Section A.3). Reference
MIRD Dose Estimate Report No. 2. (1973). Summary of current radiation dose estimates to humans from 66 Ga-, 67 Ga-, 68 Ga- and 72 Ga-citrate. J. Nucl. Med. 14, 755-756.

Biokinetie Data

Organ (S)

Fs

T 1.25 d 25.5 d 1.25 d 25.5 d 1.25 d 25.5 d

a 0.17 0.83 0.17 0.83 0.17 0.83

66Ga 12.8 hr

67Ga
3.69 d

68Ga 1.63 hr

Ga 18.9 hr

1.0 Total body (excluding GIT and bladder contents) 0.0@053 Adrenals Bone GI-tract contents SI ULI LLI Kidneys Liver Red marrow Spleen Bladder contents 0.13

24.6 s 1.67 hr

2.8 min 11.5 hr

3.1 s 12.7 min

36 s 2.45 hr

0.09 0.09 0.09 0.0084 0.050 0.054 0.0074 0.91

1.25 d 25.5 d 1.25 d 25.5 d 1.25 d 25.5 d 1.25 d 25.5 d

0.17 0.83 0.17 0.83 0.17 0.83 0.17 0.83

16.7 min 27.7 min 18.5 min 6.5 min 38.5 min 41.6 min 5.7 min 4.9 min

20.9 min 1.01 hr 1.54 hr 44.6 min 4.42 hr 4.78 hr 39.3 min 20.8 min

6.2 min 2.3 min 16s 49 s 4.9 min 5.3 min 43 s

29.5 s

18.1 min 35.8 min 30.4 min 9.5 min 56.6 min

1.02hr
8.4 min 6.9 min

141

Ga 31 Citrate

BIOKINETIC MODELS AND DATA

GALLIUM CITRATE
66GS 9.4 hours per Organ Adult * Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI vall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other Effective tissue 4.x-01 3. OE-OI 3. SE-01 1.7%01 1.8E-01 3.2E-01 8.3E-01 8.7E-01 3.2E-01 3.4B-01 1.6E-01 2.3E-01 Z.OE-01 4.6E-01 4 *3%01 1.7%01 1.6E-01 Z. lE-01 1.7E-01 15 year S.lE-01 3. SE-01 5 *6E-01 1.7%01 Z.ZE-01 4.OE-01 1. DE+00 l.OE+OO 3.9E-01 4.2E-01 Z.OE-01 Z.BE-01 2.4E-01 7.1E-01 5.9E-01 1.9E-01 Z .OE-01 2.5E-01 Z .OE-01 10 year 7.5E-01 5.4%01 9.1%01 2.8%01 3.4E-01 6.7E-01 1.7E+OO 1.8E+OO 5.6E-01 6.3E-01 3.2E-01 4.3E-01 3.8E-01 l.ZE+OO 9.2&01 3.OE-01 3.2E-01 4,OE-01 3.2&01 5 year 1 year 1.6E+OO 1.6E+OO 3.5E+OO 8.7E-01 unit Absorbed dose activity administered (mGy/MBq)

1. OE+OO 8.8E-01 1.6E+OO 4.5E-01

5.6E-01

* * *

1. lE+OO
2.9E+OO 2.9E+OO 8.2E-01 9.4E-01 S.OE-01 6.7B-01 5.9E-01 2.3E+OO 1.4B+00 4.9E-01 5.2E-01 6.2E-01 5.lE-01

1.OE+OO
Z.OE+OO 5.6E+OO 5.7E+OO 1.5E+OO 1.8E+OO 9.7E-01 1. ZE+OO

1. lB+OO
4.8E+OO 2.7E+OO 9.4E-01 9.9E-01 1.ZE+OO 9.8E-01

dose equivalent (=Bv/lras)

3.4B-01

4.3B-01

7.OB-01

1.ZB+OO

2.33+00

67Ga

78.26

hours

Organ Adult * Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue 1.4B-01 8.1E-02 5.9E-01 6.2E-02 7.2E-02 5.9E-02 l.ZE-01 Z . OE-01 l. lE-01 l . ZE-01 6.5&02 8,2E-02 8.3E-02 1.9E-01 1. SE-01 5.7&02 5.6E-02 7.9E-02 6.3E-02 15 year 1.8E-01 l.lE-01 8.7E-01 6.2E-02 8.9E-02 6.93-02 1.5E-01 2.7E-01 1.4E-01 1.6E-01 8.2E-02 l .OB-01 l .OE-01 2.5E-01 Z.OE-01 7 .OE-02 7,8E-02 9.6E-02 7.5E-02 10 year 2.6E-01 1.6E-01 1.4E+OO 9.5E-02 1.4E-01 l. lE-01 2.5E-01 4.5E-01 Z.OE-01 2.3E-01 l . ZE-01 1.6E-01 1.6E-01 4.OE-01 3.1E-01 l. lE-01 1.3E-01 1.5E-01 l.ZE-01 5 year 3.6E-01 2.3E-01 2.4E+OO 1.5E-01 Z. lE-01 1.6E-01 4.1E-01 7.2E-01 2.9E-01 3.3E-01 1.9E-01 2.4E-01 2.4E-01 7.4E-01 4.8E-01 1.7E-01 Z.OE-01 2.3E-01 1.8R-01 1 year 5.7E-01 4.3E-01 5.6E+OO 2.9E-01 3.8E-01 2.7E-01 7.5E-01 1.4E+OO 5.1E-01 6.1E-01 3.6E-01 4.4E-01 4.3E-01 1.5E+OO 8.7E-01 3.3B-01 3.7E-01 4.1B-01 3.5E-01

* * *

Bffective dose equivalent Wv/nes)

l . ZB-01 1.6B-01

2.5B-01

4.OB-01

7.9B-01

142

RADIATION

DOSE TO PATIENTS FROM RADIOPHARMACEUTICALS

Ga 31 Citrate

GALLIUM
68Gi3
Organ Adult * Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue 3.4E-02 1.4E-02 3.7%02 1.4E-02 1.4E-02 6.43-02 5.3E-02 1.8E-02 2.6E-02 2.7E-02 1,3E-02 1.5E-02 1.4E-02 4.6&02 3.6E-02 1.3E-02 1.2E-02 1.5E-02 1,3E-02 68.0 minutes per unit

CITRATE
(mGy/MBq) 5 year 8.8%02 4.4E-02 1,4E-01 3.7E-02 4.4E-02 2.3E-01 1. BE-01 5.9E-02 6. BE-02 7.9E-02 4.1E-02 5.1E-02 4.7E-02 2.1E-01 1.3E-01 3.9E-02 4.2E-02 5.OE-02 4,lE-02 1 year 1.4E-01 8.1E-02 3.x3-01 7.4E-02 8.4E-02 4.5E-01 3.6E-01 l. lE-01 1.2%01 1.5&-01 8.OE-02 9.6E-02 8.9E-02 4.5E-01 2.4E-01 7.7E-02 8.1E-02 9.4%02 8.OE-02

Absorbed dose activity administered 15 year 4.4E-02 l.bE-02 4.8E-02 1.4E-02 1.7E-02 8.0%02 6.4E-02 2.2E-02 3.2E-02 3.5E-02 1.6E-02 2.OE-02 1.8E-02 6.4E-02 5.1%02 1.5E-02 1.5E-02 1.9B-02 1.5E-02 10 year 6.4E-02 2.6E-02 8.OE-02 2.3E-02 2.7E-02 1.4%01 l. lE-01 3.63-02 4.6E-02 5.3E-02 2.5E-02 3.2E-02 2.9E-02 1.1%01 8.OE-02 2.4E-02 2.5E-02 3.1E-02 2,5E-02

* *

Effective dose equivalent WV/W)

2.7E-02

3.4E-02

5.6B-02

9.51-02

1.9g-01

72Ga

14.1

hours

Organ Adult * Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue 4.2E-01 2.3E-01 3.5E-01 2.OE-01 2.2E-01 3.3E-01 7.2E-01 8.7E-01 3.5E-01 3.6E-01 1.9E-01 2.9E-01 2.7E-01 4.5E-01 4.3E-01 2.1E-01 1.98-01 2.6E-01 2.OE-01 15 year 5.3E-01 2.5E-01 5.2E-01 2 .OE-01 2.8E-01 4.OE-01 8.7E-01 1. OE+OO 4.2&01 4.6E-01 2.4E-01 3.613-01 3.1E-01 6.6E-01 5.9E-01 2.2E-01 2.4E-01 3.1B-01 2.4E-01 10 year 7.6E-01 4.OE-01 8.3E-01 3.1E-01 4.1E-01 6.4E-01 1.5E+OO 1.7E+OO 6.1E-01 6.8%01 3.7E-01 5.5E-01 4.7E-01 5 year l.lE+OO 6.8E-01 1.4E+OO 4,9E-01 6.7E-01 9.8E-01 2.4E+OO 2.8E+OO 8.9E-01 1.OE+OO 5.8E-01 8.4E-01 7.2E-01 2.OB+OO 1.4E+OO 5.5E-01 6.OE-01 7.5E-01 5.8E-01 1 year 1.78+00

1.lE+OO
3.OE+OO 9.2E-01 1.2E+OO 1.8E+OO 4.4E+OO 5.4E+OO 1.5E+OO 1.8E+OO

* * *

1. lE+OO
1.5E+OO 1.3E+OO 4.OE+OO 2.5E+OO

1. lE+OO
9.1E-01 3.5E-01 3.8E-01 4.9E-01 3.7E-01

1. OE+OO 1.lE+OO
1.4E+OO

1.lE+OO
2.1&00

Effective dose equivalent (=8v/nBq)

3. SE-01

4.4B-01

7.OE-01

l.lB+OO

143

RADIATION

DOSE TO PATIENTS

FROM RADIOPHARMACEUTICALS

AS 33 Arsenate/Arscnite

ARSENATE, ARSENITE
=As 14As 16As Biokinetic Model The biokinetic data tabulated below are derived from the model and data given in ICRP

Publication 30 (ICRP, 1981). Excretion is assumed to be solely via the renal system.
Reference
ICRP (1981). Limitsfor Intakes of Radionuciides by Workers, ICRP Publication 30: Part 3. Pergamon, Oxford. Mealey, J. Jr, Brownell, G. L. and Sweet, W. H. (1959). Radioarsenic in plasma, urine, normal tissues and intracranial neoplasms. Distribution and turnover after intravenous infection in man. Arch. Neural. Psychiat. 81, 310-320.

Biokinetic Data

ASIA0
Organ (S) Total body (excluding bladder contents) Kidneys Liver Spleen Bladder contents 1.o T 0.5 hr Id 10 d 1d 10 d ld 10 d Id 10d a 0.35 0.28 0.37 0.4 0.6 0.4 0.6 0.4 0.6 AS 17.8 hr 14As 3.81 d 76As 18.0 hr

0.015 0.07 0.005 1.0

21 min 1.93 hr 8.3 min 1.25 hr

2.26 hr 10.2 hr 44 min 1.87 hr

28 min 1.94 hr 8.3 min 1.25 hr

ARSENATE, ARSENITE 72tIs

Organ Adult * * Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue 3.OE-01 2.3E+OO 2.2E-01 2.5E-01 2.5%01 2.6E-01 2.7E-01 2.?E-01 1 . lE+OO 8.7E-01 2.3E-01 2.5E-01 2.7E-01 2.4E-01 6. HI-01 2.6E-01 2.2E-01 3.1&01 2.3E-01 4.8B-01 15 year 3.4B-01 2.9E+OO 2.7E-01 2.5E-01 3.OE-01 3.2%01 3.2E-01 3.15-01 1.3E+OO 1. lE+OO 2.8E-01 3.3E-01 3.4E-01 2.9B-01 8.68-01 2.9E-01 2.7E-01 3.7E-01 2. EE-01 5.9B-01 10 year 5.4E-01 4.4B+OO 4.3E-01 4.OE-01 4.8E-01 5.2E-01 5.1E-01 5.1E-01 1.9E+OO 1.7E+OO 4.5E-01 5.4E-01 5. SE-01 4.5E-01 1.3E+OO 4.7E-01 4.5E-01 6.1E-01 4.5E-01 9.28-01 5 year 8.5E-01 6.9g400 6.9E-01 6.5E-01 7.8E-01 8.4E-01 8.3E-01 8_2E-01 2. BE+00 2. SE+00 7.3B-01 8.58-01 8.7E-01 7.1801 2.1E+OO 7.6E-01 7.4B-01 9.68-01 7.3E-01 1. bE+OO 1 year 1.6E+OO 1.3E+Ol 1.4E+OO 1.3E+OO 1.5B+OO 1. bE+OO 1.6E+OO 1.5E+OO 5.1B+OO 4,9E+OO 1.4E+OO 1.6B+OO 1.7B+OO 1.4B+OO 3.98*00 1.5E+OO 1.4E+OO l.EE+OO 1.4E+OO 2.7E+oO 26.0 hours per unit Absorbed dose activity administered (mGy/MBq)

* *

Bffective dose equivalent (mSv/Iwq)

145

AS

BIOKINETIC MODELS AND DATA

33

Arsenate/Arsenite

ARSENATE, 74As
Organ Adult * Adrenals * Bladderwall Bone surfaces Breast GI-tract Stomachwall Small intest ULI wall LLI wall * Kidneys * Liver Lungs Ovaries Pancreas * Red marrow Spleen Testes Thyroid Uterus Other tissue Effective dose equivalent (mSw/lras) 5.5%01 l.ZE+OO 3.7E-01 4.0%01 4.4E-01 4.5E-01 4.6B-01 4.4E-01 1.6E+OO 1.4E+OO 4.OE-01 4.OE-01 4.8E-01 4.OE-01 9.8E-01 4.2E-01 3.6E-01 4.5E-01 3.8E-01 6.38-01

ARSENITE

17.76 days
Absorbeddose per unit activityadministered (mGy/MBq) 15 year b.lE-01 1.5E+OO 4.4E-01 4.OE-01 5.2E-01 5.5E-01 5.4E-01 4.9E-01 2.OE+OO l.BE+OO 4.9E-01 5.4E-01 6.2E-01 4.8E-01 1.4E+OO 4.4E-01 4.6E-01 5.7E-01 4.5%01 7.6&01 10 year 9.6%01 2.2E+OO 7.OE-01 6.3E-01 8.1&01 E.EE-01 8.5E-01 8.OE-01 5 year 1.5EtOO 3.6EtOO l.lEtOO l.OEtOO 1.3EtOO 1.4EtOO 1.4EtOO 1.3EtOO 1 year 2.7EtOO 6.5EtOO 2.1EtOO 2.OEtOO 2.5EtOO 2.6E+OO 2.6E+OO 2.3EtOO 7.3EtOO 7.6EtOO 2.3E+OO 2.5EtOO 2.8EtOO

2.8E+OO 4.1EtOO 2.7E+OO 4.OEtOO 7.6E-01 1.2EtOO 8.6E-01 1.4EtOO 9.8E-01 l.SE+OO

7.5E-01 1.2E+OO 2.1E+OO 2.1EtOO 3.3E+OO 6.OEtOO 7.1E-01 l.lEtOO 2.2B+OO 7.5E-01 1.2EtOO 2.3EtOO 9.1E-01 1.4EtOO 2.7EtOO 7.2%01 1.2E+OO 2.2EtOO 1.2Etoo l.EE+oO 3.4E+Oo

76As

26.32 hours

Organ Adult * Adrenals * Bladderwall Bone surfaces Breast GI-tract Stomachwall Small intest ULI wall LLI wall * Kidneys * Liver Lungs Ovaries Pancreas Red marrow * Spleen Testes Thyroid Uterus Other tissue Effective dose equivalent Wv/llBq) 1.8E-01 2.1B+OO 1.6E-01 1.9E-01 1.7E-01 1.7E-01 1.7E-01 1.7E-01 9.6E-01 7.2E-01 1.6E-01 1.7E-01 1.7E-01 1.7E-01 5.1E-01 1.7E-01 1.6E-01 l.BE-01 1.6E-01 3.9E-01 15 year 2.1E-01 2.6EtOO 2.OE-01 1.9E-01 10 year 3.6E-01 4.OEtOO 3.3%01 3.2B-01 5 year 5.9E-01 6.4E+OO 5.5&01 5.4E-01 5.7%01 5.9E-01 5.9&01 5.8B-01 1 year 1.2EtOO 1.2E+Ol l.lEtOO l.lEtOO l.lEtOO 1.2EtOO 1.2EtOO 1.2BtOO

2.1E-01 3.4E-01 2.1E-01 3.5&01 2.1E-01 3.5E-01 2.1E-01 3.5E-01 1.2E+OO 9.3E-01 2.OE-01 2.1E-01 2.2E-01 2.OE-01 7.4E-01 2.OE-01 2.OE-01 2.2E-01 2.OE-01 4.8E-01 1.7EtOO 1.4E+OO 3.4E-01 3.6E-01 3.6&01 3.4E-01 1.2EtOO 3.4E-01 3.4%01 3.8E-01 3.4E-01 7.68-01

2.6EtOO 4.7E+OO 2.2EtOO 4.3E+OO 5.6E-01 l.lE+OO 5.9E-01 1.2E+OO 5.9E-01 1.2EtOO 5.6E-01 l.lEtOO 1.9EtOO 3.5EtOO 5.78-01 l.lEtOO 5.6E-01 l.lEtOO 6.2E-01 1.2EtOO 5.6E-01 l.lEtOO 1.23+00
2.4E+OO

146

RADIATION

DOSE TO PATIENTS

FROM RADIOPHARMACEUTICALS

se
34 sdenite

SELENITE
%e Biokinetic Model The biokinetic model from Jereb et af. (1975) is adopted here. It is based on total body, profile and excretion measurements in 26 humans up to 517 d after administration and on two autopsies 1 and 416 d after administration. Reference
Jereb, M., Falk, R., Jereb, B. and Lindh6, C. (1975). Radiation dose to the human body from intravenously administered sSe sodium selenite. J. Nucl. Med. 16. 846850.

Biokinetic Data
Organ (S) Total body Fs 1.0 T Id 20 d 115 d Id 20d 115d Id 20 d 115 d Id 20 d 115d Id 20d 115d Id 20 d 115d a 0.12 0.40 0.48 0.12 0.40 0.48 0.12 0.40 0.48 0.12 0.40 0.48 0.12 0.40 0.48 0.12 0.40 0.48 &IA, 50.7 d

Kidneys

0.12

6.08 d

Liver

0.28

14.12 d

Lungs

0.07

3.55 d

Red marrow

0.12

6.08 d

Testes

0.0006

44 min

147

se
34 Selenite

BIOKINETIC MODELS AND DATA

SELENITE
75Se 119.8 days

per Organ Adult * Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue 3.8EtOO 1. OEtOO

unit

Absorbed dose activity administered 10 year 7.2E+OO 2.1EtOO 3.9E+OO 2.1E+OO 3.9E+OO 3.8E+OO 4.OE+OO 2.5E+OO 2.5E+Ol 1.8E+Ol 6.4EtOO 2.9E+OO 6.2E+OO 6.OE+OO 4.5E+OO 6.6E+OO 1.9E+OO 2.7E+OO 2.3E+OO 5 year

(mGy/MBq) 1 year 1.6E+Ol 5.5E+OO 1.2E+Ol 5.6E+OO 9.9E+OO 9.5EtOO 6.3EtOO 5.8E+Ol 4.2E+Ol 1.7EtOl 7.3E+OO 1.5E+Ol 1.6E+Ol

15 year 5.OE+OO 1.4E+OO 2,6E+OO 1.3E+OO 2.4E+OO 2.4E+OO 2.6E+OO 1.6E+OO 1.8E+Ol 1.3E+Ol 4.7E+OO 1.9E+OO 4.1E+OO 4.3E+OO 2.9EtOO 1.6E+OO l.ZE+OO 1.7E+OO 1.6E+OO

1.OE+Ol
3.3E+OO 6.2E+OO 3,2E+OO 5.9E+OO 5.7E+OO 6.4E+OO 3.7E+OO 3.5E+Ol 2.5E+Ol 9.4EtOO 4.3E+OO 9,lEtOO 9.OE+OO 6.6E+OO 8.OE+OO 3.OE+OO 4.1E+OO 3.5E+OO

2. lE+OO
1,3E+OO 2 . OE+OO Z.OE+OO 2. lE+OO 1.3E+OO 1.5E+Ol l.OE+Ol 3,3E+OO 1.4E+OO 3.1EtOO 3.5E+OO 2.3E+OO 9.8E-01 8.OE-01 1,4E+OO 1.3E+OO

1. lE+Ol

* *

* *

1. lE+Ol
1. lE+Ol 5.3E+OO 6.9E+OO 6.2E+OO

Effective dose equivalent WV/_)

3. SE+00

4.4E+Oa

6.8E+OO

9.6E+oO

1.6B+Ol

148

RADIATION

DOSE TO PATIENTS FROM RADIOPHARMACEUTICALS

se
34 Selencmethionine

l-SELENOMETHIONINE
%e

Biokinetic Model The selenomethionine study by Lathrop et al. (1972) represents a very detailed investigation of the biokinetic behaviour of this radiopharmaceutical. The total body retention was measured in 24 patients up to 923 d after administration, and autopsies and biopsies of 22 patients, at up to 361 d after administration, were evaluated. The biokinetic data derived from that study are adopted here without change. For details, the reader is referred to the original publication. References
Lathrop, K. A., Johnston, R. E., Blau, M. and Rothschild, E. 0. (1972). Radiation dose to humans from 75Se-L-selenomethionine: MIRD Pamphlet No. 9. J. Nucl. Med., Suppl. 6.

Biokinetic Data
Organ (S) Total body 1.0 T
0.55 d

a 0.14 0.44 0.42 0.26 0.70 0.040 0.38 0.58 0.041 0.11 0.81 0.076 0.82 0.18 0.87 0.098 0.032 0.33 0.64 0.033 0.82 0.18 0.61 0.39

As/A, 68.2 d

Kidneys

0.039

Liver

0.24

Lungs

0.036

Ovaries Pancreas

0.00022 0.0069

0.0145

Testes Thyroid

0.00092 0.00066

2% 0.55 d 46 d 220 d 0.55 d 46 d 220 d 0.55 d 46d 220 d 46 d 220 d 0.55 d 46 d 220 d 0.55 d 46 d 220 d 46 d 220 d 46 d 220 d

1.45 d

7.82 d

1.70 d

18.8 min 1.47 hr

12.0 hr 1.31 hr 1.15 hr

149

se
34

BIOKINETIC MODELS AND DATA

Selenomethionine

I-SELENOMETHIONINE

75s

119.8

days

per Organ Adult * Adrenals Bladder wall Bone surfaces Breast GX-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Snleen Tktes Thyroid Uterus Other tissue

unit

Absorbed dose activity administered 15

(mGy/MBq) 5 year 8.6E+OO 6.38+00 6.OEtOO 4.4E+OO 7.3E+OO 7.7EtOO E.OE+OO 6.6EtOO 1.3E+Ol 1.5E+Ol 7.3E+OO 8.7E+OO 9.OE+OO 6.5E+OO l.lEtOl 1.5E+Ol 1 .OE+Ol 7.38+00 5.3EtOO 1 year 1.5E+Ol l.lE+Ol 1. lE+Ol 7.9E+OO 1.2E+Ol 1.3E+Ol 1.3E+Ol 1.2E+Ol 2.1EtOl 2.7E+Ol 1.3E+Ol 1.6E+Ol 1.6E+Ol l.lE+Ol 1.9E+Ol 2.1BtOl 1 .EEtOl 1.3EtOl 9.6.8+00

year

10 year 6.OE+OO 4.3E+OO 4.1E+OO 2. EE+OO 5.1E+OO 5.1E+OO 5.OE+OO 4.6EtOO 8.9E+OO l.lE+Ol 5 .OE+OO 5.6E+OO 6.48+00 4 * 7E+OO 7.48+00 1,2E+Ol 5.6E+OO 4.8E+OO 3.5EtOO

3.3E+OO 2.3E+OO 2.4E+OO 2.OE+OO 2.7E+OO 2.8E+OO 2.7E+OO 2.3E+OO 5.3B+OO 6.2E+OO 2.7B+OO 2.6B+OO 3.2E+OO 2.8E+OO 3.9E+OO 2.OE+OO 2.3B+OO 2.6E+OO 2.OE+OO 3.OB+OO

4.1E+OO
3.OE+OO 2. EE+OO 1.9E+OO 3.28+00 3.3E+OO 3.4E400 2.9E+OO 6.3E+OO 7.8E+OO 3.6E+OO 3.4E+OO 4.1E+OO 3.4E+OO 5.1EtOO 3.2E+OO 3.78+00 3.2E+OO 2.4E+OO

* *

* *

Effective dose equivalent

3.8B+OU

6.5B+UO

9.2E+oO

1.5B+Ol

Wv/W)

150

RADIATION DOSE TO PATIENTS FROM RADIOPHARMACEUTICALS

se
34

Cholesterol

SELENOMETHYLCHOLESTEROL
15Se

Biokinetic Model Selenomethylcholesterol, labelled with 75Se (Scintadren, 6-[75Se]-methyl-selenomethyl19-nor-cholest-5(10)-en-3/3-01) is a gamma-emitting analogue of cholesterol, having similar biokinetics and being used for investigation of disorders of steroid hormone metabolism, especially in adrenal disease. The uptake in normal adrenal glands is reported as about 0.002 per gland, with a range of 2-10 times higher values in various adrenal diseases (Montz et al., 1978; Hawkins et al., 1980). Uptake and elimination half-times of 1 d and 30 d, respectively, are assumed here. A considerable uptake in the liver has been observed. Combined data from measurements in animals and patients suggest an initial uptake of 0.5,70% of which is rapidly cleared to other parts of the body. The rest is eliminated with half-times of 5 d (0.25) and 30 d (0.05), preferentially by excretion via the gastrointestinal tract. Total body retention measurements were performed in a normal volunteer by Hawkins et al. (1980) and in three patients by Deckart et al. (1984). The data may be described by half-times of 5 d (0.5), 30 d (0.25) and 280 d (0.25). References
Deckart, H., Ertl, S., Blottner, A., Tautz, M. and Weiss, J. L. (1984). Retention und Strahlenbelastung nach intravenBser Injektion von Scintadren. In: Radioaktive Isotope in Klinik und Forschung, Vol. 16:2, pp. 663480. (Hiifer, R. Z. and Bergmann, H. eds) Egermann, Wien. Hawkins, L. A., B&ton, K. E. and Shapiro, B. (1980). Selenium 75 selenomethyl-cholesterol: A new agent for quantitative functional scintigraphy of the adrenals: Physical aspects. Br. J. Radial. 53, 883-889. Montz, R., Hagemann, J. and Mischke, W. (1978). 75-Se-6-Norcholesterol zur Nebennieren-Szintigraphie. In: Nuklearmedizin und Biokybernetik, Vol. II, pp. 231-234. (Oeff, K. and Schmidt, H. A. E. eds) MedicoInformationsdienste, Berlin.

Biokinetic Data
Organ (S) Total body Fs 1.0 T 5d 30 d 280 d Id 30 d 6 hr 5d 30d a
0.50

&IA, 42.4 d

Adrenals Liver

0.004 0.5

0.25 0.25 - -1.0 1.0 0.70 0.25 0.05

3.30 hr 1.86 d

151

Se
34 Cholesterol

BIOKINETIC MODELS AND DATA

SELENOMETHYLCHOLESTEROL
%e 119.8 days

per Organ Adult * Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue 5.1E+OO 1.6E+OO 1.6E+OO 1.2E+OO 1.6E+OO 1.8B+OO 1.7E+OO 1.6E+OO 1.6E+OO 2.OB+OO 1.4B+OO 1.6E+OO 1.8E+OO 1.8E+OO 1.6E+OO 1.2E+OO

unit

Absorbed dose activity adminiaeered 15 year 6.7EtOO 2.1E+OO 1.8EtOO 1.2E+OO 1.9E+OO 2.1EtOO 2.1EtOO 2 .OEtOO 1.9EtOO 2.6EtOO 1.7B+OO 2.1EtOO 2. x+00 2.1EtOO 1.9E+OO 1.5BtOO 1.7EtOO 2.1EtOO 1*5E+OO 10 year 9.4E+OO 2.9EtOO 2. n+oo 1.6E+OO 3.OE+OO 3.2EtOO 3.OE+OO 3.1E+OO 2,8E+OO 3.6EtOO 2. %+OO 3.2E+OO 3.4E+OO 3. OEtOO 2.8EtOO 2.1E+OO 2.7B+OO 3.2E+OO 2.2E+OO

(mGy/HBq) 5 year 1.3E+Ol 4.2B+OO 3.9EtOO 2.6E+OO 4.3E+OO 4.8E+OO 4.8BtOO 4.4BtOO 4.2EtOO 5,lEtOO 3.7EtOO 4.7EtOO 4.9E+OO 4.2B+OO 4.2B+OO 3.3EtOO 4.3EtOO 4.8EtOO 3.4E+OO 1 year 2.OE+Ol 7.1E+OO 7 .OE+OO 4.7E+OO 7.1EtOO 8.2BtOO 7.7BtOO 7.9E+OO 7.4EtOO 8.8EtOO 6.6E+OO 8.2E+OO 8.SEtOO 7.OE+OO 7.3EtOO 5.8E+OO 7. SE+00 8.2EtOO 6.2E+OO

* *

1. lE+OO
1.8EtOO 1.3EtOO

Bffective dose equivalent (=Sv/llBq)

l-73+00

2.18+00

3.1BtoO

4.5BtOO

7.7B+O0

152

RADIATION

DOSE TO PATIENTS

FROM RADIOPHARMACEUTICALS

Se 34 SeHCAT

SELENIUM-LABELLFD_BILE ACID (SeHCAT)

Biokinetic Model

Tauroselcholic acid (SeHCAT) is a bile acid analogue used to study various aspects of the enterohepatic circulation. Following oral administration, in normal humans, approximately 95% of the bile acid is absorbed (Heaton, 1976), mainly by the terminal ileum, during each enterohepatic cycle and is almost entirely confined to the lumen of the biliary ducts, gut and the liver (Nyhlin et dl., 1983). SeHCAT first appears in the gall bladder on average 73 min after oral administration (Jazrawi et al., 1984) and the substance undergoes an enterohepatic circulation roughly five times each day (Merrick et al., 1985). The distribution of the bile acid pool in the fasting state and postprandially was measured by Jazrawi et al. (1984), and on average was 30, 62 and 8% in gall-bladder, small intestine and liver, respectively. Whole-body retention data from normal subjects (Nyhlin et al., 1983) showed that 97 to 100% of the bile acid was excreted with a half time of 2.6 d and that, in most cases, a small component of about 3% was slowly eliminated with a mean half-time of 62 d. Based on the above data, the biokinetic model for the normal case assumes that a fraction (0.97) of orally administered ?$eHCAT circulates within the enterohepatic system and that a fraction (0.95) of this is absorbed by the terminal ileum during each cycle. The mean transit time through the small intestine prior to absorption is assumed to be 3 hr and, on the basis of bile acid pool distribution, the transit times through liver and gall-bladder are 0.4 and 1.4 hr respectively. These conditions lead to a total body retention half-time of 2.7 d. The small fraction of the substance transferred to the large intestine on each cycle is excreted according to the GI-tract model. The residual fraction (0.03) of the administered substance is assumed to be uniformly distributed in the total body and retained with a half-time of 62 d. In most clinical investigations for which this substance is used (e.g. Crohns disease) the effects of impaired ileal absorption and shorter gastrointestinal transit time tend to reduce the dose commitment compared with the normal case. However, in patients with severe cholestatic jaundice, the liver dose has been estimated to be about 100 times the normal value (Soundy et al., 1982).
References
Heaton, K. W. (1976). Clinical aspects of bile acid metabolism. Rec. Adv. Gastroenterol. 3, 199-230. Jazrawi, R. P., Lanzini, A., B&ten, A., Meller, S. T. and Northfield, T. C. (1984). Dynamics ofgallbladderfunction and of the enterohepatic circulation studied by y labelled bile acid. Clin. Sci. 66, 1OP. Merrick, M. V., Eastwood, M. A. and Ford, J. J. (1985). Is bile acid malabsorption underdiagnosed? An evaluation of accuracy of diagnosis by measurement of SeHCAT retention. Br. Med. J. 2!&665-668. Nyhlin, H., Merrick, M. V., Eastwood, M. A. and Brydon, W. G. (1983). Evaluation of ileal function using 23-selena-2S-homotaurocholate, a y-labeled conjugated bile acid. Gastroenterology &I, 63-68. Soundy, R. G., Simpson, J. D., Ross, H. M. and Merrick, M. V. (1982). Absorbed dose to man from the Se-75 labeled conjugated bile salt SeHCAT. J. Nucl. Med. 23, 157-161.

153

Se 34 SeHCAT

BIOKINETIC MODELS AND DATA

BiokineticData
FS
Total body (excluding contents of GI tract) Gall bladder Liver Gi-tract contents Stomach F?LI LLI 1.0 0.92 0.92 1.0 1.0 0.97 0.97 T 2.1 d 62 d a 0.97 0.03 &IA, 5.46 d 1.14 d 7.82 hr 1.0 hr 2.42 d 12.7 hr 23.3 hr

Se-LABELLED BILE ACID (SeHCAT)

Se

119.8

days Absorbed dose activity administered 15 year 3.4E-01 4.6E-01 2.2E-01 B . bE-02 7 . lE+OO 5.3B-01 3.5EtOO 2.3Btoo 2. E+OO 4.6E-01 .2B-01 1.5B-01 1.4EtOO 5.5E-01 4.4E-01 2. B-01 1. SB-01 a. N-02 9.8E-01 2.6E-01 1.3&00 10 year 5.2E-01 .2B-01 3.2E-01 1.4E-01 9.OEtoo 9.2E-01 5. SE+00 3.6BtOO 4.3E+oO 6.9E-01 1. 1EtOO 2.2B-01 2.1E+OO 1. OEtOO 5.9B-01 4. E-01 2 *6E-01 1.3B-01 1.6BtOO 3.8E-01 1.8Btoo

per unit Organ Adrenals Bladder wall Bone surfaces Breast Gall bl wall GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue
Bffective doae equivalent (*v/m)

(mGy/MBq) 1 year 1.3BtOo 1.8&+00 9.OB-01 4.5E-01 4.8E+Ol 2.5E+OO 1.4EtOl 9,2B+oo 1.2B+Ol 1.6BtOO 2. Et00 6.5E-01 5.1E+OO 2. SE+00 9.6g-01 1.3B+O0 E . lE-01 4.OB-01 3.9BtOO

Adult 2. E-01 3.6E-01 1.8E-01 E . lE-02 6.4E+OO 4.5E-01 2. B+M) 2 *2B+OO 2.1B+OO 3.9B-01 5.9B-01 l. lB-01 1. OEtOO 4.3E-01 3.8E-01 2.2B-01 l,lE-01 5.4B-02 .2E-01 Z. lB-01 l.lkoo

5 year 8.OE-01

1.lB+OO
4.8B-01 2.4E-01 1.5B+Ol 1.5BtOO 8.3BtOO 5.4B+OO 6.6EtOO l.OEtOO 1.6BtOO 3.6E-01 3. OEtOO 1. Et00 7 *2B-01 .4B-01 4.2E-01 2.2E-01 2.4B+OO 5. E-01 2.9&00

* * * * *

1. OE+OO
6.2BtOO

154

RADIATION

DOSE TO PATIENTS

FROM RADIOPHARMACEUTICALS

Br 35 Bromide

BROMIDE
76Br 77Br *Br Biokinetic Model In accordance with ICRP Publication 30 (ICRP, 1980), bromide is assumed to be uniformly distributed throughout all organs and tissues of the body, where it is retained with a biological half-life of 10 d. Reference
ICRP (1980). Limitsfir

Intakes ofRadionuclides by Workers, ICRP

Publication

30: Part 2. Pergamon,

Oxford.

Biokinetic Data

Organ

(S)

F, 1.0

76Br

Br

82Br

Total body

10d

1.0

21.8 hr

2.71 d

1.85 d

BROMIDE
76Br 16.2 hours

per Organ Adult * Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other Effective tissue 3.5B-01 3.1B-01 2.7E-01 2.9E-01 3.0s01 3.2E-01 3.2E-01 3.4E-01 3.OE-01 3.OE-01 2.7B-01 3.2B-01 3.3E-01 2.9E-01 2.9E-01 3.OE-01 2. BE-01 3.3E-01 2.7E-01

unit

Absorbed dose activity administered 15 year 3.8E-01 3.5E-01 3.2E-01 2.9E-01 3.7E-01 3.9E-01 3.8E-01 3,6E-01 3.6E-01 3.6E-01 3.4E-01 3.9E-01 3.9E-01 3.5E-01 3.6E-01 3.3E-01 3.5E-01 4.OE-01 3.3E-01 10 year 6.OE-01 5.5%01 5.1B-01 4.4E-01 5.5E-01 6.2E-01 6.OE-01 5. EE-01 5.7&01 5.7E-01 5.2E-01 6.2E-01 6.2E-01 5.4E-01 5.7E-01 5.1E-01 5.7E-01 6.2E-01 5.2E-01

(mGy/MBq) 5 year 9.3B-01 9.3E-01 8.1E-01 7,1E-01 9.OE-01 9.6E-01 9.4E-01 9.3E-01 9.OE-01 9.OB-01 8.3E-01 9.7E-01 9.6E-01 8.2E-01 9.OE-01 8.1E-01 9.1E-01 9.8B-01 8.2E-01 1 year 1.7E+OO 1.6B+OO 1.5E+OO 1.4E+OO 1.6E+OO 1.8E+OO 1.7E+OO 1.7B+OO 1.7E+OO 1.7B+OO 1.6B+OO 1.88+00 1. BE+00 1.5E+OO 1.7B+OO 1.5E+OO 1.7B+OO 1.8B+OO 1.6E+OO

* * *

dose equivalent WV/m)

3.OE-01

3.5B-01

5.5B-01

8.6B-01

1.6B+oo

155

Br 35 Bromide

BIOKINETICMODELS ANDDATA

BROMIDE
77Br Organ Adult * Adrenals Bladderwall Bone surfaces Breast GI-tract Stomachwall * Small intest * ULI wall * LLI wall Kidneys Liver Lungs Ovaries * Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue
Bffcctive doac equivalent wJv/18q)

56 hours Absorbeddose per unit activityadministered (mGy/MBq) 15 year 10 year 5 year 2.3%01 2.3E-01 1.0s01 1.3%01 1 year 4*OB-01 3.5E-01 3.3E-01 2.4E-01

9.7&02 8.48-02 7.2g-02 6.33-02 8.3B-02 9.OB-02 8.83-02 8.7B-02 E.lE-02 8.OE-02 7.OE-02 7.93-02 8.4B-02 8.0&-02 8.38-02 ?.7E-02 6.7&02 8.8E-02 6.73-02 7.8B-02

l.OE-01 1.5E-01 9.6%02 1.4&01 8.3E-02 1.2E-01 6.33-02 a.n-02

9.63-02 1.4E-01 2.1E-01 3.5E-01 l.lB-01 1.6E-01 2.4%01 4.33-01 l.OE-01 1.5&01 2.4E-01 3,9E-01 9.6E-02 1.5%01 2.2E-01 3.8B-01 2.2E-01 3.8E-01 2.2E-01 3.8E-01 1.9E-01 3.4B-01 2.5s01 4.3E-01 2.4E-01 4.3B-01 9.4E-02 1.3B-01 1.9E-01 3.3B-01 2.2E-01 3.8E-01 9.6E-02 1.4&01 1.2E-01 1.8B-01 3.2B-01 7.9B-02 2.2E-01 4.OE-01 8.9E-02 1.4%01 l.lE-01 l.?B-01 2.5B-01 4.3E-01 8.OB-02 1.2E-01 l.EE-01 3.3B-01
9.1B-02 1.3B-01 2.OB-01 3.5B-01

9.4E-02 9.6E-02 8.63-02 l.lE-01 1.m-01

1.4E-01 1.4E-01 1.2E-01 1.68-01 1.6E-01

a2Br Organ

35.30 hours Adult 15 year 10 year 5 year 1 year 2.2E+OO 1.9E+OO 1.7E+OO 1.4E+OO 1*9B+OO 2.3E+OO 2.2B+OO 2.OB+OO 2.1E+OO 2.1BtOO 1.9EtOO 2.3BtOO 2.3EtOO l.?E+OO 2.1EtOO 1.8E+OO 2.2BtOO 2.3BtOO l.BB+Oo
1.9B+oO

* Adrenals * Bladderwall Bone surfaces Breast GI-tract Stomachwall * Small intest * ULI wall * LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue
Bffective dose equivalent (=Sv/nBq)

5.5E-01 4.8E-01 3.8E-01 3.6E-01 4.2&01 4.8E-01 4.7E-01 4.9B-01 4.4%01 4.4E-01 3.7E-01 4.1E-01 4.2E-01 4.1B-01 4.4E-01 4.5B-01 3.8E-01 5.OB-01 3.7B-01 4.3B-01

5; SE-01 8.3B-01 1.2E+OO 4.8E-01 7.3E-01 1.3E+OO 4.3E-01 6.5E-01 9.8%01 3.6E-01 5.OB-01 7.8E-01

5.3E-01 5.8B-01 5.5&01 5.0%01

7.3B-01 8.8&01 8.1E-01 ?.8B-01

1.2BtOO 1.3EtOO 1.3BtOO 1.2BtOO 1.2EtOO 1.2E+OO l.OEtOO 1.3EtOO 1.3B+OO l.OE+OO 1.2EtOO l.OEtOO 1.2EtOO 1.3B+Oo 1.OBt00 l.lB+OO

7.aR-01 5.1&01 5.2E-01 7.8B-01 4.7E-01 6.8B-01 5.9E-01 8.9B-01 5.9&-01 8.8E-01 4.8B-01 7.1E-01 5.2E-01 7.8E-01 6.5B-01 4.4&01 4.9B-01 7.7B-01 9.OB-01 5.9&01 4.4E-01 6.7E-01 4.9B-01 7.3B-01

156

RADIATION

DOSE TO PATIENTS

FROM RADIOPHARMACEUTICALS

Br 35 Bromospiperone

BROMOSPIPERONE
77Br Biokinetic Model Following intravenous administration, this substance is rapidly removed from the circulation, the blood concentration falling to 0.5% of the administered activity per litre within 15 min. Total body retention of 77Br, excluding material present in the contents of the GI tract, is described by a two-exponential function, in which fractions of 0.7 and 0.3 are eliminated with half-lives of 1.69 d and 10.5 d respectively; the latter component presumably representing the removal of 77Br-bromide formed from breakdown of 77Br-bromospiperone. Rapid concentration of the injected substance occurs in liver and lungs with estimated fractional uptakes of 0.25 and 0.15, respectively. Retention of the label in liver and lungs over the first few days is similar to that in the total body and it is assumed that the later retention patterns in these organs also follow that of the total body. It is assumed that the fraction of the tracer which deposits in the liver is excreted via the GI tract and that renal excretion accounts for the remainder. Tracer not present in liver, lungs, GI-tract contents and bladder contents is assumed to be uniformly distributed throughout the remainder of the body. Reference
Crawley, J. C. W., Smith, T., Veall, N. and Zanelli, G. D. (1984). Distribution, retention and radiation dosimetry of Br-p-bromo-spiperone. Radiat. Prot. Dosim. 8, 147-153.

Biokinetic Data
Organ (S) Total body (excluding GI and bladder contents) Liver Lungs Bladder contents GI-tract contents SI ULI LLI F, 1.0 0.25 0.15 0.75 0.25 0.25 0.25 T 1.69d 10.5 d 1.69 d 10.5 d 1.69 d 10.5 d a 0.7 0.3 0.7 0.3 0.7 0.3 AslAo 1.81 d 10.9 hr 6.5 hr 36 min 27 min 1.3 hr 1.8 hr

157

Br 35 Bromospipcrone

BIOKINETIC MODELS AND DATA

BROMOSPIPERONE
77Br 56 hours

per Organ Adult * * Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue 0.3E-02 7.7~~02 4.1E-02 5.OE-02 5.9E-02 7.3E-02 1. u-01 1.4&01 6.5E-02 2.6E-01 1. SE-01 6.63-02 7.7E-02 5. IE-02 5.1E-02 3.7E-02 3.4E-02 5.53-02 4.43-02

unit

Absorbed dose activity administered 15 year 10 year 1*5E-01 1.4%01 7.1E-02 8. W-02 l. lE-01 1*4E-01 2.1E-01 2.6E-01 1.2E-01 4.5E-01 2.9E-01 1*4E-01 1.5E-01 8.8%02 9.7E-02 6.1E-02 7.2E-02 l. lE-01 7,8E-02

(mGy/MBq) 5 year 2.2E-01 2.1E-01 l. lE-01 1.2E-01 1. EE-01 2.2E-01 3.3E-01 4.2E-01 1.8E-01 6.3E-01 4,3E-01 2.OE-01 2.3E-01 1.2E-01 1.5E-01 9.4&02 1.2E-01 1.7E-01 1.2E-01 1 year 3.6E-01 3.4E-01 2 .OE-01 2.1E-01 3.2E-01 3.7E-01 5.9E-01 7.4E-01 2.9E-01 1. Hz+00 7.7E-01 3.6E-01 4.OE-01 2.OE-01 2 *6E-01 1.7E-01 2.1E-01 3.OE-01 2.1E-01

l.OE-01
9.23-02 4.8E-02 5.OE-02 7.2E-02 a .9E-02 1.3E-01 1.7E-01 7. BE-02 3.2E-01 2.1E-01 8.9&02 9.9E-02 6.3E-02 6.3E-02 3.9E-02 4.5E-02 7.2E-02 5.2E-02

* * *

Effective dose equivalent Wv/l(Bq)

B.7B-02

l . lB-01

1.6E-01

2.4B-01

4.2B-01

158

RADIATION

DOSE TO PATIENTS

FROM RADIOPHARMACEUTICALS

Kr 36 Gas

KRYPTON * lmKr
Biokinetic Model Following inhalation, the administered activity is assumed to be retained in the lungs with an effective half-life equal to the physical half-life (13 s). This assumption may overestimate the absorbed dose to the lungs, since a considerable fraction of the activity may be exhaled. References
Myers, M. J. (1981). The practical estimation of internal radiation doses from *iKrm, and similar ultra-short lived radionuclides. Nucl. Med. Commun. 2, 358-363. Ostertag, H., Kiibler, W. K. and Knopp, W. A. (1984). Strahlen-exposition bei der Anwendung von Kr-8lm. In: Nuklearmedizin, pp. 401-404. (Schmidt, H. A. E. and Adam, W. E. eds) F. K. Schattauer, Stuttgart. Swanson, A. L., Mayron, L. W. and Kaplan, E. (1976). Radiation dosimetry for krypton-8lm. Int. J. Nucl. Med. Biol. 3,
140-142.

Yano, Y., McRae, J. and Anger, H. 0. (1971). Generator-produced heart with the scintillation camera. In: Radiopharmaceuticalsfiom International Atomic Energy Agency, Vienna.

krypton-81m for dynamic studies of the lungs and Generator-produced Radionuclides, pp. 97-104.

Biokinetic Data
Organ (S) Lungs Fs 1.0 T CC a 1.0 &IA, 19s

159

BIOKINETIC MODELS AND DATA

KRYPTON
81mKr 13 seconds

per Organ Adult * Adrenals Bladder wall Bone surfaces Breast (X-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue 3.4E-06 6. BE-00 1.7%06 4.6%06 2.5B-06 2.7E-07 3.2B-07 1.4E-07 1.2E-06 3.4B-06 2. m-04 1.7E-07 3.5B-06 2.1B-06 3*1B-06 1.7B-00 1.2B-06 1.3E-07 1. EE-06

unit

Absorbed dose activity administered 15 year 10 year g.3E-06 2 *OB-07 3.2E-06 B.9E-06 4.4B-06 0.6E-07 1.2&06 3,OB-07 2.9E-06 6.6B-06 4.4E-04 4.1E-07 6.4%06 4.2E-06 6. DE-06 7.4E-08 3.7E-06 3.5E-07 3.2E-06

(mGy/llBq) 5 year 1.3B-05 4.7E-07 4 sBE-06 1.3E-05 6.73-06 1.6E-06 1.9E-06 B.OB-07 4. SE-06 9.5E-06 6.gE-04 0.OE-07 9.gE-06 5.3E-06 9.2B-06 1.3E-07 6.OE-06 7.23-07 4.7B-06 1 year 2.1E-05 1.2%06 9.3B-06 l.BE-05 l . lE-05 3.4E-06 3.5%06 2.OE-06 8.4E-06 1.6E-05 1.3E-03 1.9E-06 1. BE-o.5 B.2B-06 1.6E-05 5.6E-07 l. lB-05 l.BB-06 g.5E-06

S .7E-06
7.6E-08 2.2E-06 4.6E-06 3.2%06 4.7E-07 5.5E-07 1.5B-07 1.9E-06 4.0B-06 3. m-04 1.7&-07 4.43-06 3.3E-06 4.1E-06 2.3&08 2.1B-06 1. aE-07 2.3E-06

* *

Effective dose equivalent WV/m)

2.7B-05

4.OE-05

5.7E-05

8. gE-05

l.IB-04

160

RADIATION DOSE TO PATIENTS FROM RADIOPHARMACEUTICALS

Rb 37 IOIl

RUBIDIUM (Ultrashort-lived)
82Rb Biokinetic Model In view of the short half-life (1.3 min) of 82Rb, a model based on relative blood flow to various tissues as a proportion of cardiac output (Appendix Section A.2; Spector, 1956) has been adopted, similar to that used for 38K . For some organs this model may represent worst case conditions, since delayed uptake into organs and/or clearance of tracer from them may lead to lower cumulated activities than the present model predicts (Ryan et al., 1986). References
Ryan, J. W., Harper, P. V., Stark, V. S., Peterson, E. L. and Lathrop, K. A. (1986). Radiation absorbed dose estimate for Rubidium-82 determined from in vivo measurements in human subjects. In: Proc. Fourth Int. Radiopharmaceutical Dosimetry Symposium, Oak Ridge, Tennessee, November 1985, Oak Ridge Associated Universities CONF-851113 (DE 86010102), pp. 346358. Oak Ridge National Laboratories, Oak Ridge, Tennessee. Spector, W. S. (1956). Handbook ofBiological Data. W. B. Saunders, Philadelphia.

Biokinetic Data
Organ (S) Total body Adrenals Cortical bone Trabecular bone Heart wall Kidneys Liver Lungs Initial flow Nutritional flow Total Muscle Pancreas Red marrow Spleen Thyroid G&tract wall Stomach SI ULI LLI Fs 1.0 0.012 0.04 0.01 0.04 0.23 0.058 1.0 T co co co co co cc 00 a 1.0 1.0 1.0 1.0 1.0 1.0 1.0 &IA, 1.88 min 1.24 s 4.12 s 1.03 s 4.12 s 23.1 s 5.91 s 9.57 s 0.44 10.0 s 16.8 s 1.75 s 5.15 s 3.60 s 3.30 s 2.31 s 10.2 s 3.3 s 2.58 s

0.163 0.017 0.05 0.035 0.032 0.023 0.099 0.032 0.025

to cc
00 a3

m
CQ

1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0

co co co

161

Rb 37
IOIl

BIOKINETIC

MODELS

AND DATA

RUBIDIUM (Ultrashort-lived)
B2Rb 1.3 minutes Absorbed dose activity administered 15 year 2.7E-02 1. EE-04 9.1E-04 1.7E-04 4.9E-03 5.OE-03 4. EB-03 4.9E-03 4.2E-03 2.3E-02 1.2E-03 3.7E-03 3.2&04 6.7E-03 1.4E-03 7.2E-03 1.4E-04 6.2E-02 2.6E-04 2.6E-04 10 year 3.9E-02 2. EE-04 1.5E-03 2. EE-04 7.1E-03 8. EE-03 8.6E-03 8.5&03 6.6E-03 3.3E-02 1.9E-03 5.3E-03 4.8E-04 1.4E-02 2.3E-03 l.lE-02 2,1E-04 9.61-02 4.2E-04 4.2E-04

Per Organ Adult * Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Heart Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue 2.OE-02 1. n-04 6.78-04 1.9E-04 3.8E-03 3.9E-03 3.9E-03 3.9E-03 3.3E-03 1. EE-02 9.7E-04 2.4E-03 2.48-04 4.5E-03 9.9E-04 5.OE-03 1.3E-04 3.8E-02 2.1E-04 2.38-04

Unit

(mGy/MBq) 5 year 5.4B-02 3.63-04 2.83-03 3.8&04 1.2&02 1.4E-02 1.4B-02 1.4E-02 2.1E-02 4.9&02 2.9&03 8.2E-03 6.6E-04 1. EE-02 4.6E-03 l.EE-02 2.5g-04 2 * 2B-01 5.7E-04 6.5B-04 1 year E. lE-02 6. ?E-04 6.OE-03 6.9B-04 2. SE-02 2.98-02 2.9E-02 2.83-02 3. EE-02 8.9E-02 5.63-03 1.7B-02 1.2E-03 4.1E-02 9.7E-03 3.4B-02 5.1E-04 4.3E-01 l . OE-03 1.3E-03

* *

Effective dose equivalent (mSv/lIBq)

4. EB-03

6. X-03

1.03-02

1. EB-02

3.3E-02

162

RADIATION

DOSE TO PATIENTS

FROM RADIOPHARMACEUTICALS

Rb 31 IOn

RUBIDIUM
*iRb **Rb 86Rb Biokinetic Model The metabolism of rubidium is similar to that of potassium, with the exception of a higher concentration in bone. From total-body retention measurements on normal subjects (Ray et al., 1955; Nagai et al., 1967; Wood, 1969; Lloyd et al., 1973), biological half-lives of 5 d (0.05) and 60 d (0.95) are derived. Activity concentrations measured in human bone (Lloyd et al., 1973) indicate a fractional distribution of 0.25, in accord with the value given in ICRP Publication 30 (ICRP, 1980). Activity in bone is assumed to be uniformly distributed throughout the mineral matrix at all times after administration (ICRP, 1980). Distribution data for other organs and tissues are available only for mice, for a period of 2 to 60 min after administration (Strauss et al., 1975). The distribution data for 60 min are used herein, with values of 0.14 for liver, 0.025 for kidneys and 0.0054 for heart. It is assumed that the daughter of *lRb, *lmKr, is in equilibrium with *iRb and follows the same kinetics. References
ICRP (1980). Limitsfor Intakes of Radionuclides by Workers, ICRP Publication 30: Part 2. Pergamon, Oxford. Lloyd, R. D., Mays, C. W., McFarland, S. S., Zundel, W. S. and Tyler, F. H. (1973). Metabolism of Rb-83 and 0-l 37 in persons with muscle disease. Radiat. Res. 54,463-478. Nagai, T., Sugita, H., Iinuma, T. A., Furukawa, T. and Yashiro, S. (1968). Body-potassium concentration and rubidium metabolism determined by whole-body counting in Duchenne muscular dystrophy and its genetic carrier state. J. A&l. Med. 10, l-7. Ray, C. T., Threefoot, S. A. and Burch, G. E. (1955). The excretion of radiorubidium, Rb-86, radiopotassium, K-42, and potassium, sodium and chloride by man with and without congestive heart failure. J. Lab. Clin. Med. 45,408-430. Strauss, H. W. Harrison, K., Langan, J. K., Lebowitz, E. and Pitt, B. (1975). Thallium-201 for myocardial imaging. Circulation 51, 641-645. Wood, 0. L. (1969). Comparison of naturally occurring rubidium and potassium in human erythrocytes, plasma and urine. Health Phys. 17, 513-514.

Biokinetic Data

Organ (5) Total body Bone Heart Kidneys Liver

Fs 1.0 0.25 0.0054 0.025 0.14

T 5d 60d 5d 60d 5d 60d 5d 6Od 5d 60d

a 0.05 0.95 0.05 0.95 0.05 0.95 0.05 0.95 0.05 0.95

slRb( 5 slKr) 6.57 hr 1.64 hr 2.1 min 9.8 min 55 min

s4Rb 29.4 d 7.34 d 3.80 hr 17.6 hr 4.11 d

=Rb 19.8 d 4.95 d 2.56 hr 11.9 hr 2.77 d

163

Rb 31 Ion

BIOKINETICMODELSANDDATA

RUBIDIUM
lRb 4.58 hours per Organ Adult * Adrenals Bladder 2.8E-02 1. ?B-02 4.9&02 1.7B-02 1.9E-02 Z . OE-02 Z .OE-02 1.8E-02 2.8E-02 8.9E-02 9.6E-02 1.9E-02 1.8E-02 2.3E-02 3.2E-02 1.9B-02 1.6E-02 1.6E-02 1.8E-02 1.7E-02 15 year 3.2E-02 Z.OE-02 6.1B-02 1.7B-02 2.3B-02 2.4E-02 2.4E-02 Z. lE-02 3.5E-02 l.lE-01 l.ZE-01 2.3E-02 2.3E-02 3.OE-02 4.OE-02 2.4E-02 1.8E-02 Z . OE-02 2.3E-02 Z. lE-02 10 year 4.9E-02 3.2E-02 9.6B-02 2.8&02 3.7B-02 3.9%02 3.9E-02 3.5E-02 5.3E-02 1.6E-01 1.8E-01 3.6E-02 3.7B-02 4.6E-02 6.3E-02 3.7E-02 2.8B-02 3.2B-02 3.6E-02 3.2E-02 5 year 7.43-02 5.2E-02 5.7B-01 4.5E-02 5.83-02 6.lE-02 6.2E-02 5.5E-02 1.3E-01 2.3E-01 2.7E-01 5.63-02 5.7B-02 7.2B-02 1.8&01 5.8B-02 4. SE-02 5.2B-02 5.63-02 5.1E-02 1 year 1.3E-01 9.2%02 1.3E+OO 8.7B-02 l . lE-01 l. lB-01 l. lE-01 l . OE-01 2.3E-01 4.1E-01 5.1E-01 l-l&01 l. lE-01 1.3E-01 3.6E-01 l . lB-01 8.6E-02 9.7B-02 l .OE-01 9.7E-02 unit Abeorbed dose activity administered (mGy/MBq)

wall

Bone surfaces Breast

GI-tract Stomach wall Small intest ULI wall LLI wall Heart Kidneys Liver Lungs Ovaries Pancreas Red marrow Soleen Tbstes Thyroid Uterus Other tissue

* * *

Effective dose equivalent (=Sv/llBq)

3.1B-02

3.7B-02

5.7&02

l.lB-01

2.

m-01

84Rb Organ

32.77

days

Adult * Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Heart Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other Effective tissue 3*7B+OO

15 year 4.4B+OO 2.4EtOO 6.3BtOO 2.2BtOO 3. OBtOO 3.1E+OO 3.1BtOO 2.6BtOO 4.OB+OO l.lBtOl 1.3BtOl 3.OBtOO 3 *OB+OO 3.9B+OO 4.6BtOO 3.1BtOO 2.2B+OO 2.5BtOO 2.9B+OO 2.6B+OO

10 year 6.6B+OO 3.8EtOO 9.7BtOO 3.4B+OO 4.6BtOO 5.OE+OO 5. OBtOO 4.2EtOO 6.1EtOO 1,6B+Ol 2 . OB+Ol 4.5E+OO 4.6E+OO 6.1E+OO 7. OBtOO 4. BE+00 3.4ktOO 4.OBtOO 4.5BtOo 4.lB+OO

5 year 9.8BtOO 6.5BtOO 1.7BtOl 5.5BtOO 7.4BtOO 7 * 7B+OO 7.9BtOO 6.7BtOO 1.4BtOl 2.4BtOl 2.9E+Ol 7.OB+OO 7.1B+Oo 9.3B+oO 1.5BtOl 7 *4BtOO 5.3B+OO 6.4B+OO 7.OB+OO 6.3B+OO

1 year 1.7BtOl

2. ZE+OO
5.1E+OO 2 . ZE+OO 2 *4E+OO 2.6E+OO 2.7E+OO 2*4E+OO 3.3E+OO 9.4E+OO l.lE+Ol 2.4E+OO 2. lE+OO 3.OE+OO 3.7EtOO 2.6E+OO 2. lE+OO 2.OEtOO 2.5E+OO 2.2EtOO

1 .lB+Ol
3.6EtOl 1. OBtOl 1.4EtOl 1.4B+Ol 1.4BtOl

1.2EtOl
2.4B+Ol 4.2BtOl 5.3BtOl 1.3B+Ol 1.3B+Ol 1.7EtOl 2.8EtOl 1.3E+Ol l.OB+Ol l.ZEtOl 1.3BtOl

* * *

1. ZB+Ol

dose equivalent Wv/llBq)

3.63+00

4.4B+Oo

6.6BtOO

l.lB+Ol

Z.OB+Ol

164

RADIATION

DOSE TO PATIENTS FROM RADIOPHARMACEUTICALS

Rb 37 loll

RUBIDIUM
86Rb 18.66 days

per Organ Adult * Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Heart Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue

unit

Absorbed dose activity administered 15 year 2.2E+OO 2.OE+OO l.OB+Ol 2.OE+OO 2.1E+OO 2.1E+OO 2.1E+OO 2.1E+OO 4.2E+OO 1.9E+Ol 1.9B+Ol 2.1E+oo 2.1E+OO 2.2E+OO 5.1E+OO 2.1E+OO 2 .OE+OO 2.1E+OO 2.1E+OO 2.1E+OO 10 year 3.7E+OO 3. SE+00 1.7EtOl 3. SE+00 3.6E+OO 3.6E+OO 3.6E+OO 3. SE+00 6.7E+OO 2.7E+Ol 2.9E+Ol 3.6B+OO 3.6E+OO 3.7E+OO 8.7E+OO 3. CE+OO 3. SE+00 3. SE+00 3.6E+OO 3. SE+00

(mGy/HBq)
5 year 6.lB+OO 5.9E+OO 3.2E+Ol 5.8E+OO 5.9E+OO 5.9E+OO 6.OE+OO 5.9E+OO 2.1E+Ol 4.OE+Ol 4. SE+01 5.9E+OO 5.9E+Oo 6.OE+OO 2.6E+Ol 5.9E+OO 5.8E+OO 5.8E+OO 5.9E+OO 5.8E+OO 1 year 1.2E+Ol 1.2B+Ol 7. SE+01 1.2E+Ol 1.2E+Ol 1.2E+Ol 1.2E+Ol 1*2E+Ol 3.9E+Ol 7.4E+Ol 8.9E+Ol 1.2E+Ol 1.2E+Ol 1.2E+Ol 5.4E+Ol 1.2B+Ol 1.2E+Ol 1.2E+Ol 1.2E+Ol 1.2E+Ol

1.8B+OO 1. ?E+oo 8.1E+OO 2.OB+OO 1. ?E+OO 1. ?E+OO 1.7E+OO 1.7E+OO 3.4E+OO 1. SE+01 1. SE+01 1.7B+oO 1.7E+OO 1.7E+OO 3. BE+00 1.7E+OO 1.7E+OO 1.7E+OO 1.7E+OO 1.7B+OO

* * *

Effective dose equivalent (mSv/MBq)

3.9B+OU

4.8B+OU

7.7B+OO

1.4B+Ol

2.9B+Ol

165

RADIATION

DOSE TO PATIENTS FROM RADIOPHARMACEUTICALS

Rb 37 RBC denatured

RUBIDIUM-LABELLED

DENATURED
lRb

ERYTHROCYTES

Biokinetic Model The same model is used as for 51Cr-labelled denatured erythrocytes (see p. 113), with the exception of the excretion half-time which, in view of the short radioactive half-life, is taken as infinite. Reference
Szur, L., Glass, H. I., Lewis, S. M., uptake in the spleen using slRb
Grammaticos, 0. and de Garreta, A. C. (1968). Quantative and SICr-lahelled red cells. Br. J. Radial. 41, 819-825. estimation of red-cell

Biokinetic Data
Organ (S) Blood Spleen Liver Remaining tissues Fs 1.0 0.75 0.15 0.10
T a &I&

0 3 hr cc
?hr co

0.90 0.10 1.0 1.0

-1.0 1.0

15.7 min 4.96 hr 59.5 min

24.0 min

Rb-LABELLED DENATURED ERYTHROCYTES

lRb 4.58 hours Per Organ Adult Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Smell intest ULI wall LLI wall Heart Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue 4.8E-02 3.6E-03 8.83-03 8.9E-03 6.4E-02 1.3E-02 1.4B-02 7 .OE-03 2.3E-02 6.1E-02 l.OE-01 2.2&02 a. 31z-03 1.3E-01 1.2E-02 4.OE+OO 3.OE-03 4.OE-03 5 *7E-03 1.3E-02 15 year 6.13-02 5.2&03 l.lE-02 9.OE-03 7.2E-02 1.7E-02 1.8E-02 8.9E-03 2.9E-02 7. SE-02 1.3E-01 2.8%02 9.1E-03 1.3E-01 1.6E-02 5*7E+OO 3.3E-03 5. SE-03 8.2E-03 1. SE-02 10 year 9.9E-02 9.2&03 1. BE-02 1.6E-02 l. OE-01 2.8E-02 2.9E-02 1.6&02 4. SE-02 1,2E-01 2.OE-01 4.3B-02 1. SE-02 2.0%01 2.3E-02 0.9B+OO 5.0E-03 9.6E-03 1.4E-02 2.2E-02 5 year 1.4!&01 1.6E-02 2.8E-02 2.0E-02 1.4B-01 4. SE-02 4.8E-02 2.7E-02 6.7E-02 1.7E-01 3.OE-01 6.6E-02 2.6E-02 2. EE-01 3.2E-02 1.4E+Ol 9.3E-03 1.6E-02 2.2E-02 3.4E-02 1 year 2.2E-01 3.1E-02 5.81-02 4.6E-02 2.2E-01 unit Absorbed dose activity administered

(mGy/MBq)

a. 2E-02
0.7E-02 4.6E-02 l. lE-01

* *

* *

2.6E-01 5.6E-01 1.2E-01 4.6E-02 4. SE-01 5.2E-02 2.6B+Ol 2.OE-02 3.lB-02 4. SE-02 6.1E-02

Effective dose equivalent (mBv/lras)

2.7B-01

3.

aE-01

5.8E-01

9.1B-01

1.7E+oo

167

RADIATION

DOSE TO PATIENTS

FROM RADIOPHARMACEUTICALS

Sr 38 Ion

STRONTIUM
85Sr 87mSr 8QSr Biokinetic Model Radioisotopes of strontium are assumed to be distributed and retained in the body in accordance with the model developed by the Task Group on Alkaline Earth Metabolism in Adult Man (ICRP, 1972), except that, in the case of %r, the model was modified to allow for a faster uptake to skeleton with a half-time of 15 min. With this adjustment, the values of time integrals of retention functions have been taken from the Task Group report. According to the ICRP model, a fraction of 0.82 of intravenously administered strontium is initially distributed in soft tissues and is largely removed with a half-time of about 2 d, although a fraction of about 0.15 is retained for a much longer time. The strontium initially lost from soft tissues is partly excreted and partly taken up by the skeleton, which reaches a maximum content of 0.25 of the administered strontium, with the cortical bone content exceeding that of cancellous bone by a few percent of the administered amount. In accordance with the ICRP bone model concerning the radioactive half-lives of boneseeking radionuclides (ICRP, 1979), both Sr and Sr are assumed to be distributed throughout the volume of mineral bone and Sr is assumed to be distributed over bone surfaces at all times following their deposition in the skeleton. A urinary to faecal excretion ratio of 4:l is assumed for intravenously administered strontium. References
Bishop, M., Harrison, G. E., Raymond, W. H. A. and Sutton, A. (1960). Excretion and retention of radioactive strontium in normal men following a single intravenous injection. Int. J. Radiat. Biol. 2, 125-142. Harrison, G. E., Carr, T. E. F. and Sutton, A. (1967). Distribution of radioactive calcium, strontium, barium and radium following intravenous injection into a healthy man. Int. J. Radial. Biol. 13, 235-247. ICRP (1972). Report of the ICRP Task Group on Alkaline Earth Metabolism in Adult Man, ICRP Publication 20. Pergamon, Oxford. ICRP (1979). Limitsfor Intakes of Radionuclides by Workers, ICRP Publication 30: Part 1. Pergamon, Oxford.

Biokinetic Data

Organ (5) Total body (excluding contents of GI tract and bladder) Cortical bone Trabecular bone GI-tract content SI ULI LLI Bladder content

ssSr 22.2 d 8.4 d 6.7 d 36 min 2 hr 3.6 hr 1.12 hr 3.72 hr 32 min 30 min 1.1 min 49 s 13 s 3 min

sgSr 19.0 d 6.9 d 5.6 d 36 min 1.9 hr 3.5 hr 1.08 hr

169

Sr 38

BIOKINETIC

MODELS

AND DATA

Ion

STRONTIUM 85sr
Organ Adult * Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue 15 year 1.2E+OO 7 .OB-01 2.4E+OO 5.OE-01 6.6E-01 7.7B-01 7.91-01 10 year 1.7E+OO 5 year 2.7E+OO 1. BE+00 5.2E+OO 1.2E+OO 1,5B+OO 1.7E+OO 1.9E+OO 2. BE+00 2.OE+OO 1.6E+OO 1. BE+00 2.OEtOO 1.9E+OO 4.9EtOO 1.7BtOO 1.4B+OO 1. BE+00 1. BE+00 1. BE+00 1 year 5.1E+OO 2.9B+OO l.OB+Ol 2.3B+OO 2.6E+OO 3.2E+OO 3.4E+OO 4. BE+00 3. BE+00 3.1E+OO 3.5B+OO 3,7E+OO 3.6E+OO 9.2E+OO 3.3EtOO 2. SE+00 2.9BtOO 3.2E+OO 3.3E+OO 64.84 days per unit Absorbed dose activity administered (mGy/MBq)

1. OE+OO
6.5B-01 2 *OB+OO 5.OE-01 5.5B-01 6.4E-01 6.7B-01 9.5E-01 6.6B-01 5.9E-01 6.5B-01 7.7B-01 6.6E-01 1. BE+00 6.4B-01 5.7E-01 6.8E-01 5.6E-01 6.8B-01

1. lE+OO
3.5BtOO 7.7E-01

1.lE+OO
1.1B+00 1.2E+OO 1. BE+00 1.3B+OO

* * *

1. lE+OO
8.5E-01 7,3E-01 B. lE-01 9.2E-01 8.7%01 2.21+00 7.5E-01 6.2&01 8.2B-01 7.8E-01 8.3E-01

1. lE+OO
1.2E+OO 1.4E+OO 1.3B+OO 3.2E+OO l.lEtOO 8.9B-01 1.2B+OO l.lE+OO 1.2E+OO

Effective dose equivalent WV/n&l)

8.53-01

l.OE+OO

1.5E+clO

2.3BtOO

4.3B+oO

87mSr
Organ

2.805

hours

Adult * * Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue 6.2B-03 l. lE-02 1.4B-02 4.58-03 5.1E-03 5.5B-03 5.33-03 5.6B-03 5*1B-03 4.9%03 4.83-03 5.4B-03 5.4E-03 1.3B-02 5.1E-03 4.8B-03 4.6B-03 5.6B-03 4.7B-03

15 year 7.OE-03 1.4B-02 1. BE-02 4.53-03 5.9E-03 6.7E-03 6.3E-03 6.63-03 6.2B-03 6.OE-03 5.9B-03 7.OE-03 6.8B-03 1.7E-02 6.1E-03 5.4B-03 6.0&-03 7.1B-03 5.7B-03

10 year l . lB-02 2.OB-02 2. BE-02 6. BB-03

5 year 1.7E-02 3.1E-02 4.6E-02 l . lE-02 1.4E-02 1.68-02 1.6B-02 1.6B-02 1.5E-02 1.5B-02 1.4%02 1.6B-02 1.6B-02 5.4B-02 1.5B-02 1.3E-02 1. SB-02 1.7E-02 1,4B-02

1 year 3. M-02 5.6B-02 1 .OB-01 2.1B-02 2.5B-02 2.9B-02 2. BE-02 2.9E-02 2.8B-02 2.7B-02 2.6B-02 3 *OB-02 2.9B-02 l. lB-01 2.7B-02 2.5B-02 2.7%02 3,1B-02 2.6B-02

* *

9.3E-03
1 .OE-02 9.5B-03 l . OE-02 9.6B-03 9.3E-03 8.9B-03 l . lE-02 1.01-02 2,7E-02 9,4B-03 8.33-03 9.4B-03 l. lB-02 8.7E-03

Bffective dose l qulvaIent Wv/rras)

6.78-03

8.1B-03

1.3R-02

2.1g-02

4.1E-02

170

RADIATION

DOSE TO PATIENTS FROM RADIOPHARMACEUTICALS

SK 38 1C.n

STRONTIUM 89sr
50.5 days Absorbed dose activity administered 15 year 9.6B-01 1.6B+OO Z.ZB+Ol 9.6E-01 9.6E-01 4 *OE-02 2.3E+OO 5.9E+OO 9.6E-01 9 *6B-01 9.6B-01 9.6E-01 9.6B-01 1.6E+Ol 9.6E-01 9.6E-01 9.6E-01 9.6E-01 9.6E-01 10 year 1.6E+OO 2.6E+OO 3.6B+Ol 1.6B+OO 1.6E+OO l. lB-01 4.1B+OO 1 .OB+Ol 1.6B+OO 1.6E+OO 1.6E+OO 1.6B+OO 1.6B+OO 2,7E+Ol 1.6B+OO 1.6E+OO 1.6E+OO 1.6B+OO 1.6E+OO

per Organ Adult * * Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI vall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Soleen Testes Thyroid Uterus Other Effective tissue ?.8E-01 1.3B+OO 1.7B+Ol 9.6E-01 7.8E-01 2.3E-02 1.8E+OO 4*7E+OO 7.8E-01 7.8E-01 7.8E-01 7.8E-01 7.8B-01 1. lE+Ol 7.8E-01 7.8B-01 7.8E-01 7.8E-01 7.8E-01

unit

(mGy/UBq) 5 year 2.7E+OO 4.2E+OO 6.2B+Ol 2.7E+OO 2.7B+OO 1.9B-01 6.9E+OO 1.7%+01 2.7B+OO 2.7E+OO 2.7E+OO 2.7BtOO 2.7B+OO 5.2B+Ol 2.7BtOO 2.7EtOO 2.7B+OO 2.7B+OO 2.7E+OO 1 year 5.6EtOO 8.4B+OO 1.53+02 5.6E+OO 5.6E+OO 2.9E-01 1.4E+Ol 3.5BtOl 5.6B+OO 5.6BtOO 5. bE+OO 5.6EtOO 5.6EtOO l.lEt02 5.6B+OO 5.6B+GG 5.6X+00 5.6E+OO 5.6B+OO

* * *

dose equivalent Wv/llBq)

2.9B+oO

3.8E+OO

6.5B+OO

1.2E+Ol

2.5&01

171

RADIATION

DOSE TO PATIENTS FROM RADIOPHARMACEUTICALS

Tc 43 Albumin

TECHNETIUM-LABELLED
ggmTc

ALBUMIN (HSA)

Biokinetic Model The model for Tc-labelled human serum albumin is the same as that used for iodine-labelled albumin (see p. 285). Reference to Diaplacental Transfer
Russell, J. T., Hibbard, H. B. M. and Sheppard, M. A. (1969). Metabolic behaviour and radiation dosimetry of 99m Tc-albumin in pregnancy. J. Nucl. Med. 10, 224232.

Biokinetic Data
Organ (S) Total body FS 1.0 T 6.8 hr 1.29 d 19.4 d 6.8 hr 1.29d 19.4 d a 0.015 0.035 0.95 0.40 0.22 0.38 ASIA, 8.47 hr

Blood

1.0

6.70 hr

Tc-LABELLED
99mTc

ALBUMIN (HSA)
Absorbed dose activity administered 15 year l .OE-02 5.8E-03 l .ZE-02 4.7E-03 6.5E-03 5.8E-03 6.OE-03 5.6E-03 2,5E-02 9.7B-03 8.7E-03 1.6E-02 5,7E-03 7.7B-03 9.0e-03 1.6&02 3.9E-03 7.3%03 5.7E-03 4.7E-03 10 year 1.6E-02 8.1E-03 2.2E-02 7e 4E-03 l .OE-02 8.83-03 8.6E-03 8.6E-03 3.6E-02 1.5E-02 1.4B-02 2.6E-02 8.5E-03 I. ZE-02 1,3E-02 2.6E-02 5.7B-03 1.2%02 8.5E-03 6.9E-03

6.02

hours per unit (mGy/MBq) 5 year 2.5E-02 l .lE-02 3.6E-02 l. lE-02 1.4E-02 1.3E-02 1.4E-02 l .ZE-02 5.4E-02 2.4E-02 Z. lE-02 4.1E-02 1.3E-02 1.7E-02 2.OE-02 4.O.B-02 8.8B-03 1.9B-02 1.3B-02 l. lE-02 1 year 4.7E-02 Z. lE-02 7.1E-02 2.OE-02 2.5E-02 2.4E-02 2.3E-02 2.3E-02 9.2E-02 4.4E-02 3.7E-02 7.6E-02 2.3E-02 3.OE-02 3.5B02 7.6E-02 1.6E-02 3.5B-02 2.3B-02 Z.OE-02

Organ Adult * Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Heart Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue a. 3B-03 4.OE-03 a. 9E-03 4,6E-03 5.1E-03 4.8B-03 4.7E-03 4.2B-03 2.OE-02 8.1E-03 7.3E-03 1.3E-02 4.4%03 6.43-03 7.5B-03 1.4E-02 2.9E-03 4.9E-03 4.83-03 4.OE-03

* * *

Bffective dose equivalent (=Sv/llBq)

7.9B-03

9.7B-03

1.5E-02

2.3B-02

4.2B-02

173

RADIATION

DOSE TO PATIENTS

FROM RADIOPHARMACEUTICALS

Tc 43 Albumin

TECHNETIUM-LABELLED ALBUMIN (INTRATHECAL ADMINISTRATION)

Tc Biokinetic Model The model has been defined in Appendix Section A.10. Two sites of intrathecal administration are considered, viz lumbar injection (region A) and cisternal injection (region C). It is assumed that activity reaching the blood is metabolized according to the model for intravenously administered albumin (HSA). Reference
Ashburn, W. L., Harbert, J. C., Briner, W. H. and Di Chiro, G. (1968). Cerebrospinal fluid rhinorrhea studied with the gamma scintillation camera. J. Nucl. Med. 9, 523-529.

Biokinetic Data
Organ (S) (1) Lumbar injection Cerebrospinal fluid space: (A) Cisterna terminalis (B) Spinal cord space (C) Brain cisterns Blood Total body (2) Cistemal injection Cerebrospinal fluid space (A & B) Cisterna terminalis and spinal cord space (C) Brain cisterns Blood Total body Fs &IA,

1.0

0.5 0.25 1.0 1.0

4.45 hr 1.82 hr 19.2 min 1.62 hr 8.63 hr

0.5 1.0 1.0 1.0

49.4 min 6.54 hr 1.02 hr 8.65 hr

175

TC

BIOKINETIC MODELS AND DATA

43 Albumin

Tc-LABELLED ALBUMIN (Intrathecal administration)

Lumbar injection ggmTc

6.02 hours
*

Organ

Absorbed dose per unit activity administered (mGy/MBq) 1.3E-02

Adrenals Bladder wall Bone surfaces Brain Breast GI-tract Stomach wall Small intest ULI wall LLI wall Heart Kidneys Liver Lungs Ovaries Pancreas Spinal cord Red marrow Spleen Testes Thyroid Uterus Other tissue Effective dose equivalent (mSv/RBrl)

l.EE-03 8.2E-03 4.OE-03 l.SE-03 S.lE-03 8.6E-03 6.8E-03 2.63-03 J.lE-03 1.8E-02 5.31-03 5.3E-03 4.83-03 l.Oh-02 4.63-02 3.OE-02 7.63-03 9.33-04 2.3E-03 3.83-03 3.1E-03 l.lB-02

* *

Cisternal

injection Organ

* *

Adrenals Bladder wall Bone surfaces Brain Breast GI-tract Stomach wall Small intest ULI wall LLI wall Heart Kidneys Liver Lungs Ovaries Pancreas Spinal cord Red marrow Spleen Testes Thyroid Uterus Other tissue Effective dose equivalent (mSv/naS)

2.8E-03 6.73-04 6.93-03 5.63-02 l.lE-03 1.3E-03 l.ZE-03 l.lE-03

7.4E-04

3.83-03 2.43-03 l.SE-03 2.73-03 9.1E-04 1.9E-03 1.4E-02 9.33-03 2.63-03 4.63-04 3.63-03 9.OE-04 l.ZE-03 6.8E-03

* *

176

RADIATION

DOSE TO PATIENTS

FROM RADIOPHARMACEUTICALS

TC 43

Citrate

TECHNETIUM-LABELLED
ggmT~

CITRATE COMPLEX

Biokinetic Model After injection, the ggmTc-citrate complex is rapidly distributed throughout the body, with an enhanced concentration in the kidneys. Distribution data from rat experiments indicate a fractional uptake in the kidneys of 0.17 and a two-exponential total-body retention function, with component half-lives of 0.5 hr (0.3) and 1.25 d (0.7). The substance is excreted exclusively by the kidneys. Reference
99mTcSolcocitran, product information: N-MED AG, Nuklearmedizinische PrHparate, Postfach 186, 8030 Ziirich.

Biokinetic Data
Organ (S) Total body (excluding bladder contents) Kidneys Bladder contents FS I.0 0.17 1.0 T 0.50 hr 1.25 d 0.50 hr 1.25 d a 0.3 0.7 0.3 0.7 &IA, 5.26 hr 57 min 52 min

177

l-C

BIOKINETIC MODELS AND DATA

43 Citrate

Tc-LABELLED
6.02 hours

CITRATE

COMPLEX

Per Organ Adult * * Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue 5 *3E-03 3.93-02 3.5E-03 2.2E-03 3.53-03 4.3E-03 4.03-03 4.5E-03 4.6E-02 3.5E-03 2.5E-03 4.0&03 4.53-03 4.83-03 4.7E-03 3.OE-03 1.8%03 ? . OE-03 2.9E-03

unit

Absorbed dose activity administered 15 year 6.4E-03 4.0B-02 49 3e-03 2.2E-03 4.3E-03 5.3&03 5.1E-03 5 * 9E-03 5.53-02 4.3E-03 3.2%03 6.OE-03 5.5E-03 5.8E-03 5.7E-03 4.2E-03 3.OE-03 8.43-03 3.5E-03 10 year 9.0E-03 7.OE-02 6.3E-03 3.23-03 6.9E-03 0.2E-03 7.5E-03 9.2E-03 7.7&02 6.6B-03 4.8E-03 9 sOE-03 0.4B-03 8.1&03 a. ix-03 6.7E-03 4.83-03 1.3E-02 5.2E-03

(mGy/MBq) 5 year 1.5E-02 l.OE-01 9.53-03 5.1B-03 9.6E-03 1.2E-02 1.2&02 1.3E-02 l.ll3-01 9.83-03 7.4E-03 l .bE-02 1.2&02 l. lE-02 1.3E-02 1.01-02 1 year 2.6E-02 1.9E-01 1.8E-02 9.6B-03 1.6E-02 2.1E-02 2.OB-02 2.3E-02 1.9E-01 1.7E-02 1.3%02 2.3%02 2.1E-02 1. EE-02 2.2E-02 1.9E-02 1.4E-02 3.28-02 1.4%02

* *

7.6E-03
1.9E-02 8.08-03

Effective dose equivalent Wv/l(Bq)

8.3B-03

l.OB-02

1.5E-02

2.2B-02

3.9B-02

178

RADIATION

DOSE TO PATIENTS

FROM RADIOPHARMACEUTICALS

TC

43

Colloids

TECHNETIUM-LABELLED
Tc Biokinetic Models

COLLOIDS

These are defined in Appendix Section A.8 for two types of ggTc-labelled colloids: (a) Large colloids (100-1000 nm): Sulphur colloid, tin colloid, microaggregated albumin and phytate. (b) Small colloids (< 100 nm): Minimicroaggregated albumin and antimony sulphide colloid. Because of the short radioactive half-life of ggmTc, it is assumed that no redistribution or excretion occurs. Biokinetic Data for Large Coiloids
Organ (S) Fs I a U% 6.08 hr 52.1 min 52.1 min 52.1 min 4.34 hr 1.74 hr 1.30 hr 1.30 hr 2.61 hr 2.61 hr 2.17 hr 1.30 hr

(1) Normal liver condition 0.70 cc 1.0 Liver 0.10 cc 1.0 Spleen 0.10 cc 1.0 Red marrow Remaining tissues 0.10 (2) Early to intermediate diffuse parenchymal live~diseas~O 0.50 co 1.0 Liver 0.20 co 1.0 Spleen 0.15 cc 1.0 Red marrow Remaining tissues 0.15 1.0 (3) Intermediate to advanced diffuse parenchymaziver disease 0.30 00 1.0 Liver 0.30 cc 1.0 Spleen 0.25 cc 1.0 Red marrow 0.15 co 1.0 Remaining tissues

179

Tc 43 Colloids

BIOKINETIC MODELS AND DATA

Biokinetic Data for Small Colloids

Organ (S) Fs T a M% 6.08 hr 52.1 min 1.30 hr 26.1 min 4.34 hr 1.74 hr 2.17 hr 26.1 min 2.61 hr 2.61 hr 2.61 hr 52.1 min

(1) Normal liver condition Liver 0.70 co 1.0 Spleen 0.10 cc 1.0 Red marrow 0.15 cc 1.0 Remaining tissues 0.05 co 1.0 (2) Early to intermediate diffuse parenchymal liver disease Liver 0.50 cc 1.0 Spleen 0.20 co 1.0 Red marrow 0.25 co 1.0 Remaining tissues 0.05 a! 1.0 (3) Intermediate to advanced diffuse parenchymal liver disease Liver 0.30 cc 1.0 Spleen 0.30 cc 1.0 Red marrow 0.30 co 1.0 Remaining tissues 0.10 co 1.0

Tc-LABELLED
ggmTc 6.02 hours

LARGE COLLOIDS

per Organ Adult * Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas

unit

Absorbed dose activity administered 15 year 10 year Z.lB-02 z.aB-03 1.3E-02 4.6B-03 1.3E-02 9.OE-03 l .ZE-02 3.8E-03 1.7E-02 1.4B-01 l . OE-02 4.9E-03 2.5E-02 2.3E-02 1.6E-01 1.3E-03 2 .OE-03 4.4E-03 4.9E-03 5

(mGy/MBq)

year

1 year 4.2E-02 9.5E-03 4.6E-02 1.3E-02 3.53-02 2.5.E02 3.4E-02 l.lE-02 3. SE-02 3.4E-01 2.5B-02 1.4%02 5.9E-02 7.2E-02 4.5B-01 4.5%03 6.5E-03 1.3E-02 1.3E-02

l . OE-02 1.5E-02
1. m-03 6.4E-03 2.7E-03 6.2E-03 4.3E-03 5.63-03 1. BE-03 9.7E-03 7.4E-02 5.5E-03 Z. ZE-03 l . ZE-02 l. lE-02 7.7E-02 6.2E-04 7.9E-04 1.6E-03 B.4&03 2.7E-03 a. 3~03 5.1&03 6.9E-03 Z. ZE-03 l. lE-02 9.2E-02 7.5B-03 2.9E-03 1.7&02 1.5E-02 l. lE-01 7.6E-04 l. ZE-03 2.5E-03 3.4&03

2. aB-02 5.7B-03 Z. ZE-02 7.3E-03 2. lE-02 1.4E-02 2.1E-02 6.1E-03 2.4E-02 1.9&01

* *

1.5E-02
7.9E-03 3.7E-02 3.83-02 2.5E-01 Z.ZE-03 3.5E-03 7.4E-03 7.3E-03

Red marrow Spleen Testes Thyroid Uterus Other tissue

1.9E-03
2. BE-03

Effective dose equivalent (mSv/ktBq)

1.4B-02

1.8E-02

2. BE-02

4.1B-02

7.3E-02

180

RADIATION DOSE TO PATIENTS FROM RADIOPHARMACEUTICALS

TC

43 Colloids

Tc-LABELLED
Earlv to intermediate

LARGE COLLOIDS
diffuse parenchymal liver disease Absorbed dose per unit activity administered (mGy/MBq) 9.9E-03 1.4%03 8.2E-03 2.6E-03 E. lE-03 4.43-03 5.3E-03 2.4E-03 l. lE-02 4.OE-02 5.2E-03 2.7E-03 1.5E-02 1.5E-02 l.OE-01 8.6E-04 l .OE-03 2.4E-03 3.OE-03 1.4%02

6.02

hours *

Organ

Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue

* * * *

Effective dose equivalent (mSv/HBq) Intermediate to advanced Organ * Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue diffuse

parenchymal

disease

9.83-03 1.6E-03 1.2E-02 2.4E-03 9.03-03 4.6E-03 4.9E-03 3.1E-03 1. IE-02 4.2E-02 4.8E-03 3.3E-03 1. EE-02 2.3E-02 1.4E-01 9.5E-04 l. lE-03 2.8E-03 3.1E-03 1.7E-02

* * * *

Effective dose equivalent (mSv/IIB9)

*ICRP 18:1-4-G

181

-I-C

BIOKINETICMODELS

ANDDATA

43 Colloids

Tc-LABELLED
6.02 hours

SMALL COLLOIDS

per Organ Adult * Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue l * OB-02 9.1%04 7 *9E-03 2.5E-03 6.OE-03 4.3E-03 5.5E-03 1. BE-03 9.?B-03 7.4E-02 5.43-03 2.3B-03 1.2E-02 1.5E-02 7.7E-02 4.%E-04 6.9B-04 1.0E-03 2.7E-03

unit

Absorbed dose activity administered 15 year 1.5E-02 1.4E-03 l. lE-02 2.5E-03 8.1E-03 5.1E-03 6. EE-03 2.2E-03 l. lE-02 9.2E-02 7.4B-03 3.OE-03 1.7E-02 2.OE-02 l.lE-01 5.7B-04 l. lE-03 2.4E-03 3.3E-03 10 year

(mGy/MBq) 5 year 2.73-02 5.2B-03 2.9&-02 6.9E-03 2.1E-02 1.4E-02 2.OE-02 5.83-03 2.4B-02 1.9%01 1.4B-02 7.7B-03 3.7E-02 5.1E-02 2.5%01 l .OB-03 2.9B-03 7.OE-03 7.OE-03 1 year

2.1E-02 2.53-03
1.7B-02 4.43-03 1.3E-02 0.9E-03 1*2B-02 3.8E-03 1,7E-02 1.4E-01 l , OE-02 4.9E-03 2.5E-02 3.OE-02 1.6E-01 9.7E-04 1.7B-03 4.2E-03 4.7%03

4*1B-02 8.5B-03 6.0%02 1.2B-02 3.43-02 2.4E-02 3.33-02 l.OE-02 3.51-02 3.4I.b01 2.43-02 1.3B-02 5.0B-02 l . OB-01
4.5E-01 3.63-03 5,4&03 1.3E-02 1.2B-02

* *

* *

Effective dose equivalent (=Bv/llBq)

1.4B-02

1.9%02

2.9B-02

4.3B-02

7.6B-02

182

RADIATION DOSE TO PATIENTS FROM RADIOPHARMACEUTICALS

TC

43 Colloids

Tc-LABELLED
Early ppmTc 6.02 to intermediate diffuse

SMALL COLLOIDS
parenchymal liver disease Absorbed dose per unit activity administered (mGy/MBq) 9. PE-03 1.1%03 l. lE-02 2.3E-03 7.0B-03 4.4E-03 5.28-03 2.6B-03 1.18-02 4.03-02 5.OE-03 2. PE-03 1. SE-02 2.2&02 l.OE-01 5.78-04

hours *

Organ Adrenals Bladder vall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue Effective dose equivalent Wv/lrecl)

8.OE-04
2.3E-03 2 *PB-03 1.5E-02

Intermediate

to advanced Organ *

diffuse

parcnchymal

disease

Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue

9.0E-03 1.4E-03 1.3B-02 2.3E-03 9.6B-03 4.6E-03 4. PE-03 3.2B-03 1.1%02 4.2E-02 4 .?B-03 3.4E-03 1. BE-02 2.6E-02 1.4E-01 0.OB-04 l .OE-03 2 *0E-03 3.OE-03 1. BB-02

* * * *

Bffective dose equivalent (mSv/)(B9)

183

RADIATION

DOSE TO PATIENTS

FROM RADIOPHARMACEUTICALS

TC

43 DMSA

TECHNETIUM-DMSA
99mT~ Biokinetic Model Intravenous injection of Tc-dimercaptosuccinic acid (DMSA) gives rise to an initial distribution in the extracellular fluid. Of material entering the extracellular fluid, half is deposited in the renal cortex, where it is retained for a long time. A further fraction is temporarily retained in liver and spleen. Excretion is exclusively via the kidneys. The total body retention is described by a three-exponential function. A fraction of 0.5 is taken up in the renal cortex, with an uptake half-time of 1 hr, and is assumed to be retained permanently. Fractions of 0.1 and 0.01 are taken up in liver and spleen, respectively, with a half-time of 1 hr, and eliminated with half-times of 2.0 hr (0.50) and 1.8 d (0.50).

Arnold, R. W., Subramanian, G., McAfee, J. G., Blair, R. J. and Thomas, F. D. (1975). Comparison of 99mTccomplexes for renal imaging. J. Nucl. Med. 16, 357-367. Elliott, A. T., Britton, K. E., Brown, N. J. G., Pearce, P. C., Smith, F. R. and Barnasconi, E. W. (1976). Dosimetry of current radiopharmaceuticals used in renal investigation. Proc. Radiopharmaceutical Dosimetry Symposium, Oak Ridge, Tennessee, April 2629,1976, HEW Publication (FDA) 768044, pp. 293-304. U.S. Department of Health and Welfare, Washington, DC. Enlander, D., Weber, P. M. and dos Remedios, L. V. (1974). Renal cortical imaging in 35 patients: Superior quality with 99mTc-DMSA. J. Nucl. Med. 15,743-749. Handmaker, H., Young, B. W. and Lowenstein, J. M. (1975). Clinical experience with 99mTc-DMSA [Dimercaptosuccinic acid], a new renal imaging agent. J. Nucl. Med. 16, 28-32.

Biokinetic Data
Organ (S) Total body (excluding bladder contents) Fs 1.0 T 2.0 hr 1.8 d 00 1.0 hr co 1.0 hr 2.0 hr 1.8 d 1.0 hr 2.0 hr 1.8d a 0.25 0.25 0.50 -1.0 1.0 -1.0 0.5 0.5 -1.0 0.5 0.5 As/A, 6.77 hr

Kidneys (cortex) Liver Spleen Bladder contents

0.50 0.10 0.01

3.71 hr 25.1 min

2.5 min

0.50

24 min

185

Tc 43 DMSA

BIOKINETIC MODELS AND DATA

Tc-DMSA
gg%
6.02 hours

per Organ Adult * * Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue 1.3E-02 1.9E-02 3.5E-03 1. BE-03 5.5E-03 5.2E-03 5. W-03 3.2E-03 1.7E-01 9.7E-03 2.5E-03 3.7E-03 9.OE-03 6.3E-03 1.3E-02 l.fx-03 l. lE-03 4.6&03 3.OE-03

unit

Absorbed dose activity administered 15 year 1.6E-02 2.4E-02 4.3E-03 1.8E-03 6.3E-03 6.4%03 6.3E-03 4.2E-03 2.1E-01 1.2E-02 3.5E-03 4.6E-03 l. lE-02 7.5E-03 1.7E-02 2.4E-03 1.9E-03 5.5E-03 3.63-03 10 year 2.43-02 3.5E-02 6.4E-03 2.0E-03 9.8E-03 1 .OE-02 9.6E-03 6.7E-03 2.9E-01 1 *El&02 5.2E-03 7.2E-03 1.6E-02 l .OE-02 2.6E-02 3.9E-03 3.1E-03 8.9E-03 5.x-03

(mGy/MBq) 5 year 3.5E-02 5.1E-02 9.9E-03 4.5%03 1.3E-02 1.5E-02 1.4E-02 l.OE-02 4.2E-01 2.5E-02 8.OE-03 l . lE-02 2.3E-02 1.4E-02 3.8E-02 6.2E-03 5.1E-03 1.3E-02 8.OE-03 1 year 6.0!3-02 9.4E-02 1.9E-02 8.4E-03 2.OE-02 2.5E-02 2.3E-02 1.8E-02 7.3E-01 4.1E-02 1.4E-02 2.OE-02 3.7E-02 2.OR-02 6. H-02 1.2E-02 9.2E-03 2.3E-02 1.4E-02

* *

Effective dose equivalent (mSv/HBq)

1.6E-02

1.9%02

2.7B-02

4.OE-02

6.9%02

186

RADIATION DOSE TO PATIENTS FROM RADIOPHARMACEUTICALS

TC

43 DTPA

TECHNETIUM-DTPA
ggmTc Biokinetic Model Intravenous administration of Tc-diethylenetriaminepentaacetic acid (DTPA) gives rise to an initial distribution in the extracellular fluid. Following this initial distribution phase, the substance is excreted exclusively by the renal system according to the model for GFR substances and the kidney-bladder model (see Appendix Sections A.6 and AS, respectively). In the normal case, total body retention is described by a double exponential function with component half-times of 100 min (0.99) and 7 d (0.01). The fraction excreted by the kidneys is 1.0, and the renal transit time is 5 min. For the abnormal case, it is assumed that the retention half-time of the major component is 1000 min and that the renal transit time is increased to 20 min. References
Klopper, J. F., Hauser, W., Atkins, H. L., Eckelman, W. C. and Richards, P. (1972). Evaluation of ggmT~-DTPA for the measurement of glomerular filtration rate. J. Nucl. Med. 13, 107-l 10. McAfee, J. G., Gagne, G., Atkins, H. L., Kirchner, P. T., Reba, R. C., Blaufox, M. D. and Smith, E. M. (1979). Biological distribution and excretion of DFPA labelled with Tc-PPm and In-I Il. J. Nucl. Med. 20, 1273-1278. GReilly, P. H., Shields, R. A. and Testa, H. J. (1979). Nuclear Medicine in Urology and Nephrology. Butterworths, London.

Biokinetic Data
Organ (S) (1) Normal renal function Total body (excluding bladder contents) Kidneys Bladder contents (2) Abnormal renal function Total body (excluding bladder contents) Kidneys Bladder contents Fs 1.0 T a
0.99

&/A,
1.97 hr

1.67 hr 7d

0.01 4.4 min 1.51 hr

1.0 1.0 1.0 16.7 hr 7d 1.0 1.0 0.99 0.01

6.39 hr

6.3 min 26.2 min

187

Tc 43 DTPA

BIOKINETIC MODELS AND DATA

Tc-DTPA

ggmTc
Organ

6.02

hours per Adult Unit Absorbed dose activity administered 15 year 1.8B-03 8.1E-02 2.1B-03 9.43-04 1.7B-03 3.1B-03 2.9B-03 5.4E-03 5.4B-03 1.6%03 1.3B-03 5.3B-03 l . EE-03 3.OB-03 1.7B-03 4.1B-03 1.3E-03 9.6B-03 2.OE-03 10 year 2.7B-03 1.2B-01 3.1&03 1,4B-03 2.8B-03 5.OE-03 4.4B-03 8.2B-03 7.7E-03 2.5E-03 2.OB-03 7.0B-03 2.9E-03 4.2B-03 2.5B-03 6.8B-03 2.lB-03 1.5B-02 3.1E-03 (mGy/MBq) 5 year 4.2E-03 1.7B-01 4.6B-03 2.23-03 4.1E-03 7.5E-03 7.1B-03 l. lB-02 l.lB-02 3.93-03 3.1E-03 l. lE-02 4.5E-03 5.7B-03 4 .OB-03 l . OE-02 3.43-03 2.1E-02 4.6E-03 1 year 7.0B-03 3.2B-01 0.5E-03 4.3E-03 7.5E-03 1.3B-02 1.2B-02 1.9E-02 2.OB-02 7.OB-03 5.7E-03 1.8B-02 8.1B-03 8.7B-03 7.23-43 1.9E-02 6.1E-03 3.5B-02 8.3B-03

* * * *

Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue

1.4E-03 6.5%02 1. ?B-03 9.4B-04 1.3E-03 2.6B-03 2.2B-03 4.2B-03 4.4B-03 1.3B-03 l.OB-03 4.3B-03 1.5E-03 2.5B-03 1.4B-03 2.83-03 7.9B-04 7.9B-03 1.7B-03

Effective dose equivalent Wv/lles) Bladder wall contributes

6.3E-03

7.8B-03

1.1%02

1.7E-02

3.OB-02

to

61.9

X of

the

effective

dose

equivalent.

Abnormal Organ Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Soleen Testes Thyroid Uterus Other tissue Adult 4.1B-03 2.2B-02 4.4B-03 3.OE-03 3.8&03 4.7B-03 4.4E-03 4.7&03 7.9E-03 3.83-03 3.3E-03 4.9E-03 4.3&03 5.2E-03 4.0&03 3 *3B-03 2.5E-03 6.3B-03 3.3E-03

renal 15 year 5.1B-03 2.7B-02 5.3E-03 3.OE-03 5.OE-03 5.6B-03 5.68-03 6.2E-03 9.6E-03 4.6B-03 4.2E-03 6.3B-03 5.4E-03 6.3B-03 4.8E-03 4.5B-03 4.3E-03 7. SE-03 4.OB-03

function 10 year 7.8B-03 4.OE-02 7.9B-03 4.3E-03 7.9B-03 E .bE-03 8.1E-03 9.6E-03 1.4E-02 7.1E-03 6.2E-03 9.4E-03 8.1E-03 9.OB-03 7.2B-03 6.9B-03 6.8B-03 l.lB-02 6.1E-03 5 year 1.2B-02 5.8B-02 1.2B-02 6.9E-03 l.lE-02 1.3B-02 1.3B-02 1.4B-02 2.OE-02 l. lE-02 9. SE-03 1.4E-02 l.ZE-02 1.3E-02 l. lE-02 l. lB-02 l. lE-02 1.7E-02 9.4E-03 1 year 2.1B-02 l. lB-01 2.1E-02 1.3B-02 2 .OE-02 2.3B-02 2.2B-02 2.5E-02 3.4B-02 1.9E-02 1.7E-02 2.4E-02 2.2E-02 2.26-02 2.OB-02 2.OE-02 1.9B-02 2.9B-02 1.7B-02

* * * *

Bffective dose equivalent (mSv/m)

5.3B-03

6.6B-03

9.7B-03

1.5B-02

2.6B-02

188

RADIATION

DOSE TO PATIENTS

FROM RADIOPHARMACEUTICALS

TC

43 DTPA

TECHNETIUM-DTPA

(INTItkrECAL
Biokinetic Model

ADMINISTRATION)

The model has been defined in Appendix Section A.lO. Two sites of intrathecal administration are considered, viz lumbar injection (region A) and cisternal injection (region C). It is assumed that activity reaching the blood is metabolized according to the model for intravenously administered Tc-DTPA. Reference
Som, P., Hosain, F., Wagner, H. N. Jr and SchelTel,U. (1972). Cistemography with chelated complex of 99mTc.J. Nucl. Med. 13,551-553.

Biokinetic Data
Organ (S) (1) Lumbar injection Cerebrospinal fluid space (A) Cisterna terminalis (B) Spinal cord space (C) Brain cisterns Kidneys Bladder contents Total body (excluding bladder contents) (2) Cistemal injection Cerebrospinal fluid space (A & B) Cisterna terminalis and spinal cord space (C) Brain cisterns Kidneys Bladder contents Total body (excluding bladder contents)

1.0 0.5 0.25 1.0 1.0 1.0

4.45 hr 1.82 hr 19.2 min 1.06 min 21.9 min 7.07 hr

0.5
1.0

49.4 min 6.54 hr

40s

1.0 1.0 1.0

13.8 min 7.66 hr

.JbICRP 10:1-4-G'

189

Tc 43 DTPA

BIOKINETIC MODELS AND DATA

Tc-DTPA (Intrathecal administration)

Lumbar injection 99mTc 6.02 hours Organ Absorbeddose par unit activity administered (mGy/MBq) l.lE-02 1.7E-02 6.43-03 3.23-03 6.5E-04 4.2E-03 8.1E-03 6.23-03 2.63-03 1.7E-02 3.8B-03 2.43-03 4.8E-03 9.3E-03 4.61-02 2.93-02 4.63-03 8.93-04 1.3E-03 4.53-03 2.53-03 1.1%02

* Adrenals * Bladderwall Bone surfaces Brain Breast GI-tract Stomachwall Small intest ULI wall LLI wall * Kidneys Liver Lungs Ovaries * Pancreas * Spinal cord Red marrow Spleen Testes Thyroid Uterus Other tissue Effective dose equivalent Wv/tW) Cisternalinjection Organ * Adrenals * Bladderwall Bone surfaces * Brain Breast GI-tract Stomachwall Small intest ULI wall LLI wall *
Kidneys

1.8E-03 l.OE-02 5.93-03 5.53-02 5.43-04 7.63-04 8.83-04 ?.lE-04 7.53-04 1.9E-03 6.OE-04 8.63-04 8.93-04 1.2E-03 1.3E-02 8.53-03 6.63-04 4.43-04 3.OE-03 1.4E-03 8.63-04 6.6R-03

Liver Lungs Ovaries Pancreas * Spinal cord Red marrow Spleen Testes Thyroid Uterus Other tissue Effective dose equivalent (mSv/HBq)

190

RADIATIONDOSE TO PATIENTS FROM RADIOPHARMACEUTICALS

Tc

43
Plasmin

TECHNETIUM-LABELLED
ggmT~ Biokinetic Model

PLASMIN

Plasmin is a fibrinolytic enzyme, which on intravenous administration forms a stable complex with qantiplasmin. Part of the complex is rapidly taken up in the liver and spleen. In patients with venous thrombosis, circulating complex may be bound to the thrombus, thereby enabling its demonstration. On the basis of reports by Khan et al. (1981) and Persson et al. (1981) it is assumed that 25% and 10% are taken up in liver and spleen, respectively, while 30% remains circulating in blood and 35% is uniformly distributed in remaining tissues. The biological half-life is long compared to the physical half-life of the label, and can be assumed to be 7 d. References
Khan, O., Ell, P. J., Cullum, I. D., Jar&t, P. H. and Williams, 99mTc-plasmin. In: Progress in Radiopharmacology, Vol. 2, Persson, B., Olsson, C. G., Darte, L., Strand, S. E., Bergqvist, 99Tc-labelled plasmin for thrombus detection. In: Progress ed.) Elsevier, Amsterdam. E. S. (1981). Clinical and pharmacological studies with pp. 157-171. (Cox, P. H. ed.) Elsevier, Amsterdam. L. and Stahlberg, F. (1981). Preparation and testing of in Radiophamtacology, Vol. 2, pp. 147-156. (Cox, P. H.

Biokinetic Data
Organ (S) Blood Liver Spleen Remaining tissues Fs 0.30 0.25 0.10 0.35 T 7d Id 7d 7d a 1.0 1.0 1.0 1.0 -&IA, 2.51 hr 2.10 hr 50.3 min 2.93 hr

191

Tc 43 Plasmin

BIOKINETIC MODELS AND DATA

Tc-LABELLED
gg%
6.02 hours

PLASMIN

per Organ Adult Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Heart Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue 8.4E-03 3.1E-03 5. ?E-03 3.7E-03 6.63-03 4.6&03 5.OE-03 3.3E-03 l. lE-02 8.6E-03 2.9E-02 a*OE-03 3.5E-03 l. lE-02 5.9E-03 7.8E-02 2.2E-03 2.9E-03 3. aB-03 3.5&03

unit

Absorbed doae activity administered 10 year 1.7E-02 6.4E-03 1.2E-02 6.OE-03 1.3E-02 9.OE-03 9.93-03 7.OE-03 1.9E-02 1.6E-02 5.23-02 1.5E-02 7.2E-03 1.9E-02 l. lE-02 1.6E-01 4.3E-03 7.2E-03 7.2E-03 6.3E-03

(mGy/KBq) 1 year 4.2E-02 1.8E-02 3.9E-02 1.7E-02 3.1E-02 2.x-02 2.7E-02 2.OE-02 4.8E-02 3.9E-02 1.3E-01 4.4E-02 2.OE-02 4.6E-02 2.6E-02 4.5E-01 1.3E-02 2.23-02 2.OE-02 1.8E-02

15 year l. lE-02 4.43-03 7.5E-03 3.7E-03 a. 3E-03 5.6E-03 6.3E-03 4.4E-03 1.3E-02 l.OE-02 3.5E-02 l .OE-02 4.6E-03 1.3E-02 7.4E-03 l.lE-01 2.9E-03 4.4E-03 4.5E-03 4.2E-03

5 year 2.4E-02 9.6E-03 2.OE-02 9.4E-03 1.9E-02 1.4E-02 1.6E-02 l .OE-02 2.8E-02 2.3E-02 7.5E-02 2.4E-02 l. lE-02 2. aB-02 1.5E-02 2.5E-01 6.83-03 1.2E-02 1.1%02 9.6E-03

* * *

* *

Effective dose equivalent (=Sv/llBq)

l . lB-02

1.5E-02

2.2%02

3.4g-02

6.Og-02

192

RADIATION DOSE TO PATIENTS FROM RADIOPHARMACEUTICALS

TC 43 Glucoheptonate

TECHNETIUM-GLUCONATE,
99mT~

GLUCOHEITONATE

Biokinetic Model After intravenous injection these substances are rapidly distributed in the extracellular space, from which they are cleared by the kidneys. Some of the cleared material is retained for a long time in the kidneys and the rest is cleared by glomerular filtration. The total body retention can be described by a three-exponential function with the following half-times: 20 min (0.35), 2.4 hr (0.30), 3.7 d (0.35). In the kidneys, a fraction of 0.15 is taken up with a half-time of 45 min and retained with a half-life of 24 hr. Material filtered by the kidneys is assumed to behave according to the kidney-bladder model for GFR substances. References
Arnold, R. W., Subramanian, G., McAfee, J. G., Blair, R. J. and Thomas, F. D. (1975). Comparison of 99Tc complexes for renal imaging. J. Nucl. Med. 16, 357-367. Boyd, R. E., Robson, J., Hunt, F. C., Sorby, P. J., Murray. I. P. C. and McKay, W. J. (1973). 99Tcmgluconatecomplexes for renal scintigraphy. Br. J. Rudiol. 46, 604612.

Biokinetic Data
Organ (S) Total body (excluding GI and bladder contents) Fs 1.0 T 20 min 2.4 hr 3.7 d 45 min 24 hr a 0.35 0.30 0.35 -1.0 1.0 As/A, 3.74 hr

Kidneys Bladder contents

0.15 1.0

58.2 min 1.28 hr

193

Tc 43
Glucoheptonate

BIOKINETIC MODELS AND DATA

Tc-GLUCONATE,
6.02 hours

GLUCOHEPTONATE

per Organ Adult * * Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue 4.6B-03 5.63-02 2. LE-03 1.48-03 2.7B-03 3.7E-03 3.3E-03 4.41-03 4.9E-02 2.7E-03 1.78-03 4.6E-03 3.6E-03 3.9E-03 3.93-03 2.93-03 l * lE-03 7 .?E-03 2.3E-03

unit

Absorbed dose activity administered 15 year 5.5E-03 6.9E-02 3.1E-03 1.4E-03 3.2E-03 4.5E-03 4.2E-03 5.8E-03 5.9E-02 3.3E-03 2.2E-03 5. EE-03 4.4E-03 4.7E-03 4.93-03 4.1E-03 1.9E-03 9.43-03 2. EE-03 10 year 8.4E-03 l.OE-01 4.78-03 2.1E-03 5.2E-03 7 .OE-03 6.3E-03 8. EE-03 8.2E-02 5.0%03 3.3E-03 8.63-03 6.78-03 6.5E-03 7.4B-03 6. EB-03 3.0e-03 1.5%02 4.23-03

(mCy/MBq)

5 year
1.2B-02 1,5E-01 7.OE-03 3.4B-03 7.3E-03 l. lE-02 l . OE-02 1.2&-02 1*2E-01 7.5E-03 5. HI-03 1.3B-02 9.8E-03 8. EE-03 l . lE-02 1.13-02 4.9E-03 2.1E-02 6.4E-03

1 year 2.2E-02 2.7E-01 1.3E-02 6.5E-03 1.2E-02 1. EE-02 1.6E-02 2.1E-02 2.x-01 l . JE-02 9.3g-03 2.1E-02 1.7E-02 1.3E-02 1. EE-02 1.9E-02 E.EB-03 3.5E-02 l . lE-02

* *

Bffective dose equivalent (=Sv/llBq)

9.0%03

l . lg_02

1.6&02

2.48-02

4.2&02

194

RADIATION DOSE TO PATIENTS FROM RADIOPHARMACEUTICALS

Tc
43 Penicillamine

TECHNETIUM-PENICILLAMINE
99mT~ Biokinetic Model The in uiuo distribution of this substance depends on the method of preparation. When produced as a renotrophic agent, it appears to have biokinetic properties similar to those of 99mTc-DMSA, although studies on animals suggest somewhat smaller uptakes in kidneys and liver. Studies on dogs indicate that 97% of the administered activity becomes bound to plasma proteins and only a very small quantity is excreted in urine. Following intravenous administration of this radiopharmaceutical, it is assumed that fractions of 0.4 and 0.08, respectively, are taken up by the renal cortex and liver with an uptake half-time of 1 hr, the remainder of the activity being distributed uniformly throughout all other organs and tissues. The half-life for elimination from the total body, and individual organs and tissues, is taken to be 3 d. References
Hagan, P. L., Chauncey, D. M., Halpern, S. E. and Ayres, P. R. (1977). 99Tcm-thiomalic acid complex: A nonstannous chelate for renal scanning. J. Nucl. Med. 18, 353-359. Halpern, S., Tubis, M., Endow, I., Walsh, C., Kunsa, J. and Zwicker, B. (1972). 99Tcm-Penicillamine-Acetazolamide complex, a new renal scanning agent. J. Nucl. Med. 13, 45-50. Halpem, S. E., Tubis, M., Golden, M., Kunsa, J., Endow, J. and Walsh, C. (1972). 99mTcPAC, a new renal scanning agent. II. Evaluation in humans. J. Nucl. Med. 13, 723-728. Taylor, A., Davis, G., Halpern, S. and Ashbum, W. (1977). 99mTechnetium Penicillamine, a renal cortical scanning agent. J. Urol.117,418420.

Biokinetic Data
Organ (S) Total body Kidneys (cortex) Liver Pa 1.0 0.4 0.08 T 3d 1 hr 3d 1 hr 3d a 1.0 -1.0 1.0 -1.0 1.0 &IA, 8.0 hr 2.7 hr 32 min

195

Tc 43 Penicillamine

BIOKINETIC MODELS AND DATA

Tc-PENICILLAMINE

99%

6.02

hours

per Organ Adult * Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue 1.2E-02 3.2B-03 h . XI-03 2.7E-03 5.7B-03 5.6E-03 5.6E-03 3.5E-03 1.4E-01 l. lE-02 3.5E-03 4.OE-03 8.63-03 6. EE-03 9. U-03 2.2E-03 2.0%03 4.2B-03 3.5E-03

unit

Absorbed dose activity administered 15 year 1.4B-02 4.6E-03 5.5E-03 2.7B-03 6.93-03 6.83-03 6.9B-03 4.7B-03 1.7B-01 1.3B-02 4.6B-03 5.0&03 l. lB-02 E. lB-03 1.2B-02 2.9E-03 3.3B-03 4.9B-03 4.2&03 10 year 2.1B-02 6.5E-03 E. lB-03 4.2B-03 l. lB-02 l.lB-02 l.OE-02 7.5B-03 2.4E-01 2*OB-02 6.83-03 7.9%03 1.6E-02 l.lB-02 1. EE-02 4.3B-03 5.4B-03 7.7B-03 6.33-03

fmGy/MBq) 5 year 3.1E-02 9.6B-03 1.2B-02 6.6E-03 1.5E-02 1.6B-02 1.6E-02 l. lB-02 3.4E-01 2. EE-02 l .OB-02 1.2B-02 2.3B-02 1.5E-02 2.6B-02 6.9&03 8.7B-03 1.2E-02 9.6E-03 1 year 5.3B-02 1. BE-02 2.3E-02 1.2E-02 2.4B-02 2.7B-02 2.6E-02 2.OB-02 5.9E-01 4.7B-02 1.9E-02 2.2B-02 3.7B-02 2.4E-02 4.1B-02 1.3B-02 1.6E-02 2.1E-02 1. BE-02

* *

* *

Bffective dose equivalent (=Sv/lras)

1,3E-02

1.6E-02

2.3B-02

3.4B-02

5.9B-02

196

RADIATION DOSE TO PATIENTS FROM RADIOPHARMACEUTICALS

TC

4: Pertechnetate

PERTECHNETATE
99mTc Biokinetic Model The MIRD Dose Estimate Report No. 8 (1976) presents two sets of biological parameters based on a compartmental model and constructed using data from measurements on different groups of subjects. The two groups are possibly related to different levels of physical activity (resting and non-resting). For most organs and tissues the difference in absorbed dose per unit administered activity between the two groups is small (less than a factor of two). The following model is based on mean values for the parameters in the two MIRD groups. Data published by Dayton et al. (1969) on renal clearance, by Beasley et al. (1966) on distribution in humans, and by Andros et al. (1965) have also been used. All published studies have demonstrated an early active uptake in the thyroid, salivary glands and stomach, and a delayed uptake in the colon. The remaining fraction of administered activity is assumed to be uniformly distributed throughout all other organs and tissues (except brain). Elimination is by way of the kidneys and intestines. Pretreatment with blocking agents such as perchlorate or iodide inhibits active uptake and diminishes whole-body retention (Coffey et al., 1984). The model for this case, therefore, assumes uniform distribution and a higher rate of renal excretion than in the standard model set out above. For oral administration, the fractional absorption is taken to be 0.8 (ICRP, 1980). References
Andros, G., Harper, P. V., Lathrop, K. A. and McCardle, R. J. (1965). Pertechnetate-99m localisation in man with application to thyroid scanning and the study of thyroid physiology. J. Clin. Erufocrinof. 25, 1067-1076. Beasley, T. M., Palmer, H. E. and Nelp, W. B. (1966). Distribution and excretion oftechnetium in humans. Health Phys. 12, 1425-1435. Coffey, J. L., Hayes, R. L., Rafter, J. J., Watson, E. E. and Carlton, J. E. (1984). Radiation dosimetry and chemical toxicity considerations for 9QTc.Health Phys. 46,418-422, Dayton, D. A., Maher, F. T. and Elveback, L. R. (1969). Renal clearance of technetium (gQmTc) as pertechnetate. Mayo Clin. Proc. 44, 549-551. ICRP (1980). Limits for &takes of Radionuclides by Workers, ICRP Publication 30: Part 2. Pergamon, Oxford. MIRD Dose Estimate Report No. 8 (1976). Summary of current radiation dose estimates to normal humans from 99mTcas sodium pertechnetate. J. Nucl. Med. 17, 7477.

197

Tc
43 Pcrtechnctate

BIOKINETIC MODELS AND DATA

Biokinetic Data
Organ (S) Intravenous administration (1) No blocking agent given Thyroid Salivary glands Stomach wall Stomach contents SI contents ULI wall ULI contents LLI contents Kidneys Bladder contents Remaining tissues F, T a AsI&

0.02 0.03 0.20 0.20 0.20 0.15 0.35 0.35 0.65 0.65 0.75

1 hr 10 hr 1 hr 10 hr 1 hr

0.85 0.15 0.85 0.15 1.0

2.23 min 3.35 min 14.9 min 9.24 min 25.3 min 32.6 min 44.6 min 21.8 min 2.00 min 20.7 min 4.32 hr

3 hr 10hr

-1.0 1.0

3 hr 4.5 hr 45 hr 4.5 hr 45 hr

0.20 0.24 0.56 0.60 0.40

(2) Blocking agent given Total body (excluding bladder contents) Kidneys Bladder Oral administration, no blocking agent given (fr =O.S) Thyroid Salivary glands Stomach wall Stomach contents SI contents ULI wall ULI contents LLI contents Kidneys Bladder contents Remaining tissues

1.0 1.0

5.29 hr 3.35 min 40.8 min 1.47 min 2.20 min 9.79 min 59.9 min 56.0 min 21.4 min 1.34 hr 23.1 min 1.31 min 13.6 min 2.84 hr

1.0

198

RADIATION

DOSE TO PATIENTS FROM RADIOPHARMACEUTICALS

TC

43 Pertechnetate

PERTECHNETATE 99%
Organ Adult Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Salivary 3.6E-03 1.9&02 3.9E-03 2.3E-03 2.9E-02 1.8E-02 6.2E-02 Z.ZE-02 5.OE-03 3.9E-03 2. ?E-03 l .OE-02 5.9E-03 9.3E-03 6.1E-03 4.4E-03 2.78-03 2.38-02 8.1E-03 3.4E-03 15 year 4.7E-03 2.3E-02 4 . ?E-03 2.3E-03 3.6&02 Z. ZE-02 7.7E-02 2.8E-02 6.0%03 4.83-03 3.43-03 1.3E-02 7.2E-03 l . ZE-02 7. IE-03 5.3E-03 3.7B-03 3.7E-02 l.OE-02 4.OE-03 10 year 7.1E-03 3.4E-02 6.9E-03 3.53-03 5.OE-02 3.4E-02 1.3E-01 4.6E-02 8.7%03 8.OE-03 5.lE-03 1.9E-02 l . lE-02 1.7E-02 9.8E-03 7.9E-03 5.9E-03 5.6E-02 1.6&02 6.OE-03 5 year l . lE-02 5.1%02 l . OB-02 5.7E-03 8.1E-02 5.2E-02 Z.lE-01 7.4E-02 1.3E-02 1.3B-02 7.9E-03 2.7E-02 1.6E-02 2.4E-02 1.3E-02 l. ZE-02 9.3E-03 l.ZE-01 2,4E-02 9.3E-03 1 year 1.9B-02 9.1E-02 1.9B-02 1.1%02 1.5E-01 9.OE-02 3.9E-01 1.4B-01 Z.lE-02 2.2%02 1.4B-02 4.5E-02 2.7E-02 3.9E-02 Z .OE-02 Z.lE-02 1.7E-02 2.3E-01 4.OE-02 1.7E-02 6.02 hours per unit Absorbed dose activity administered (mGy/MBq)

* * * *

glands

Red marrow Spleen Testes Thyroid uterus Other tissue

Effective dose equivalent (mSv/nBq)

1.3B-02

1.6B-02

2.5E-02

4.OE-02

7.3B-02

Blocking Organ Adult Adrenals Bladder wall Bone surfaces Breast GI-t&t Stomach vall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue 3.3E-03 3.23-02 3.8B-03 2.5E-03 3.2E-03 4. M-03 3.83-03 4.5E-03 4.7B-03 3.1B-03 2. BE-03 4.7E-03 3.5B-03 4.5B-03 3.2B-03 3.2B-03 Z.lE-03 6.63-03 2.9E-03

agent

given

15 year 4.1B-03 3.9B-02 4.5B-03 2.5&03 4.1E-03 4.9E-03 4.9E-03 5.93-03 5.7E-03 3.83-03 3.5E-03 6.OB-03 4.4E-03 5.4E-03 3.9B-03 4.4E-03 3.53-03 7.98-03 3.5E-03

10 year 6.3E-03 5.7E-02 6.7E-03 3.6E-03 6.6E-03 7.61-03 7.1E-03 9.2E-03 8.2E-03 5.93-03 5.21-03 8.9E-03 6.7E-03 7.8E-03 5.9E-03 6.8B-03 5.7B-03 l. ZB-02 5.3E-03

5 year 9.5E-03 8.43-02 l . OE-02 5.7E-03 9.3E-03 l. lE-02 l.lE-02 1.3%02 l.ZE-02 9.OE-03 7.9E-03 1.3B-02 l . OB-02 l . lB-02 9.OB-03 l. lE-02 9.OE-03 1.8E-02 8.2E-03

1 year 1.7E-02 1.5E-01 1.8E-02 l. lE-02 1.7%02 Z.OE-02 1.9E-02 2.3E-02 Z. lE-02 1.6E-02 1.4E-02 2.3E-02 1.8E-02 1.8E-02 1.6E-02 1.9E-02 1.6E-02 3.OB-02 1.5B-02

*
* * *

Bffective dose equivalent (mSv/lI8q)

5.38-03

6.6B-03

9.8B-03

1.5E-02

2.6B-02

199

TC

BIOKINETIC MODELS AND DATA

43 Pertechnetate

PERTECHNETATE
Oral administration, no blockingagent given 6.02 hours Absorbeddose per unit activityadministered (mGy/HBq) Organ
Adult 15 year 10 year 5 year l. lE-02 3.00-02 0.0E-03 4.0E-03 1.4E-01 9.1B-02 2.4E-01 7.9E-02 1.3E-02 1.40-02 6.7E-03 3.3B-02 2.2E-02 l . bE-02 1,3E-02 1.5E-02 7.3B-03 0.OE-02 2.7E-02 0.70-03 1 year 1.9E-02 6,7E-02 1.7E-02 0.9E-03 2.60-01 1.6B-01 4.5E-01 1.50-01 2.1E-02 2.43-02 1.2E-02 5.3E-02 3.6B-02 2.63-02 1.0E-02 2.4E-02 1.4E-02 1.5E-01 4.40-02 1. SE-02

Adrenals * Bladderwall
Bone surfaces Breast GI-tract Stomach wall Small fntest ULI wall

3.4E-03 1.4B-02 3.3E-03 1.0E-03 S.OE-02 3.OE-02 7.4E-02 2.4E-02 5.4E-03 4.0%03 2.2E-03 1.2E-02 9.2E-03 6.13-03 6.2E-03 6.OE-03 1.9E-03 1.5B-02 0.7E-03 3.23-03

4.7E-03 l.?B-02 4.OE-03 l.BE-03

7.2E-03 2.53-02 5.9E-03 2.0E-03

* * *

LLI wall Kidneys Liver Lungs Ovaries Pancreas Salivaryglands Bed marrow Spleen Testes Thyroid Uterus Other tissue Effective
dose equivalent (mSv/naq)

6.1E-02 0.43-02 3.7B-02 5.93-02 9.1E-02 l.SB-01 3.OE-02 5.OE-02 6.43-03 4.93-03 2.BE-03 1.x-02 l.lE-02 7.9E-02 9.2E-03 0.5E-03 4.3E-03 2.2E-02 1.6E-02 1.1%02

7.23-03 9.73-03 7.OE-03 l.OB-02 2.7B-03 4.5E-03 2.4B-02 3.7E-02 l.lE-02 1.0E-02 3.83-03
1.9E-02

5.73-03
2.90-02

1.50-02

4.61-02

0.4E-02

200

RADIATIONDOSE TO PATIENTSFROM RADIOPHARMACEUTlCALS

TC

43 IDA

TECHNETIUM-LABELLED IMINODIACETIC ACID (IDA) DERIVATIVES

QQmTc Biokinetic Model Radiopharmaceuticals belonging to this group are predominantly taken up in the liver and excreted, via the biliary tract, to the intestine. A minor fraction is excreted by the kidneys. The individual compounds are based on N-substitution of iminodiacetic acid and are named according to type of substitute, e.g. BIDA, DISIDA (disofenin) EIDA, HIDA, PBIDA, PIPIDA and mebrofenin. The dosimetry model has been presented in Appendix Section A.9. Calculations are performed for the normal case, and for three pathological conditions, namely parenchymal liver disease, cholecystitis with occlusion of the cystic duct, and occlusion of the common bile duct. A special case of the latter condition is congenital biliary atresia, for which reason calculations have been done also for newborns. The assumed magnitude and rate of the different flows in the model are evident from the F, and T values in the Biokinetic Data table. The final excretion from the body follows the models for the gastrointestinal tract (Appendix Section A.3) and for kidney-bladder (Appendix Section AS). In the atresia case it is assumed that activity initially taken up in the liver is slowly (T1,2 = 8 d) transported back to blood for excretion by the kidneys. Biokinetic Data
Organ (S) (1) Normal hepato-biliary conditions Blood Liver Gallbladder GI-tract contents SI ULI LLI Kidneys Bladder contents (2) Parenchymal liver disease Blood Liver Gallbladder GI-tract contents SI ULI LLI Kidneys Bladder contents Fs 1.0 0.85 0.30 0.85 0.85 0.85 0.15 0.15 1.0 0.35 0.10 0.35 0.35 0.35 0.65 0.65 20 min 20 min 2 hr 1.0 - 1.0 1.0 T a &IA, 8.52 min 48.2 min 46.0 min 1.79 hr 2.34 hr 1.14 hr
44s

6 min 6 min 45 min

1.0 -1.0 1.0

24.7 min 27.4 min 43.1 min 13.4 min 36.7 min 47.8 min 23.3 min 4.71 min 1.58 hr
continued

201

TC

BIOKINETIC MODELS AND DATA

43 IDA

Biokinetic Data (continued)

Organ (S) (3) Occlusion of the cystic duct Blood Liver Gallbladder GI-tract contents SI ULI LLI Kidneys Bladder content (4) Occlusion of the common bile duct Blood Liver Gallbladder GI-tract contents SI ULI LLI Kidneys Bladder contents Fs 1.0 0.7 0.0 0.7 0.7 0.7 0.3 0.3 E5 0 6min 6 min 8d 1.0 -1.0 1.0 T a 1.0 -1.0 1.0 &l&l 14.0 mm 39.3 min 1.66 hr 2.16 hr 1.06 hr 1.45 mm 47.6 min 8.52 min 7.04 hr -

10 min 10 min 45 min

0
0 0 1.0 1.0

52 s 27.3 min

202

RADIATION

DOSE TO PATIENTS FROM RADIOPHARMACEUTICALS

TC

43 IDA

Tc-LABELLED IMINODIACETIC ACID (IDA) DERIVATIVES 99%

Organ Adult Adrenals Bladder wall Bone surfaces Breast Gall bl wall GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue 3.2E-03 2.3E-02 2.6E-03 6.1E-04 l.lE-01 6.1E-03 5.2E-02 9.2E-02 6.2E-02 6.3E-03 1.5E-02 1. H-03 Z.OE-02 5,7E-03 7 .OE-03 2.6E-03 1.5E-03 l.ZE-04 1.3E-02 3.OE-03 15 year 4.7E-03 2.0E-02 3.3E-03 6.4E-04 l .ZE-01 7.7E-03 6.5E-02 l. lE-01 7.7E-02 7.4E-03 1.8E-02 1.6E-03 2.4E-02 7.5E-03 8.OE-03 3.4E-03 2.3E-03 1.8E-04 1.7E-02 3.6E-03 10 year 7.4E-03 4.2E-02 4.71-03 1.3E-03 1.6E-01 1.3E-02 l.lE-01 1.9E-01 1.3E-01 l.lE-02 2.7E-02 2.5E-03 3.6E-02 1.4E-02 l .OE-02 5.9E-03 4.2E-03 3,7E-04 2,7E-02 5.3E-03 5 year l. lE-02 6.3E-02 7.1E-03 2. SE-03 2.8E-01 Z. lE-02 1.6E-01 2.9E-01 Z. lE-01 1.6E-02 4.OE-02 4.OE-03 5.2E-02 2.2%02 1.3E-02 9.6E-03 7 .OE-03 7.3E-04 4.OE-02 8.OE-03 1 year 1.8E-02 l. lE-01 1.4E-02 4.83-03 9.6E-01 3.4E-02 2.9E-01 5.5E-01 3.9E-01 2.5E-02 7.2E-02 7.5E-03 8.4E-02 3.4E-02 1.5E-02 1.6E-02 1.3E-02 1.7E-03 6.5E-02 1.4E-02 6.02 hours per unit Absorbed dose activity administered (mGy/HBq)

* * *

Effective dose equivalent (nSv/lras)

2.4E-02

2.9E-02

4.4E-02

7 .OE-02

1.5E-01

Parenchymal Organ Adrenals Bladder wall Bone surfaces Breast Gall bl wall GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue Adult Z. lE-03 6.93-02 1.7E-03 5.6E-04 3.5E-02 2.7E-03 1.9E-02 3.3E-02 2.4E-02 6.6E-03 l .OE-02 9.2E-04 9.9F-03 2.8E-03 3.8E-03 1,5E-03 2.5E-03 2.3E-04 l. lE-02 Z. lE-03

liver

diseese 10 year 4.6E-03 l.ZE-01 3 .OE-03 l.OE-03 5.3E-02 5.83-03 3.9E-02 6.61-02 5.OE-02 l.lE-02 Z.OE-02 1.9E-03 1.8E-0: 6.6E-03 6.OE-03 3.2E-03 6.7E-03 6.4E-04 2.2&02 3.6E-03 5 year 6.7E-03 1.9E-01 4.6E-03 1.8E-03 9.2E-02 9.4E-03 6.OE-02 l .OE-01 7.9E-02 1.7E-02 2.8E-02 2.9E-03 2.6E-02 l.OE-02 7.4E-03 5.2E-03 l. lE-02 l. lE-03 3.1E-02 5.5E-03 1 year l. lE-02 3.4E-01 8.7E-03 3.53-03 3.OE-01 1.6E-02 l.lE-01 1.9E-01 1.5E-01 2.7E-02 5.OE-CIZ 5.4E-Cl3 4.2E-02 1.7E-02 9.4E-03 9 .OE-03 Z .OE-02 Z. ZE-03 5.1E-02 9.5E-03

15 year 3.OE-03 8.5E-02 Z. lE-03 5.7E-04 4.OE-02 3.4E-03 2.4E-02 4.OE-02 3.OE-02 7.9E-03 1.3E-02 1.3E-03 1.2E-112 3.8E-03 4.5E-03 1.9E-03 3.8E-03 3.7E-04 1.4E-02 2.5E-03

* * * *

Effective dose equivalent (=Sv/nes)

1.3%02

1.6E-02

2.4B-02

3.7E-02

7.5B-02

203

Tc 43 IDA

BIOKINETICMODELSANDDATA

Tc-LABELLED IMINODIACETIC (IDA) DERIVATIVES

Occlusion 99% Organ Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue Effective dose equivalent @Sv/l(Bq) 6.02 hours par unit Adult * 2.2B-03 3.9B-02 2.3E-03 !i. lE-04 5.0%03 4. ?B-02 8.4B-02 5.8E-02 5.5B-03 l . OE-02 0.6%04 1.9%02 3.5&-03 6.63-03 2.2E-03 1.9B-03 1.5E-04 1.3B-02 2.78-03 1. BE-02 of the cystic duct

ACID

Absorbed dose activity administered 15 year 3.3E-03 4.03-02 2.03-03 5.1e-04 6.2E-03 5.9B-02 l .OB-01 7.2B-02 6.53-03 1.3E-02 1.5E-03 2.3E-02 4. ?B-03 ?.5B-03 2.?E-03 10 year 5.2g-03 7 .OB-02 4.1E-03 9.9B-04 9.3e-03 9.6B-02 1. ?E-01 1.2E-01 9. ?E-03 2.OE-02 1.9E-03 3.4E-02 ?.6B-03 9.83-03 4.63-03 5.4E-03 4.2E-04 2. ?B-02

(mGy/MBq) 1 year 1.3E-02 1.9E-01 1.2E-02 3. ?E-03 2.53-02 2.6B-01 s.oe-01 3. ?B-01 2.3B-02 5.43-02 5.8B-03 ?.9B-02 2.1e-02 1.4E-02 1.3E-02 1.6B-02 1, ?E-03 6.68-02 1.3E-02 9.8B-02

5 year ?.9E-03 1 .OE-01 6.1B-03 1.9E-03 1.5E-02 1.5E-01 2.?E-01 1.9%01 1.4B-02 3.OB-02 3.1%03 4.9E-02 1.2E-02 1.2%02 ?.4E-03 0.6E-03 7 .?E-04 4.OE-02 ?.3E-03 5.48-02

* * * *

3.OB-03 2.23-04 l.?B-02

3.33-03 4.0E-03
2,2B-02 3.5E-02

Occlusion Organ * * Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue Effective dose equivalent (=Sv/ml) Adult

of

the common bile 15 year 1.3E-02 2.4B-02 3.0x&03 2.3E-03 5.6E-03 4.4E-03 6.4E-03 1. BE-03 9.9E-03 l. lB-01 6.8E-03 2.6E-03 1.3B-02 4.9E-03 2.9E-03 l. lE-03 4.6B-04 3.?B-03 2. BE-03 1.2E-02 10 year 1.9B-02 3.6E-02 4.216-03 4.OE-03 l.OE-02 a. 3~03 1.2E-02 3.3E-03 1.5E-02 1.6E-01 9.3E-03 4. ?E-03 2.OE-02 6.6E-03 5.2B-03 1.9E-03 9.1e-04 6.63-03 4.OE-03 1.8B-02

duct 5 year 2.4B-02 5.6B-02 6.5E-03 6.4B-03 1, ?B-02 1.4B-02 2.1E-02 5. ?E-03 2.1E-02 2.2E-01 1.3E-02 7.8E-03 3.OB-02 a. 513-03 8.5E-03 3.3E-03 1.0E-03 l. lE-02 6.OE-03 2.6B02 1 year 3.6E-02 l.oe-01 1.3E-02 1.2E-02 3.OE-02 2.4B-02 3.5B-02 l .OE-02 3.1E-02 3.9e-01 2,2E-02 1,4E-02 4.9E-02 1.2E-02 1.4E-02 6.53-03 3.5E-03 1.9B-02 l . lB-02 4.6B-02

B.BB-03 2.OB-02 2.4e-03 2.33-03 3.73-03 3.63-03 5.23-03

1.5e-03

* * *

0.4E-03 0.51-02 4.93-03

1.9E-03

8.3E-03 3.5B-03
1.9E-03

7.63-04 3.4E-04 2.83-03 2.3E-03 9.6B-03

204

RADIATION DOSE TO PATIENTS FROM RADIOPHARMACEUTICALS

TC

43 IDA

Tc-LABELLED IMINODIACETIC DERIVATIVES

Newborns. Congenital biliary atresia 99mTc 6.02 hours Absorbed dose par unit activity administered (mGy/MBq) 3.3E-02 2.6E-01 2.6E-02 3,6E-02 7.OE-02 1.2EtOl 2.3E-02 1.5E-01 9.OE-01 4.4E-02 4.5E-02 5.7E-02 4 .?E-02 1.9E-02 3.5E-02 1.2E-02 3.7E-02 2.1E-02 8.5B-01

Organ * Adrenals Bladder wall Bone surfaces GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue Effective dose equivalent (mSv/nBq)

* * *

205

RADIATION DOSE TO PATIENTS FROM RADIOPHARMACEUTICALS

TC 43 Fibrinogen

TECHNETIUM-LABELLED
g9mT~ Biokinetic Model

FIBRINOGEN

The model for Tc-labelled fibrinogen is the same as that used for iodine-labelled fibrinogen (see p. 381). Reference
Jonckheer, M. H., Vandenbrock, M. and van den Brande, P. (1981). The biological behaviour of technetium labelled fibrinogen with reference to thrombus localisation. In: Progress in Radiopharmacology, Vol. 2, pp. 127-136. (Cox, P. H. ed.) Elsevier, Amsterdam.

Biokinetic Data
Organ (S) Total body Blood Fs 1.0 1.0 T 4d 8 hr 4d a 1.0 0.25 0.75 &IA, 8.17 hr 7.37 hr

207

Tc 43 Fibrinogen

BIOKINETIC MODELS AND DATA

Tc-LABELLED
ggmTc 6.02 hours

FIBRINOGEN

per Organ Adult * Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest IJLI wall LLI wall Heart Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue 8.51-03 3.7E-03 9.OE-03 4.4E-03 4.9E-03 4.53-03 4.4E-03 3.913-03 2.23-02 8.2E-03 7.4B-03 1.4E-02 4.1E-03 6.3E-03 7.3E-03 1,4E-02 2.7E-03 4.9E-03 4.4E-03 3. BE-03

unit

Absorbed dose activity administered 15 year l. lE-02 5.43-03 1.3%02 4.6E-03 6.3E-03 5.5E-03 5.63-03 5.2E-03 2.7E-02 9.8E-03 8.7E-03 i. 7E-02 5.4E-03 7.6E-03 8.9E-03 1.7E-02 3.7E-03 7.23-03 5.3E-03 4.5E-03 10 year 1.7B-02 7.5E-03 2.2E-02 7.3E-03 9.7B-03 8.2B-03 E. lE-03 8 .OE-03 3.9E-02 1.6E-02 1.4E-02 2.7E-02 7.9E-03 l. lE-02 1.3E-02 2.7E-02 5.3B-03 l.ZE-02 7.9E-03 6.6E-03

(mGy/MBq) 5 year 2.6E-02 l. lE-02 3.7E-02 l.lE-02 1.4E-02 l .ZB-02 1.3E-02 l. lE-02 5.9E-02 2.4E-02 Z. lE-02 4.3E-02 l.ZE-02 1.7E-02 Z.OE-02 4.3E-02 E. lE-03 1.9&02 l.ZE-02 l .OE-02 1 year 4. EB-02 Z . OB-02 7.5E-02 Z.OE-02 2.4E-02 2.23-02 Z.ZE-02 Z. lE-02 l.OE-01 4.5B-02 3. EE-02 E. lE-02 Z. lE-02 3.OE-02 3.5E-02 E. lE-02 1.5E-02 3,5E-02 Z. lE-02 1.9E-02

* * *

Effective dose equivalent (B8v/IW

8.18-03

9.9B-03

1.58-02

2.48-02

4.3B-02

208

RADIATION

DOSE TO PATIENTS

FROM RADIOPHARMACEUTICALS

TC

43 RBC

TECHNETIUM-LABELLED
ggmTc

ERYTHROCYTES

Biokinetic Model Erythrocytes can be labelled with ggmTc in vitro, in vivo, or with a combined in vitro/in vivo method (Callahan et al., 1982). Several studies have demonstrated some elution of technetium from the circulating cells, with half-times of 40 and 80 hr after in vitro or in vivo labelling, respectively. The exact mechanism of elution and the fate of the eluted technetium is not known, but approximately 15% of the activity is excreted in the urine during the first day (Porter et al., 1983). In the model chosen, the activity is assumed to be distributed in the blood, being removed with a half-time of 60 hr, by excretion via the kidneys. No specific uptake in any organ or tissue is assumed. The model assumes 100% efficiency in labelling of the erythrocytes. In the case of incomplete labelling, the separate contribution from free pertechnetate has to be taken into account. References
Callahan, R. J., Froelich, J. W., McKusick, K. A., Leppo, J. and Strauss, W. H. (1982). A modified method for the in uioo labeling of red blood cells with Tc-99m: Concise communication. J. Nucl. Med. 23, 315-318. Dahlstrom, J. A., Carlsson, S., Lilja, B., Mattsson, S. and Pettersson, C. (1979). Cardiac blood pool imaging-A clinical comparison between red blood cells labeled with ggmTcin uivo and in vitro and 99mTc-labeled human serum albumin. Nuk&7rredizin 18, 271-273. Larson, S. M., Hamilton, G. W., Richards, P. and Ritchie, J. L. (1978). Kit-labeled technetium-99m red blood cells (Tc99m-RBCs) for clinical cardiac chamber imaaina. Eur. J. Nucl. Med. 3. 227-231. Porter, W. C.,Dees, S. M., Freitas, J. E. and Dw&kr&, H. J. (1983). Acid-citrate-dextrose compared with heparin in the preparation of in viva/in vitro technetium-99m red blood cells. J. Nucl. Med. 24,383387. Ryo, U. Y. and Pinsky, S. M. (1976). Radionuclide angiography with 99m Technetium-RBCs. In: Crit. Reu. Clin.
Radiol. Nucl. Med. 8, 107-128.

Biokinetic Data
Organ (S) Blood Kidneys Bladder contents FS 1.0 1.0 1.0 T 60 hr a 1.0 A,/& 7.89 hr 2.6 min 9 min

209

rc
43
RBC

BIOKINETIC MODELS AND DATA

Tc-LABELLEDERYTHROCYTES 99%
6.02
hours

per Organ Adult * * Adrenals Bladder vail Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Heart Kidneys Liver Lungs Ovaries Pancreas Red marrav Spleen Testes Thyroid Uterus Other tissue

unit

Absorbed dose activity administered 15 year 1. x-02 l . ZR-02 1.3E-02 4.5%03 6.1E-03 5.3E-03 5.5E-03 5.3E-03 2.8E-02 l .ZE-02 8.8E-03 1. SE-02 5.4E-03 ?.5E-03 8.8E-03 1.0E-02 3.7E-03 7.1E-03 5.7E-03 4.4E-03 10 year 1.7E-02 1.7E-02 2,3B-02 7.2E-03 9,5E-03 8.1E-03 7.9E-03 S.OB-03 4.1E-02 1.9E-02 1,4E-02 2.9E-02 7.9E-03 l . lE-02 1,3E-02 2. SE-02 5.4E-03 l.ZR-02 0.53-03 6.4E-03

(mGy/MBq) 5 .year 2.7E-02 2.5E-02 3.9E-02 l. lE-02 1.4E-02 l .ZB-02 1.3E-02 l . lB-02 6.2E-02 3.OE-02 Z. lB-02 4.53-02 l.ZE-02 1.7E-02 2.0&-02 4.4E-02 8.3E-03 1.9E-02 1.3&02 9. BE-03 1 year 4.9R-02 4.6E-02 7. BE-02 1.9E-02 2.4E-02 2.2%02 Z. lE-02 2.1E-02 l. lE-01 5.58-02 3 *all-02 a. 58-02 2.18-02 2.93-02 3.5E-02 8.4B-02 1.x-02 3.5E-02 2.2E-02 1. SE-02

6.7E-03
9.2E-03 9.2E-03 4.3E-03 4.%B-03 4.4E-03 4.3E-03 3.9E-03 2.3%02 l . OR-02 7.53-03 1.4B-02 4.23-03 6.2%03 7.3E-03 1.5E-02 2 .?E-03 4.9E-03 4.7B-03 3.7E-03

* *

Bffective dose equivalent Wv/lrecl)

0.5%03

l . lB-02

1.6B-02

2.5&02

4.6%02

210

RADIATION

DOSE TO PATIENTS FROM RADIOPHARMACEUTICALS

TC 43 RBC denatured

TECHNETIUM-LABELLED

DENATURED
Tc

ERYTHROCYTES

Biokinetic Model The same model is used as for Cr-labelled denatured erythrocytes (see p. 113), with the exception of the excretion half-time which, because of the short radioactive half-life, is taken as infinite. Reference
Atkins, H. L., Goldman, A. G., Fairchild, R. G., Oster, Z. H., Som, P., Richards, O., Meinken, G. E. and Srivastava, S. C. (1980). Splenic sequestration of 99mTc-labeled, heat-treated red blood cells. Radiology 136, 501-503.

Biokinetic Data
Organ (S) Blood Spleen Liver Remaining tissues Fs 1.00 0.75 0.15 0.10 T 0 3 hr a, ?hr 00 a 0.90 0.10 1.0 1.0 - 1.0 1.0 ASIA, 17 min 6.5 hr 1.3 hr 35 min

211

TC
43 RBC denatured

BIOKINETIC MODELS AND DATA

Tc-LABELLED DENATURED ERYTHROCYTES ggnTc

6.02 hours

per Organ Adult Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Heart Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue 1.3E-02 7. SE-04 3.1E-03 2.1E-03 1.9E-02 3,7E-03 4 .OE-03 1.7E-03 6_OE-03 1. BE-02 1. BE-02 5.7E-03 1.4E-03 3.6E-02 4.3E-03 5.6E-01 4.7E-04 6.3E-04 1.4E-03 3.3E-03

unit

Absorbed dose activity administered 15 year 1.0%02 l. lE-03 4.1E-03 2.1E-03 2.1E-02 4.6%03 4.9E-03 2.3%03 7.3%03 2.2E-02 2.3%02 7.5B-03 2.2E-03 4.OE-02 6.OE-03 7.8E-01 5.9E-04 l .OE-03 1.8E-03 4.1E-03 10 year 2.7B-02 2.1E-03 6.1E-03 4.lE-03 3.OE-02 7.7E-03 8.5E-03 4.3E-03 l . lE-02 3.2E-02 3.4E-O? l. lE-02 3.9E-03 5.7E-02 8.4B-03 1.2E+OO l. lE-03 1. BE-03 3.6E-03 5.0E-03

(mGy/MBq) 5 year 3.8E-02 3.8E-03 9. SE-03 6,8E-03 4.OE-02 1.3E-02 i.bE-02 6.9E-03 1.6E-02 4.6E-02 4.9E-02 1.7B-02 7.0%03 7. BE-02 l. lE-02 1. EEtOO 1.7E-03 3.2E-03 5.9E-03 8.7E-03 1 year 6.33-02 7.3%03 1. W-02 l .OE-02 5. W-02 2.2E-02 2.3E-02 1.3%02 2.6&02 7.0%02 0.7%02 2. BE-02 1.2%02 1.2E-01 1.7%02 3.2E+OO 4. H-03 6.63-03 1.1%02 1.5E-02

* *

* *

Effective dose equivalent WV/W)

4.13-02

5.6B-02

8.4%02

1.3E-01

2.2B-01

212

RADIATION

DOSE TO PATIENTS FROM RADIOPHARMACEUTICALS

TC 43 Phosphonates

TECHNETIUM-LABELLED

PHOSPHATES AND PHOSPHONATES

Tc Biokinetic Model

This group of radiopharmaceuticals includes phosphates, such as pyrophosphate and polyphosphate, and phosphonates such as methylene diphosphonate (MDP, medronate), hydroxymethylene diphosphonate (HMDP, oxidronate), hydroxyethylidene diphosphonate (HEDP), ethane-hydroxy diphosphonate (EHDP), dicarboxypropane diphosphonate (DPD), imido diphosphate (IDP) and similar compounds used for bone imaging. The biokinetic behaviour of these substances is sufficiently similar to justify the use of a common biokinetic model. The main uptake is in bone, with a further small uptake in kidneys, and the excretion is via the renal system. On the basis of the references given below, it is assumed that a fraction of 0.5 of the injected activity is taken up by bone with a half-time of 15 min, and retained there with halftimes of 2 hr (0.3) and 3 d (0.7). In children the uptake is predominantly in the metaphyseal growth zones; this question is discussed in Section 4 of General Considerations. The kidney uptake is set at 0.02 with a retention identical to that of the total body, having half-times (with fractional retention) of 0.5 hr (0.3), 2 hr (0.3) and 3 d (0.4). In pathological cases there may be higher uptake and/or longer retention in bone, especially in kidney diseases. The 24 hr total body retention, which normally amounts to 30%, has been reported as 40% in osteomalacia, 50% in primary hyperparathyroidism, 60% in Pagets disease and 90% in renal osteodystrophia (Fogelman et al., 1978). For absorbed dose calculations in pathological cases an average bone uptake of 70% is assumed, with no excretion. References
Ackerhalt, R. E., Blau, M., Bakshi, S. and Sondel, J. A. (1974). A comparative study of three 99mTc-labeled phosphorus compounds and 18F-fluoride for skeletal imaging. J. Nucl. Med. 15, 1153-l 157. Fogelman, F., Bessent, R. G., Turner, J. G., Citrin, D. L., Boyle, I. T. and Greig, W. R. (1978). The use of whole body retention of Tc99m diphosphonate in the diagnosis of metabolic bone disease. J. Nucl. Med. 19, 270-275. Krishnamurthy, G. T., Huebotter, R. J., Walsh, C. F., Taylor, J. R., Kehr, M. D., Tubis, M. and Blahd, W. H. (1975). Kinetics of 99mTc-labeled pyrophosphate and polyphosphate in man. J. Nucl. Med. 16, 109115. Makler, P. T. and Charkes, N. D. (1980). Studies of skeletal tracer kinetics IV. Optimum time delay for Tc-99m (Sn) methylene diphosphonate bone imaging. J. Nucl. Med. 21, 641-645. Rudd, T. G., Allen, D. R. and Hartnett, D. E. (1977). Tc99m methylene diphosphonate versus Tc99m pyrophosphate: Biologic and clinical comparison. J. Nucl. Med. 18, 872-876. Subramanian, G., McAfee, J. G., Blair, R. J., Kallfelz, F. and Thomas, F. D. (1975). Technetium 99m methylene diphosphate-A superior agent for skeletal imaging. Comparison with other technetium complexes. J. Nucl. Med. 16, 744755.

JAICRP

1s: 1-4-n

213

Tc 43 Phosphonates

BIOKINETIC MODELS AND DATA

Biokinetic Data
Organ (S) (1) Normal uptake and excretion Total body (excluding bladder contents) Fs 1.0 T 0.5 hr 2 hr 3d 0.25 hr 2 hr 3d 0.5 hr 2 hr 3d a &/A, 4.06 hr

Bone

0.5

0.3 0.3 0.4 -1.0 0.3 8.: 0:3 0.4

3.01 hr

Kidneys

0.02

7.5 min

Bladder contents (2) High bone uptake and/or severely impaired kidney function Total body Bone

1.0 1.0 0.7 1.0 -1.0 1.0

1.15 hr 8.69 hr 5.84 hr

oq)25 hr co

214

RADIATION

DOSE TO PATIENTS FROM RADIOPHARMACEUTICALS

TC

43 Phosphonates

99%c
Organ

6.02

Tc-LABELLED PHOSPHATES PHOSPHONATES hours

per Adult unit

AND

Absorbed dose activity administered 15 year 2.7&03 6.2E-02 8.2E-02 8 *0E-04 1. SE-03 2. BE-03 2.5E-03 4.7E-03 8.9E-03 1.6E-03 1.6B-03 4.6B-03 2.0%03 1.3E-02 1.8B-03 3.3E-03 1.6B-03 7.6B-03 2 *3%03 10 year 3.9B-03 9.OE-02 1.3E-01 1.4E-03 2. SE-03 4.4E-03 3.83-03 7.2B-03 1.3%02 2.4E-03 2.4E-03 6.6E-03 3,OE-03 2.OB-02 2.83-03 5.5E-03 2.2E-03 1.2B-02 3.3E-03

(mGy/MBq) 5 year 6.OE-03 1.3E-01 2.2E-01 2.2B-03 3.7B-03 6.6B-03 6.2B-03 l .OE-02 1. BE-02 3.8B-03 3.6B-03 9.7E-03 4.6B-03 3.03-02 4.3B-03 8.4B-03 3.5B-03 1.7E-02 5.OE-03 1 year l. lE-02 2.4E-01 5.3B-01 4.2E-03 7 .OE-03 1.2B-02 l, lE-02 1.7E-02 3.3E-02 7.OE-03 6.9B-03 1.6E-02 8.5B-03 7.5B-02 B . lE-03 1.6B-02 5.6E-03 2.0E-02 8.9E-03

* * * *

Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue

1.9B-03 5 .OB-02 6.3E-02% 0 .a~-04

1.2%03
2.3B-03 2.OB-03 3.03-03 7.3E-03 1.3B-03 1.3B-03 3.5B-03 1.6E-03 9.6E-03 1.4B-03 2.4E-03 l .OE-03 6. HZ-03 1.9E-03

Effective dose equivalent (=Bv/llBq) High Organ * Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue bone

B . OE-03

l . OB-02

1.51-02

2.5B-02

5.OB-02

uptake Adult

and/or

severely 15 year 5,OE-03 3.5B-03 1.6B-01 2.1E-03 3.2E-03 3. BE-03 3.6E-03 4.2E-03 3.7B-03 3.3E-03 3.7E-03 4.1E-03 4.OE-03 2,3E-02 3.4E-03 2.7E-03 3 *7B-03 3.7E-03 3.6E-03

impaired 10 year 7.2B-03 5.4B-03 2.6E-01 3.2E-03 5.1B-03 5.7E-03 5.3E-03 6.53-03 5.6E-03 4.9E-03 5.3E-03 5.9E-03 5.9E-03 3.7E-02 5.1E-03 3.9B-03 5.4E-03 5.4E-03 5.3B-03

kidney 5 year

function 1 year 2.1B-02 l.SE-02

3.5B-03 2.5B-03 1.2E-01 2.1&03 2.6B-03 3.1E-03 2.9E-03 3.4E-03 3.OE-03 2.7E-03 3.0&03 2.9E-03 3.2E-03 1.8E-02 2.6E-03 2.3E-03 2.4E-03 2,9E-03 3.OE-03

l . lE-02 7.4E-03 4.3E-01 5.1E-03 7.3&-03 8. SE-03 8.6E-03 9.63-03 0.7E-03 7.5E-03 E.lE-03 8.9E-03 8.9E-03 7.2E-02 7.0E-03 6.OE-03 8.3E-03 0.2E-03 0.1E-03

1. OR+00
9.63-03 1.4E-02 1.6E-02 1.5E-02 1. EE-02 1.6E-02 1.4E-02 1.5%02 1.6E-02 1.6E-02 1.4E-01 1,5E-02 l. lE-02 1.4E-02 1. SE-02 1.53-02

* * *

Bffective dose equivalent (mBv/lras)

8.2B-03

l . lE-02

1.7B-02

Z.BB-02

6.18-02

215

RADIATION DOSE TO PATIENTS FROM RADIOPHARMACEUTICALS

Tc 43

TECHNETIUM-LABELLED
99mT~ Biokinetic Data

AEROSOLS

Inhalation of aerosols consisting of particles smaller than 2-3 pm in diameter in well-defined respiratory breathing patterns results in a deposition mainly in the alveoli, with only minimal deposition in bronchi and upper airways (Taplin and Chopra, 1978). In free breathing, such particles are deposited in the bronchii and upper airways. Particles made of readily soluble substances !tre rapidly cleared from the lungs via the blood stream, while particles made of slowly dissolving or insoluble material are retained for longer times, up to several weeks or months, depending upon type of material. During this time the label is slowly released to the bloodstream. There is thus a need for two variants of the biokinetic model. Soluble particles are usually prepared from DTPA, although pertechnetate may also be used. The biological half-time of Tc-DTPA in the lungs is 6@80 min in normal non-smokers; it is shortened in smokers and in most patients with lung disease (Cook and Lander, 1971; Jones et al., 1980; Barber, 1985; Coates and OBrodovich, 1986). A value of 60 min is adopted here. Substance reaching the blood is eliminated according to the model for intravenously administered Tc-DTPA. The other type of particles is usually prepared from an albumin solution, but other materials such as colloidal albumin, albumin millimicrospheres, sulphur colloid and dry (solid) particles are also used. (Pircher et al., 1967; Kotrappa et al., 1977; Kiihn et al., 1985). It is assumed that the label is released in the lung with a biological half-time of 24 hr, and that the activity is excreted by the kidneys according to the model proposed for pertechnetate when a blocking agent has been given. References
Barber, R. W. (1985). Radiation doses from technetium-99m DTPA administered as an aerosol. J. Nucl. Med. 26, 119&l 194. Coates, G. and OBrodovich, H. (1986). Measurement of pulmonary epithelial permeability with 99Tc-DTPA aerosol. Semin. Nucl. Med. 16, 275-284. Cook, D. J. and Lander, H. (1971). Inhalation pulmonary scintiphotography using pertechnetate. Am. J. RoenrgenoL 113,682-689. Jones, J. G., Lawler, P., Crawley, J. C. W., Minty, B. D., Hulands, G. and Veal&N. (1980). Increased alveolar epithelial permeability in cigarette smokers. Lancet i, 6G68. Kiihn, H., Klech, H., Angelberger, P., Strigl, A., Zolle, I., Kummer, F. and Mostbeck, A. (1985). Dry aerosol of monodisperse millimicrospheres for ventilation imaging: Production, delivery system, and clinical results in comparison with 8lm-krypton and 127-xenon. Eur. J. Nucl. Med. 10,411-416. Kotrappa, P., Raghunath, B., Subramanyam, P. S. S., Raikar, U. R. and Sharma, S. M. (1977). Scintiphotography of lungs with dry aerosol-generation and delivery system: Concise communication. J. Nucl. Med. 18, 1082-1085. Pircher, F. J., Knight, C. M., Barry, W. F., Temple, J. R. and Kirsch, W. J. (1967). Retention, distribution and absorption of inhaled albumin aerosol and absorbed dose estimates from its 1 and Tcppmlabels. Am. J. Roentgenok 100,813-821. Taplin, G. V. and Chopra, S. K. (1978). Lung perfusion-inhalation scintigraphy in obstructive airway disease and pulmonary embolism. Radiol. C[in. N. Am. 16, 491-513.

217

TC

BIOKINETIC

MODELS

AND DATA

43
Aerosol

BiokineticData
Organ (S) Fs T a As/A, 1.24 hr 3.8 min 1.08 hr 1.61 hr

(1) Substances with fast clearance from lungs (e.g. DTPA) Lungs 1.0 1.0 hr 1.0 Kidneys 1.0 Bladder contents 1.0 Remaining tissues 1.0 1.0 hr -1.0 1.67 hr 0.99 7.0d 0.01 (2) Substances with slow clearance from lungs (e.g. albumin) Lungs 1.0 24 hr 1.0 Kidneys 1.0 Bladder contents 1.0 Remaining tissues 1.0 24 hr -1.0 1.67 hr 0.99
7.0 d 0.01

6.94 hr 53 s 18.3 min 23.5 min

Tc-LABELLED AEROSOLS
Substances ggmTc 6.02 hours per Organ Adult 15 year 10 year 4.4B-03 8.43-02 3.5E-03 3.3E-03 3.5E-03 4.1E-03 3.8B-03 6.3B-03 7.2E-03 3.78-03 3.6E-02 6.1E-03 4.OB-03 4 *7B-03 3.6B-03 5,2E-03 2.7E-03 l.lB-02 3.2B-03 5 year 6.7E-03 l.ZE-01 5.3E-03 4.83-03 5.1E-03 6.38-03 6.1E-03 8.8E-03 l. lE-02 5.5E-03 5.4B-02 8.9E-03 6.lE-03 6.2&03 5.6B-03 7.9B-03 4.4E-03 1.6B-02 4.9E-03 1 year unit with fast clearance from lungs (e.g. UTPA) Absorbed dose activity administered

(mGy/MBq)

Adrenals Bladder wall Bone surfaces

Breast (X-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue

Z. lE-03 4.7E-02 1.9E-03 1.9E-03 1.7E-03 Z . lB-03 1.9E-03 3.2B-03 4.1E-03 1.91-03

2.9B-03
5.8E-02 2.4B-03 1.9E-03 Z. ZE-03 2.6B-03 2.4E-03 4.2B-03 5. H-03 2.5E-03 2.6B-02 4.1E-03 2.6B-03 3.4E-03 2.4E-03 3.1E-03 1.7B-03 7.2&03 Z.ZE-03

l.ZE-02
2.3E-01 9.83-03 7.8E-03 8.9E-03 l. lE-02 l .OE-02 1.5E-02 1.9E-02 9.7B-03 l .OB-01 1.5E-02 l. lE-02 9.6B03 9.9E-03 1.5B-02 7.8E-03 2.7E-02 8.6E-03

1.7E-02
3.3E-03 Z. lE-03 2.7E-03 1.9E-03 Z. lE-03 9.98-04 5.9E-03

1.8E-03
7.OB-03

Effective dose equivalent (mSv/nes)

9.1B-03

1.3B-02

Z . OB-02

3.6B-02

218

RADIATION

DOSE TO PATIENTS FROM RADIOPHARMACEUTICALS

Tc 43 Aerosol

Tc-LABELLED
Substances with slow clearance

AEROSOLS
from lungs (e.g. albumin)

99%c
Organ * *

6.02

hours per Adult 5. x-03 1.3E-02 3.1E-03 6.43-03 3.8E-03 8.9E-04 8.?E-04 9.9E-04 2.53-03 4.93-03 9.3E-02 1 .OE-03 5.2E-03 4.1E-03 4,6B-03 5.8E-04 1.9E-03 l .?E-03 2.8E-03 unit

Absorbed dose activity administered 15 year 8.1E-03 1.6E-02 4.1E-03 6.4E-03 4.6E-03 l.ZE-03 1.3E-03 1.3E-03 3.5E-03 7.OE-03 1.4E-01 1.3E-03 6.4E-1!3 6.OE-03 5.9E-03 8.4E-04 3.2E-03 Z. lE-03 3.5E-03 10 year l.ZE-02 2.4E-02 5.9E-03 l . ZE-02 6.7E-03 Z.lE-03 2.4E-03 Z.OE-03 5.4E-03 9.5E-03 1.9E-01 Z. lE-03 9.4E-03 7.81-03 8.6E-03 1.5E-03 5.53-03 3,4E-03 4.83-03

(mCy/MBq) 5 year 1. BE-02 3.6E-02 0.9E-03 1.7%02 9.9E-03 3.6E-03 4.1E-03 3.3E-03 8.3E-03 1.4E-02 2.9E-01 3.4E-03 1.4E-02 9.9E-03 1.3E-02 2.3E-03 9.OE-03 5.2E-03 7.2E-03 1 year 3.1%02 6.X-02 1.7E-02 2.41-02 1.6E-02 7.1E-03 7.6E-03 6.3E-03 1.5E-02 2.3E-02 5.6E-01 6.4E-03 2.53-02 1.6E-02 2.3%02 4.6E-03 1.6E-02 9.5E-03 1.3E-02

Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue

* *

Effective dose equivalent (=Sv/lIBq)

l . %-02

Z . ZB-02

3.1E-02

4.6B-02

8. SB-02

219

RADIATION DOSE TO PATIENTS FROM RADIOPHARMACEUTICALS

TC

43 Heparin

TECHNETIUM-LABELLED
99mT~ Biokinetic Model

HEPARIN

Kinetic data from studies in humans have been published by Esquerrk et al. (1979) and Utne et al. (1981). The blood clearance is biphasic with a rapid (T,,,=613 min) and a slow (T,,, = 3.9-4.1 hr) phase. There is a dominating uptake in the liver, and some further uptake in spleen and bone marrow, presumably in the reticula-endothelial cells. The label is rapidly excreted in the urine. No biliary excretion is demonstrable in man. Quantitative organ uptake measurements in dogs have been performed by Kulkarni et al. (1978). On the basis of these reports it can be assumed that 80% of intravenously injected substance immediately leaves the blood by uptake in the liver (30%), spleen (5%), bone marrow (10%) and other tissues (35%). From all organs and tissues thk activity disappears with a half-time of 4 hr for excretion by the kidneys. References
Esquerrb, .I. P., Boneu, B. and Guiraud, R. (1979). Kinetics of technetium-labeled heparin in thromboembolism: Preliminary report. Int. J. Nucl. Med. Biol. 6, 215-220. Kulkami, P. V., Parkey, R. W., Buja, L. M., Wilson III, J. E., Bonte, F. J. and Willerson, J. T. (1978). Technetiumlabeled heparin: Preliminary report of a new radiopharmaceutical with potential for imaging damaged coronary arteries and myocardium. J. Nucl. Med. 19,810-815. Utne, H. E., Pors Nielsen, S. and de Schrijver, M. (1981). Technetium-Heparin: Radiopharmacokinetic and clinical aspects. In: Progress in Radiopharmacology, Vol. 2, pp. 193-201. (Cox, P. H. ed.) Elsevier, Amsterdam.

Biokinetic Data
Organ (S) Blood Liver Red marrow Spleen Kidneys Bladder contents Remaining tissues Fs 0.20 0.30 0.10 0.05 1.0 1.0 0.35 T 4.0 hr 4.0 hr 4.0 hr 4.0 hr a 1.0 1.0 1.0 1.0 &IA, 41.6 min 1.04 hr 20.8 min 10.4 min 3.3 min 1.07 hr 1.21 hr

4.0 hr

1.0

JAICRP

18:1-4-H*

221

Tc

BIOKlNETlC

MODELS AND DATA

43 Heparin

Tc-LABELLED HEPARIN

99%

6.02

hours

per Organ Adult Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI vall LLI wall Heart Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue 3.4E-03 4.73-02 3.6E-03 1.5&03 2.4E-03 2.9E-03 2.8E-03 3.6E-03 3.6E-03 5.78-03 1.4E-02 2.8&03 3. ?E-03 3 . ?B-03 5.7%03 1. ?E-02 2.2&03 1.1%03 6.2E-03 1.9E-03

unit

Absorbed doee activity administered 15 year 4.7E-03 5.8%02 4.8E-03 1.5E-03 3.1E-03 3.5E-03 3.6E-03 4.6E-03 4.48-03 6.8E-03 1. x-02 3.7E-03 4.?B-03 4.8E-03 ?.3E-03 2.4E-02 3.2E-03 1. ?B-03 7.6&03 2.3E-03 10 year 7.OE-03 8.4B-02 7 .?E-03 2.3E-03 4.9E-03 5.6E-03 5.7E-03 70 OE-03 6.4E-03 l . OE-02 2.5B-02 5.5E-03 6.9B-03 ?.3E-03 l. lB-02 3.6%02 5.3E-03 2.6B-03 1.2B-02 3.4B-03

(mGy/MBq) 5 year 9.8B-03 1.2E-01 1.3E-02 3.7E-03 7.4B-03 8.6E-03 9.3B-03 9.8E-03 9,5E-03 1.5B-02 3.6E-02 8.3E-03 l . OE-02 l . lE-02 1.7e-02 5.53-02 8.2B-03 4.3B-03 1.7E-02 5.2E-03 1 year 1.7B-02 2.3E-01 2.6E-02 6.7E-03 1,3E-02 1.5E-02 1.5E-02 1.78-02 1.6E-02 2.5E-02 6.5%02 1.5E-02 l. ?E-02 1.8B-02 3.2E-02 9.93-02 1.5E-02 7.8E-03 2.83-02 9.23-03

* *

* *

Effective dose equivalent (=Sv/nss)

7.3B-03

9.3B-03

1.48-02

Z . lE-02

3.83-02

222

RADIATION

DOSE TO PATIENTS

FROM RADIOPHARMACEUTICALS

TC 43 MAA

TECHNETIUM-LABELLED

MACROAGGREGATED
ggmTC

ALBUMIN

Biokinetic Model The model for Tc-labelled MAA is the same as that used for iodine-labelled MAA (see p. 293), with the modification that released technetium is assumed to be excreted by the kidneys according to the model proposed for pertechnetate when a blocking agent has been given. Biokinetic Data
Organ (S) Total body (excluding bladder contents) Lungs Liver Kidneys Bladder contents Fs 1.0 1.0 0.25 1.0 1.0 6 hr 3d 6 hr 5d 0.85 0.15 -1.0 1.0 T a &IA, 7.61 hr 4.89 hr 1.04 hr 1.07 min 13.0 min

223

Tc 43 MAA

BIOKINETIC MODELS AND DATA

gg%c

Tc-LABELLED MACROAGGREGATED ALBUMIN

6.02 hours

Absorbed

dose

per Organ Adult * * Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue 5.8&03 l . OE-02 3.5E-03 5.6E-03 4 .OE-03 2.lE-03 2.2E-03 1.6E-03 3.7E-03 1*6E-02 6.7B-02 1.8E-03 5. BE-03 4.41-03 4.4B-03 l. lE-03 2.OE-03 2.4E-03 2.9E-03

unit

activity 15 year 8.7E-03 1.3E-02 4.4B-03 5.53-03 5,2E-03 2.6E-03 2.9E-03 2.lE-03 4.83-03 2.1E-02 9.9E-02 2.3E-03 7.5E-03 6.2E-03 5.63-03 1.4E-03 3.3E-03 2.9E-03 3.6B-03

administered,(mGy/MBq) 10 year 5 year 1.9E-02 2. BE-02 9.7E-03 1.4&02 1.2E-02 7.OE-03 8.4E-03 5.4E-03 l.lE-02 4.3E-02 2.1e-01 5.9E-03 1.7E-02 l. lB-02 1.3E-02 3.78-03 9.OB-03 7.1&03 7. BE-03 1 year 3.lB-02 5.lE-02 1.9&02 2.2B-02 2.OE-02 1.3E-02 1.5E-02 l .OE-02 1. BE-02 7.5E-02 4.OE-01 l . lE-02 2.9E-02 1.7E-02 2.2E-02 7.lE-03 1.6E-02 1.3E-02 1.4E-02

.l .3E-02
1.9E-02 6.4E-03 l .OE-02 7.8E-03 4.3E-03 5.0%03 3.53-03 7.2E-03 3.OE-02 1.4E-01 3.7B03 1. H-02 8.3E-03 8.3E-03 2.3B03 5.5E-03 4.6E-03 5.2E-03

* *

Effective dose equivalent (=Sv/llBq)

l.i!B-02

1. EE-02

2.5B-02

3.8B-02

6.9B-02

224

RADIATIONDOSE TO PATIENTS FROM RADIOPHARMACEUTICALS

TC 43 Markers

TECHNETIUM-LABELLED

NON-ABSORBABLE
Tc

MARKERS

Biokinetic Models Substances labelled with technetium are used as non-absorbable markers in studies of the gastrointestinal tract. For absorbed dose calculations a modified ICRP model for the gastrointestinal tract is used, as described in Appendix Section A.3. References
Chadhuri, T. K. (1974). Use of 99m Tc-DTPA for measuring gastric emptying time. J. Nucl. Med. 15, 391-395. Fisher, R. S., Malmud, L. S., Roberts, G. S. and Lobis, I. F. (1976). Gastroesophageal (GE) scintiscanning to detect and quantitate GE reflux. Gasrroenterology 70, 301-308, Meyer, J. H., MacGregor, I. L., Gueller, R., Martin, P. and Cavalieri, R. (1976). 99mTc-tagged chicken liver as a marker of solid food in the human stomach. Am. J. Dig. Dis. 21, 296304.

Biokinetic Data
Organ (S) (1) Oral administration of fluids GI-tract contents Stomach SI ULI LLI (2) Oral administration of solids G&tract contents Stomach SI ULI LLI Fs AslAo

1.0 1.0 1.0 1.0

1.0 1.0

31.0min 2.58 hr 3.35 hr 1.64 hr

1.0 1.0

1.69 hr 2.21 hr 2.87 hr 1.41 hr

225

TC

BIOKINETIC MODELS AND DATA

43 Markers

Tc-LABELLED NON-ABSORBABLE MARKERS

Oral administration of fluids

ggnspc
6.02

hours Absorbeddose Par unit activityadministered (mGy/MBq) Adult 15 year 3.33-03 9.OE-03 3.53-03 4.23-04 3.OE-02 9.1E-02 1.6E-01 l.lE-01 6.7E-03 4.93-03 9.1E-04 3.23-02 7.93-03 l.OE-02 5.OE-03 Z.OE-03 4.8E-05 Z.OE-02 4.OE-03 2.9E-02 10 year 5.43-03 1.4E-02 5.0&03 9.23-04 4.23-02 1.5E-01 2.6801 1.8E-01 l.OE-02 9.33-03 1.6E-03 4.73-02 1.2%02 1.3E-02 7.83-03 3.83-03 1.5E-04 3.1E-02 5.9E-03 4.7B-02 5 year 8.9E-03 Z.ZB-02 7.4E-03 1.9E-03 6.83-02 2.3E-01 4.1E-01 2.9E-01 1.5E-02 l.bE-02 2.9E-03 6.93-02 1.8B-02 1.5E-02 l.ZE-02 6.4E-03 3.83-04 4.83-02 8.93-03 7.31-02 1 year 1.5%02 3.5B-02 1.4E-02 3.83-03 1.3E-01 4.OE-01 7.7E-01 5.5E-01 2.33-02 2.73-02 5.78-03 l.lE-01 3.1E-02 1.8E-02 Z.OE-02 l.ZE-02 l.lE-03 7.7E-02 1.5E-02 1.3%01

Organ Adrenals Bladderwall Bone surfaces Breast GI-tract Stomachwall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue Effective dose equivalent (mSv/lras) Z.lE-03 ?.OE-03 2.83-03 4.23-04 2.4E-02 ?.ZE-02 1.3E-01 8.83-02 5.73-03 4.OE-03 6.73-04 2.6E-02 6.5%03 8.93-03 4.23-03 1.3E-03 4.08-05 1.5E-02 3.43-03 2.4B-02

* * * *

Oral administration of solids Organ Adrenals Bladder wall Bone surfaces Breast GI-tract Stomachwall Small intest ULI wall LLI wall Adult 2.7E-03 6.1E-03 2.73-03 6.93-04 6.lE-02 6.23-02 l.lE-01 7.63-02 6.1E-03 4.23-03 l.ZE-03 2.33-02 l.ZE-02 8.23-03 7.OE-03 l.lE-03 6.43-05 1.3E-02 3.4E-03 2.43-02 15 year 4.33-03 7.93-03 3.43-03 6.93-04 7.73-02 7.93-02 1.3E-01 9.43-02 7.1E-03 5.1E-03 1.5E-03 2.83-02 1.3E-02 9.3E-03 8.2E-03 1.7E-03 7.4B-05 1.8E-02 4.OE-03 2.9B-02 10 year 6.83-03 1.3E-02 4.83-03 1.4E-03 l.lE-01 1.3E-01 2.2%01 1.6E-01 l.lE-02 9.63-03 2.33-03 4.lE-02 Z.OE-02 l.ZE-02 l.ZE-02 3.33-03 1.9E-04 2.8E-02 5.93-03 4.6E-02 5 year l.lE-02 1.9E-02 7.2E-03 2.73-03 1.7E-01 Z.OE-01 3.5E-01 2.5E-01 1.5E-02 1.6E-02 4.OE-03 6.OE-02 2.7E-02 1.4E-02 1.7E-02 5.63-03 5.1E-04 4.26-02 8.8E-03 7.1B-02 1 year 1.8E-02 3.1E-02 1.4E-02 5.1E-03 3.3E-01 3.5E-01 6.6E-01 4.8E-01 2.43-02 2.83-02 7.63-03 9.73-02 4.43-02 1.7%02 2.63-02 l.lE-02 1.4E-03 6.83-02 1.5E-02 1.3E-01

* * * *

Kidneys Liver Lungs Ovaries * Pancreas. Red marrow Spleen Testes Thyroid Uterus Other tissue Effective dose equivalent (=Sv/W)

226

RADIATIONDOSE TO PATIENTS FROM RADIOPHARMACEUTICALS

Tc 43 Microspheres

TECHNETIUM-LABELLED

ALBUMIN MICROSPHERES
QQmT~

Biokinetic Model Technetium-labelled microspheres, prepared from human serum albumin, are used and metabolized in the same way as macroaggregated albumin, with the exception that no appreciable liver uptake has been seen. The kinetics have been studied by Wicks et al. (1981), whose results form the basis for the MIRD dose estimate report (Blau et al., 1981). The microspheres are initially trapped in the lungs, and the activity leaves the lungs in the form of pertechnetate by leaching off the microspheres rather than by their breakup. In the model adopted here the disappearance rate in the lungs is taken from the MIRD report, and the pertechnetate set free is treated according to the model proposed for pertechnetate when a blocking agent has been given. References
Blau, M., Wicks, R., Thomas, S. R. and Lathrop, K. A. (1982). MIRD dose estimate report No. 10. Radiation absorbed dose from albumin microspheres labeled with technetium-99m. J. Nucl. Med. 23,915-917. Wicks, R., Rosenspire, K., Ackerhalt, R., Langan, M., Steinbach, J. J. and Blau, M. (1981). Distribution of Tc-99m administered as labeled microspheres for lung imaging. In: hoc. Third ht. Radiopharmaceutical Dosimetry Symposium, Oak Ridge, 1980, pp. 454463, FDA 81-8166. Oak Ridge National Laboratories, Oak Ridge, Tennessee.

Biokinetic Data
Organ (S) Total body (excluding bladder contents) Lungs Kidneys Bladder contents F, 1.0 1.0 1.0 1.0 T a &/A, 7.03 hr 4.26 hr 1.75 min 21.4 min

1.8 hr 1.5 d

0.60 0.40

227

TC

BIOKINETIC MODELS AND DATA

43 Microspheres

Tc-LABELLED ALBUMIN MICROSPHERES

gg%
6.02 hours

per Organ Adult * * Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue 4.BB-03 1.7&-02 3 *7%03 5.2%03 3.8E-03 2.48-03 2.3E-03 2.5E-03 3.4E-03 4.5E-03 5.03-02 2.6E-03 4.9E-03 4.6E-03 4.43-03 1.7%03 Z. ZE-03 3.63-03 3.OE-03

unit

Absorbed doee activity administered 15 year 6.9E-03 Z. lE-02 4.6E-03 5.2E-03 4.8E-03 3.OE-03 3.OE-03 3.2E-03 4.5&03 6.1E-03 8.6&02 3.3E-03 6.OE-03 6.2E-03 5.4E-03 2.3%03 3. ?E-03 4.3E-03 3.7E-03 10 year l . OE-02 3.OB-02 6.7E-03 9. HI-03 7.2E-03 4.7E-03 4.7B-03 5.1E-03 6.6B-03 8.6E-03 1.2%01 5.OB-03 9.0&03 8.4E-03 8.1E-03 3.7E-03 6.1E-03 6.7E-03 5.4E-03

(mGy/MBq) 5 year 1.6E-02 4.5E-02 l . OE-02 1.3E-02 l . OE-02 7.38-03 7.7E-03 7.4E-03 l . OE-02 l .ZE-02 1.8E-01 7.7g-03 1.4B-02 l. lE-02 1.2&-02 5.7E-03 9. BE-03 9.9&-03 B. lE-03 1 year 2.7E-02 0.2E-02 1.9B-02 Z . OE-02 1.8E-02 1.3E-02 1.3E-02 1.4B-02 1.7E-02 2 *ZE-02 3.5E-01 1.4B-02 2.4E-02 1.0E-02 Z. lE-02 l . lB-02 1.7B-02 1.78-02 1.5E-02

* *

Effective dose aquivalant (=Sv/wes)

1.1%02

1.6B-02

2.2E-02

3.3B-02

6.2B-02

228

RADIATION

DOSE TO PATIENTS

FROM RADIOPHARMACEUTICALS

TC 43 Platelets

TECHNETIUM-LABELLED

TktcTELETS (THROMBOCYTES)

Biokinetic Model The same model is used as for 1lIn-labelled thrombocytes (see p. 253), with the exception of the excretion half-time which, in view of the short radioactive half-life, is taken as infinite. Biokinetic Data
Organ (S) Blood Liver F, 1.0 0.30 T 0 4d 0 4d ?d 0 4d ?d aJ a 0.40 0.60 -0.33 -0.67 1.0 -1.0 1.0 -0.86 -0.14 1.0 -1.0 1.0 UA, 4.90 hr 57.8 min

Red marrow Spleen

0.25 0.35

7.69 min 2.64 hr

Remaining tissues

0.10

3.08 min

229

BIOKJNETIC MODELS AND DATA

gg%

Tc-LABELLED PLATELETS (THROMBOCYTES)

6.02 hours

per Organ Adult Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach vall Small intest ULI wall LLI wall Heart Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue l. lE-02 2.4B-03 7.3&03 3.5E-03 l. lE-02 4.2E-03 4.4E-03 2.9E-03 1.7E-02 1.3E-02 1.7E-02 l. lE-02 2.9E-03 1.9E-02 7.3E-03 2.4E-01 1.7E-03 3.2E-03 3,1E-03 3.6E-03

unit

Absorbed dose activity administered 15 year 1.5E-02 3.4E-03 l. OE-02 3.6%03 1.3E-02 5.2E-03 5.5E-03 3.9E-03 Z .OE-02 1.5E-02 2.1E-02 1.4B-02 4.OE-03 2.1E-02 9.3E-03 3.3E-01 2.2E-03 4.7E-03 3.7B-03 4.3E-03 10 year 2.2E-02 5.OE-03 1.8E-02 6.2E-03 1.8E-02 8.2E-03 a. TE-03 6.3E-03 3.OE-02 2.3E-02 3.2E-02 2.2E-02 6.2E-03 3.1E-02 1.4E-02 5.OE-01 3.3E-03 7.6E-03 6.OE-03 6.3E-03

(mGy/HBq) 5 year 3.3&02 7.5E-03 3.OE-02 9.7B-03 2. SE-02 1.3E-02 1.4B-02 9.2E-03 4.5E-02 3.5E-02 4.6E-02 3.5&02 9.7E-03 4.3%02 2.1E-02 7.6&01 5.1E-03 1.2E-02 9.1E-03 9.5E-03 1 year 5.7B-02 1.4%02 6.OB-02 1.6E-02 3.9E-02 2.28-02 2.3E-02 1.7%02 7.6E-02

* * *

a. 2E-02
6.4%02 1.7%02 6.8%02 3.73-02 1.4EtOO

5.71-02

* *

9.8E-03
2.3E-02 1.7%02 1.7E-02

Effective dose equivalent (BSV/llBq)

Z . ZB-02

2.9B-02

4.4B-02

6.7%02

l . ZB-01

230

RADIATION

DOSE TO PATIENTS FROM RADIOPHARMACEUTICALS

TC 43 WBC

TECHNETIUM-LABELLED

WH~~;,LOOD

CELLS (LEUKOCYTES)

Biokinetic Model The same model is used as for indium-labelled leukocytes (see p. 255), with the exception that, in view of the short physical half-life, the retention half-times are set to infinity. References
Hanna, R., Braun, T., Levendel, A. and Lomas, F. (1984). Radiochemistry and biostability of autologous leukocytes labelled with 99mTc-stannous colloid in whole blood. Eur. J. Nucl. Med. 9, 2&219. Kelbaek, H., Fogh, J., Gjorup, T., Billow, K. and Vestergaard, B. (1985). Scintigraphic demonstration of subcutaneous abscesses with 99mTc-labeled leukocytes. Eur. J. Nucl. Med. 10, 302-303. Schroth, H. J., Oberhausen, E. and Be&rich, R. (1981). Cell labelling with colloidal substances in whole blood. Eur. .I. Nucl. Med. 6,469-472.

Biokinetic Data
Organ (S) Blood Liver F, 1.0 0.20 T 0 7 hr 0 7 hr 0 7 hr 0 7 hr 0 7 hr cc a 0.60 0.40 -0.60 -0.40 1.0 -0.60 -0.40 1.0 -0.60 -0.40 1.0 -0.60 -0.40 1.0 &JA, 1.87 hr 1.36 hr

Red marrow

0.30

2.05 hr

Spleen

0.25

1.70 hr

Remaining tissues

0.25

1.70 hr

231

Tc 43 WBC

BIOKINETIC MODELS AND DATA

Tc-LABELLED WHITE BLOOD CELLS (LEUKOCYTES)

ggmTc 6.02 hours

per Organ Adult Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI vall LLI vall Heart Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue 8.9B-03 2.6E-03 1,3E-02 3.1%03 8.OE-03 4.9E-03 4.9E-03 3.9E-03 9.OE-03 9.9E-03 2.OE-02 6.9E-03 4.2E-03 1.4E-02 2.23-02 1.5E-01 1,7E-03 2.48-03 3.83-03 3.4B-03

unit

Absorbed dose activity administered 15 year 1.2E-02 3.7E-03 1.7E-02 3.1E-03 9.6&03 5.8E-03 6.OE-03 5.OE-03 l. lE-02 1.2E-02 2.4E-02 9.0%03 5.2%03 1.6E-02 2.9E-02 2.1E-01 2.3E-03 3.7E-03 4.5%03 4.2E-03 10 year 1.8E-02 5.6E-03 2.8E-02 5.1E-03 1.4E-02 8.8E-03 9.3803 7.6E-03 1.6E-02 1.8E-02 3.6E-02 1.3E-02 7.5E-03 2.4E-02 4.5E-02 3.2E-01 3.43-03 5.7E-03 6.8E-03 6.OE-03

(mGy/MBq) 5 year 2.5E-02 8.OE-03 5,OE-02 7,8E-03 2.OE-02 1.3E-02 1.4E-02 1.0%02 2.3E-02 2.5E-02 5.2E-02 2.OE-02 l. lE-02 3.3E-02 7.8E-02 4.8E-01 5.2E-03 9.lE-03 9.9E-03 9.OE-03 1 year 4.2%02 1.4E-02 l .OE-01 1.3E-02 3.1%02 2.2E-02 2.3E-02 1.8E-02 3.9E-02 4.0&02 9.2E-02 3.6E-02 1.8E-02 5.2E-02 1.5E-01 8.7E-01 9.7E-03 1.7E-02 1.7E-02 1.6E-02

* * *

* *

Effective dose equivalent (mSv/HBq)

1.7B-02

2.3B-02

3.5B-02

5.4B-02

9.83-02

232

RADIATION

DOSE TO PATIENTS

FROM RADIOPHARMACEUTICALS

In
49 Ion

INDIUM
Biokinetic Model Ionic indium, injected intravenously at a pH of about 2, binds to plasma transferrin. With a metabolism qualitatively resembling that of iron, it localizes in the red bone marrow and is partly incorporated into the circulating red blood cells (4% of the injected activity after 12 d, see McAfee and Subramanian, 1975). Liver accumulation is reported to be greater than that of iron. In accordance with ZCRP Publication 30 (ICRP, 1980), it is assumed that fractions of 0.3,0.2, 0.07 and 0.01 of the injected activity are deposited in red bone marrow, liver, kidneys and spleen, respectively. The remaining fraction of indium is assumed to be uniformly distributed through all other organs and tissues of the body. The total-body retention function, which is based on measurements in mice (Castronovo and Wagner, 1971, 1973), has component half-lives of 2 d (0.3) and 70 d (0.7). References
Castronovo, F. P. and Wagner, H. N. (1971). Factors affecting the toxicity ofthe element indium. &. J. Exp. Pathol. 52, 543-559. Castronovo, F. P. and Wagner, H. N. (1973). Comparative toxicity and pharmacodynamics of ionic indium chloride and hydrated indium oxide. J. &cl. Med. 14,677-682. ICRP (1980). Limitsfir Intakes ofhdionuclides by Workers, ICRP Publication 30: Part 2. Pergamon, Oxford. McAfee, J. G. and Subramanian, G. (1975). Radioactive agents for imaging. In: Clinical Scintillation Imaging, p. 62. (Freeman, L. M. and Johnson, P. M. eds) Grune and Stratton, New York.

Biokinetic Data

Organ (S) Total body Red marrow Kidneys Liver Spleen

Fs 1.0 0.3 0.07 0.2 0.01,

T 2d 70 d 2d 70 d 2d 70 d 2d 70 d 2d 70d

a 0.3 0.7 0.3 0.7 0.3 0.7 0.3 0.7 0.3 0.7

In 3.25 d 23.4 hr 5.47 hr 15.6 hr 47 min

113nqn
2.37 hr 43 min 10 min 28 min 1.4 min

233

In 49 Ion

BIOKINETIC MODELS AND DATA

INDIUM
2.03 days per Organ Adult * Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue 2.3E-01 8.21-02 3.1E-01 8.2E-02 1.3E-01 1.5E-01 1.5E-01 1.2R-01 8.8E-01 6.1E-01 l. lE-01 1.2E-01 1.9E-01 6.OE-01 3 .OE-01 5.3E-02 6.4E-02 1.2E-01 9.5E-02 15 year 2.9E-01 1.1%01 4.3E-01 0.1E-02 1.5E-01 1.8E-01 1.8E-01 1.5%01 10 year 4.2E-01 1.7E-01 7 *OR-O1 1.2%01 2.4E-01 2.7E-01 2.7E-01 2.3E-01 1,5E+OO 1. lE+OO 2.2E-01 2.4E-01 3.7E-01 1.2E+OO 6.OE-01 l. lB-01 1.4E-01 2.1E-01 1.7E-01 5 year 5.9%01 2.5E-01 1.2R+oO 1.9%01 3.6E-01 3.9E-01 4.2%01 3.1E-01 2.lE+OO 1.6E+OO 3.2E-01 3.4E-01 5.4E-01 2.OE+OO 9.OE-01 1.7E-01 2.2%01 3.1E-01 2.6E-01 1 year 9.8E-01 4.3E-01 2. SE+00 3.4E-01 6.2E-01 6.4E-01 6.9E-01 5.2E-01 3.5E+OO 2.7E+OO 5.6E-01 5.6E-01 8.9E-01 3.9E+OO 1.5E+OO 3.1E-01 4.OE-01 5.1E-01 4.6E-01 unit Absorbed dose activity administered (mGy/MBq)

* *

1. lE+OO
?.6E-01 1.5E-01 1.6E-01 2.5E-01 7.6%01 4.OE-01 7.4E-02 9.43-02 1.4E-01 1.2E-01

* *

Effective dose equivalent WV/W) ose 114mIn 113rnIn Organ * Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue (49.51 d)

2.6B-01

3.3%01

4.9E-01

7.5%01

1.4B+oo

equivalent 2.5E+Ol

(mSv/MBq of 3.1B+Ol

the

impurity) 5.OEtOl

a.

6E+Ol

1.0Et02

1.658

hours Adult 5.33-03 2.53-03 2. Hz-02 2.0E-03 3.4E-03 3.0B-03 3.83-03 3.4B-03 S . lE-02 2.RE-02 3.1E-03 3.4B-03 4.63-03 4.1E-02 1.4E-02 2.2B-03 2.33-03 3.1B-03 2.8B-03 15 year 6.83-03 3.2E-03 3.0&-02 2. BB-03 4.OE-03 4.5E-03 4,5E-03 4 .OB-03 6.33-02 3.63-02 4.OE-03 4.3E-03 5.6%03 5.7E-02 2.OE-02 2.6E-03 3.OE-03 3,9E-03 3.4%03 10 year l . OB-02 5.2B-03 S. lE-02 4.6E-03 6.4E-03 7.1%03 7,1E-03 6.2E-03 8.9%02 5.5%02 6.1B-03 6.6B-03 B.9E-03 9.6B-02 3.1E-02 4.2E-03 4.8B-03 6.OB-03 5.3E-03 5 year 1. SE-02 0.1!&03 9.53-02 7.2B-03 l .OE-02 l. lE-02 l. lB-02 9.2%03 1.3%01 B . lB-02 9.4B-03 9.9%03 1.3E-02 1. BE-01 4.8E-02 6.BB-03 7.7E-03 9.3&03 8.4B-03 1 year 2.6E-02 1.5E-02 2.OE-01 1.4B-02 1.9E-02 1.9B-02 2.OB-02 1,6E-02 2.4E-01 1.6&01 1.7B-02 1. BB-02 2.4B-02 3.8E-01 0.9B-02 1.3B-02 1. SE-02 1.7B-02 1.6E-02

* *

* *

Effective dose equivalent (=Sv/_)

1. JB-02

1.7%02

Z.BB-02

4.6-2

9.2B-02

234

RADIATION

DOSE TO PATIENTS FROM RADIOPHARMACEUTICALS

In 49 Colloid

INDIUM HYDROXIDE (COLLOIDAL)

113rn1~

Biokinetic Model

This colloid belongs to the group of substances discussed in Appendix Section A.8, where uptake data and organ masses for different patient categories are defined. It is assumed that no redistribution or excretion of the label takes place.
Biokinetic Data
Organ (S) F, T a &I& 1.67 hr 14.4 min 14.4 min 14.4 min 1.20 hr 28.7 min 21.5 min 21.5 min 43.1 min 43.1 min 35.9 min 21.5 min

(1) Normal liver condition 0.70 ai 1.0 Liver 0.10 m 1.0 Spleen 0.10 x 1.0 Red marrow 0.10 Remaining tissues 1.0 (2) Early to intermediate diffuse parenchymal?iver disease 0.50 co 1.0 Liver 0.20 co 1.0 Spleen 0.15 oj 1.0 Red marrow 0.15 Remaining tissues 1.0 (3) Intermediate to advanced diffuse parenchytal liver disease 0.30 co 1.0 Liver 0.30 co 1.0 Spleen 0.25 cc 1.0 Red marrow 0.15 a, 1.0 Remaining tissues

INDIUM
113mIn 1.658

HYDROXIDE

(COLLOIDAL)

hours per unit Absorbed dose activity administered 15 year 7.9E-03 l.lE-03 l. lE-02 1.8E-03 4.3E-03 2.93-03 3.73-03 1.5E-03 6.X-03 l.ZE-01 4.1E-03 1.8%03 8,6E-03 Z.lE-02 1.7E-01 7.4E-04 9.8E-04 1.7E-03 2.1E-03 2.3B-02 10 year 1.2E-02 2 .OE-03 1.83-02 3.2E-03 7.2E-03 5.OE-03 6.63-03 2.4E-03 9.5E-03 1.9E-01 5.9E-03 3.1E-03 1.3E-02 3.4E-02 2.7E-01 1.3E-03 1.6E-03 2.81-03 3.2E-03 3.6B-02
(mGy/MBq)

Organ

Adult
* Adrenals

5 year 1.6E-02 3.6E-03 3.3E-02 5.1E-03 1.2E-02 8.2E-03 l. lE-02 4.OE-03 1.4E-02 2.8E-01 E.SB-03 5.OE-03 2.OE-02 6.3B-02 4.3&01 2. N-03 2.7B-03 4.71-03 4.9E-03 5.71-02

1 year 2.4E-02 6.X-03 7.lE-02 9.4E-03 2.3E-02 1.5E-02 2.OB-02 ?.2E-03 2. M-02 5.3%01 1.6E-02 9.1E-03 3.4E-02 1.3E-01 8.OB-01 4.2B-03 5.28-03 8.7E-03 9 1x-03 l . lB-01

Bladder wall Bone surfaces Breast Cl-tract Stomach wall Small intest ULI wall LLI wall * * * * Kidneys Liver Lungs Ovaries Pancreas Red nwrrow Spleen Testes Thyroid Uterus Other tissue

5.9%03 8.6E-04 7.7E-03 1. BE-03 3 *5E-03 2.4E-03 3. N-03 l. ZE-03 S. lE-03 9.6B-02 3.OE-03 1.3E-03 7 *OE-03 1. SE-02 l.ZE-01 6.4E-04 7.5&04 1. z-03 1.8E-03 1.7B-02

Effective dose equivalent (eSv/W)

235

In 49 CoIloid

BIOKINETIC MODELS AND DATA

INDIUM HYDROXIDE
Barly to intermediate diffuse

(COLLOIDAL)
parenchyaal liver disease

113111n

1.658

hours *

Organ Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach vall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Bed marrow Soleen Testes Thyroid Uterus Other tissue

Absorbed dose per unit activity administered (mGy/Bgq) 5.8E-03 l. lE-03 1. x-02 1.9B-03 4. SE-03 2.6E-03 3.OE-03 1.7B-03 5.7E-03 5 *2E-02 3.OE-03 l . ?E-03 8.73-03 2.1%02 1.7&01 8.78-04 9.8B-04 1. SE-03 2.OB-03 1.9B-02

* * * *

Effective dose equivalent (=Sv/BW Intermediate to advanced Organ * Adrenals Bladder vall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Soleen Testes Thyroid Uterus Other tissue Effective douc equivalent (=Bv/*) diffuse

parenchymal

disease

5.63-03 l. lB-03 1.8B-02 1. BE-03 5.4B-03 2. ?B-03 2.8E-03 2. D-03 6.1B-03 5.4&02 2.8E-03 2.1B-03 1.0%02 3. SE-02 2.3E-01 9.1B-04 l. lE-03 1 .?B-03 2.OB-03 2.4B-02

* * * *

236

RADIATION

DOSE TO PATIENTS FROM RADIOPHARMACEUTICALS

In
49 DTPA

INDIUM-DTPA
In
113mIn

Biokinetic Model After intravenous administration and initial distribution in the extracellular fluid, the substance is excreted exclusively by the renal system according to the models for GFR-substances and the kidney-bladder (see Appendix Sections A.6 and AS, respectively). In the normal case, total-body retention is described by a double-exponential function, with component half-times of 100 min (0.99) and 7 d (0.01). The fraction excreted by the kidneys is 1.0 and the renal transit time is 5 min. For the abnormal case, it is assumed that the retention half-time of the major component is loo0 min and that the renal transit time is increased to 20 min. References
McAfee, J. G., Gagne, G., Atkins, H. L., Kirchner, P. T., Reba, R. C., Blaufox, M. D. and Smith, E. M. (1974). Biological distribution and excretion of DTPA labelled with Tc-99m and In-l 11. J. Nucl. Med. 24, 1273-1278. OMara, R. E., Subramanian, G., McAfree, J. G. and Burger, C. L. (1969). Comparison of 113mInand other short lived agents for cerebral scanning. J. Nucl. Med. 10, 18-27. Sziklas, J. J., Hosain, F., Reba, R. C. and Wagner, H. N. (1971). Comparison of 169Yb-DTPA, 113mIn-DTPA, %inulin and endogenous creatinine to estimate glomerular filtration. J. Nucl. Biol. Med. 15, 122-125.

Biokinetic Data

Organ (S) (1) Normal renal function Total body (excluding bladder contents) Kidneys Bladder contents (2) Abnormal renal function Total body (excluding bladder contents) Kidneys Bladder contents

Fs 1.0 1.0 1.0 1.0 1.0 1.0

iilIn

11 3yn

1.67 hr 7.0 d

0.99 0.01

3.0 hr 5.6 min 2.07 hr

1.21 hr 2.7 min 44 min 2.19 hr 2.3 min 7.28 min

16.7 hr 7.0d

0.99 0.01

19.8 hr 21.2 min 1.42 hr

237

In 49 DTPA

BIOKINETIC MODELS AND DATA

In-DTPA
% 2.83 days

Organ

per Adult

unit

Absorbed dose activity administered 15 year 7 *9E-03 3.1E-01 8.1E-03 4 *3E-03 7.3E-03 1.3E-02 1.2E-02 2.3E-02 2 .OE-02 7.1E-03 6.1E-03 2.23-02 8.1E-03 l. lE-02 7.43-03 1.7E-02 6.OE-03 4.1E-02 9.OE-03 10 year 1,2E-02 4.4E-01 1.2E-02 6.1E-03 1.2E-02 2.1E-02 1.8E-02 3.4E-02 2.8E-02 l. lE-02 9.OE-03 3.3E-02 1.3E-02 1.6E-02 l. lE-02 3,OE-02 9. SE-03 6.4E-02 1.4E-02

(mGy/MBq) 5 year 1.9E-02 6.5E-01 1.8E-02 9.93-03 1.8E-02 3.3E-02 3.OE-02 5 .OE-02 4.1E-02 1.7E-02 1,4E-02 4.8E-02 2.OE-02 2.2E-02 1.8E-02 4.6E-02 1.5E-02 9.6E-02 2.1E-02 1 year 3.5B-02 1.2Etoo 3.4E-02 1.9E-02 3.1E-02 5.7&02 5.08-02 8.58-02 7.1&02 3.2%02 2.6E-02 8.3E-02 3.6%02 3.5E-02 3.38-02 8. BE-02 2.8E-02 1.7E-01 3.7E-02

* * * *

Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI vall LLI vall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue

6. SE-03 2. x-01 6.8B-03 4.3E-03 6.3E-03 l.lE-02 9.6E-03 1,7E-02 1.7E-02 5.7E-03 4.7E-03 1.8E-02 7.1E-03 9.2%03 6.2E-03 1.2E-02 4.1E-03 3,3E-02 7.6E-03

Effective dose equivalent (mSv/BBq) Bladder wall contributes

2.5%02

3.1E-02

4.%x-02

6.7B-02

l . ZB-01

to

60.0

X of

the

effective

dose

equivalent.

ose 114mIn (49.51 d)

equivalent 2.1E-01

(mSv/MBq

of

the

impurity) 4.3E-01 6.8E-01 1.3EtOO

2.7E-01

238

RADIATION

DOSE TO PATIENTS

FROM RADIOPHARMACEUTICALS

Is 49 DTPA

In-DTPA
Abnormal renal function

lllIn

2.83

days

Organ

per unit Adult

Absorbed dose activity administered 15 year 4.8B-02 2.5E-01 4.4B-02 2. BE-02 4.4B-02 5.2B-02 5.OB-02 5.6E-02 8.6B-02 4.3B-02 3.9B-02 5.8B-02 5.OB-02 5.1E-02 4.4B-02 4.2B-02 3.9B-02 7.OE-02 3.8E-02 10 year 7.2E-02 3.5E-01 6.6B-02 3.9B-02 6.9B-02 8.OB-02 7.3E-02 8.5B-02 1.2%01 6.6B-02 5.83-02 8.7E-02 7.5B-02 7.5B-02 6.8B-02 6.6B-02 6.3&02 l. lE-01 5,7B-02

(mGy/MBq)

5 year l.lE-01 5,2E-01 9.9B-02 6.2B-02 1.0%01 1.2B-01 1.2%01 1.3B-01 1.7B-01 l . OB-01 8.9E-02 1.3B-01 l. lB-01 l. lB-01 l .OB-01 l.OB-01 1 .OB-01 1.6E-01 8.8E-02

1 year 2.OB-01 9.2E-01 1.9E-01 1.2B-01 1.7B-01 2.1B-01 Z.OB-01 2.3B-01 3.OE-01 1. BE-01 1.6B-01 2.3B-01 2.OB-01 1.9E-01 1.8B-01 1.9B-01 l.EE-01 2.9E-01 1.6B-01

* * *

Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue

3.9E-02 2.OE-01 3.7B-02 2.8B-02 3.8E-02 4.3E-02 4.OB-02 4.3E-02 7.1E-02 3.5E-02 3.1B-02 4.5E-02 4.3E-02 4.3E-02 3.8B-02 3.1B-02 2.7B-02 5.9B-02 3.1B-02

Bffective dose equivalent (=Svnras)

4.83-02

5.9B-02

8.8B-02

1.3B-01

2.3E-01

ose 114mIn (49.51 d)

equivalent 4.2B-01

(mSv/RBq

of

the

impurity)

6.6B-01

1. OE+OO

1. bB+OO

3.x+00

239

In

BIOKINETIC MODELS AND DATA

49 DTPA

In-DTPA
113mIn 1.658 hours per Organ Adult Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue 2.9E-03 1.7B-01 2 *5E-03 2.4E-03 2.6E-03 3.6E-03 3.43-03 5.1E-03 1.4E-02 2.5E-03 2.3E-03 4.9E-03 2.7E-03 3.OE-03 2.6E-03 4.1E-03 2.1E-03 8.2E-03 2.9B-03 15 year 3.33-03 2.2E-01 3.OB-03 2.4%03 3. M-03 4.5E-03 4.1E-03 6.43-03 1.7E-02 3.1E-03 2.8E-03 6.3E-03 3.3E-03 3.6E-03 3.23-03 5.28-03 2.8&03 1 .OE-02 3.5E-03 10 year 5.33-03 3.3E-01 4.8E-03 3. BE-03 5.OE-03 7.1E-03 6.5&03 9.78-03 2.5&02 5.OR-03 4.4E-03 9.5E-03 5.4803 5.53-03 5. M-03 9. H-03 4.68-03 1.6E-02 5.5%03 5 year 0.53-03 5.1E-01 7.7E-03 6.3E-03 8.1E-03 l. lE-02 1.18-02 1.5E-02 3.7E-02 8.1E-03 7.2E-03 1.5E-02 8.7B-03 8.38-03 8.2E-03 1.4E-02 7.5E-03 2 t 5E-02 8.8E-03 1 year 1.6E-02 9.8E-01 1.5E-02 1.3E-02 1.5E-02 2.1E-02 1.9E-02 2.6E-02 6.6E-02 1.6E-02 1.4E-02 2.6E-02 1,6B-02 1.5E-02 1.6E-02 2.7E-02 1. SE-02 4.4E-02 1.7E-02 unit Absorbed dose activity administered (mGy/MBq)

* * * *

Effective dose equivalent

1.4B-02

1.8E-02

2.7E-02

4.2R-02

7.9B-02

WV/W)
Bladder wall contributes to 72.9 X of the effective dose equivalent.

Abnormal Organ * * Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue Adult 5.OE-03 3.1&02 4,3E-03 4.4E-03 4.6E-03 4.9E-03 4.7E-03 5.OE-03 1.3E-02 4.4E-03 4.1E-03 4.8E-03 4.73-03 4.6E-03 4.6E-03 4.5E-03 4.OE-03 5.53-03 4.1E-03

renal 15 year 5.7E-03 3.9E-02 5.1E-03 4.4E-03 5.4E-03 5.93-03 5.7E-03 5.9E-03 1.6E-02 5,4E-03 5.1E-03 6.2E-03 5,8E-03 5.5E-03 5.5E-03 5.3E-03 5,1E-03 6.8E-03 5.OE-03

function 10 year 9.1E-03 5.9E-02 8.2E-03 7.OE-03 8.6E-03 9.5E-03 9.OE-03 9.5E-03 2.2E-02 8.7E-03 8.1E-03 9,9E-03 9.3E-03 8.63-03 8.8E-03 8,6E-03 8.5E-03 l. lE-02 8.1E-03 5 year 1.4B-02 9.2E-02 1.3E-02 l. lE-02 1.4E-02 1.5E-02 1.5E-02 1.5E-02 3.3E-02 1.4E-02 1.3E-02 1.6E-02 1.5E-02 1.4E-02 1.4E-02 1.4E-02 1.4R-02 1.7E-02 1,3E-02 1 year 2.8E-02 1.7E-01 2.6E-02 2.3E-02 2.6E-02 2.9E-02 2.7E-02 2.8E-02 5.9E-02 2.7E-02 2.5E-02 2.9E-02 2.8E-02 2.63-02 2.7E-02 2.7E-02 2.7E-02 3.2E-02 2.5E-02

* * *

Effective dose equivalent (mSv/llBq)

6.6%03

8.OE-03

1.2B-02

2.OR-02

3.7R-02

240

RADIATION DOSE TO PATIENTS FROM RADIOPHARMACEUTICALS

Ill 49 DTPA

INDIUM-DTPA

(1NTRAT;ICAL

ADMINISTRATION)

Biokinetic Model The model has been defined in Appendix Section A.lO. Two sites of intrathecal administration are considered, viz lumbar injection (region A) and cisternal injection (region C). It is assumed that activity reaching the blood is metabolized according to the model for intravenously administered In-DTPA. Reference
Goodwin, D. A., Song, C. H., Finston, R. and Matin, P. (1973). Preparation, t1 In-labeled radiopharmaceuticals for cisternography. Radiology 108, 91-98. physiology, and dosimetry of

Biokinetic Data
Organ (S) (1) Lumbar injection Cerebrospinal fluid space (A) Cisterna terminalis (B) Spinal cord space (C) Brain cisterns Kidneys Bladder contents Total body (excluding bladder contents) (2) Cisternal injection Cerebrospinal fluid space (A & B) Cisterna terminalis and spinal cord space (C) Brain cisterns Kidneys Bladder contents Total body (excluding bladder contents) Fs &IA,

1.0 0.5 0.25 1.0 1.0 1.0

0.5

10.3 hr 9.89 hr 4.19 hr 3.16 min 1.56 hr 26.6 hr

1.0 1.0 1.0 1.0

8.93 hr 21.6 hr 3.86 min 1.42 hr 32.6 hr

241

Ill 49 DTPA

In-DTPA (Intrathecal administration)

Lumbar injection l% 2.83 days Absorbed dose per unit activity administered (mGy/BRq) 1.6E-01 2.OB-01 7.2B-02 1*3E-01 1 .OE-02 4,OB-02 6.OB-02 4.7E-02 2.4B-02 1.3E-01 3.6E-02 3.3E-02 3.9B-02 8.2E-02 9.5E-01 2.4E-01 4.OB-02 l . lB-02 2.1E-02 4.4B-02 2.7E-02 1.4B-01

Organ * * *

Adrenals Bladder wall Bone surfaces Brain Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Spinal cord Red marrow Spleen Testes Thyroid Uterus Other tissue Bffective dose equivalent (mSv/llBq)

ose equivalent 114mIn (49.51 d)

(mSv/BBq of

the impurity)

1.8E+OO

242

RADIATION

DOSE TO PATIENTS

FROM RADIOPHARMACEUTICALS

In 49
DTPA

In-DTPA (Intrathecal administration)

Cisternal
%l

injection

2.83

days Absorbed dose Per unit activity administered (mGy/MBq) 6.5E-02 1.8E-01 7.63-02 6.5E-01 9.6%03 2. ?E-02 2.3E-02 1.9E-02 1.5E-02 5.OE-02 1.7E-02 2.2E-02 2.OE-02 3.5E-02 5.7E-01 1.4E-01 1.9E-02 8.5E-03 3.9%02 2.9E-02 1.7E-02 l.ZB-01

Organ * * * Adrenals Bladder wall Bone surfaces Brain Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Spinal cord Red marrow Spleen Testes Thyroid Uterus Other tissue Effective dose equivalent (mSv/llBq)

ose equivalent 114mIn (49.51 d)

(mSv/RBq of

the impurity)

2.1E+OO

243

RADIATION DOSE TO PATIENTS FROM RADIOPHARMACEUTICALS

INDIUM-LABELLED
lllIn

l13In

AEROSOLS

Biokinetic Data The same models are used as for technetium-labelled aerosols (see p. 217), with the modification that indium slowly released from the lungs is metabolized according to the model proposed for ionic indium. References
Isawa, T., Hayes, M. and Taplin, G. V. (1971). Radioaerosol inhalation lung scanning: Its role in suspected pulmonary embolism. J. &xl. Med. 12.606609. Fazio, F., Wollmer, P., Lavender, J. P. and Barr, M. M. (1982). Clinical ventilation imaging with In-113m aerosol: A comparison with Kr-81m. J. NucI. Med. 23,306314.

Biokinetic Data

Organ (S)

Fs

In

13In

(1) Substances with fast clearance from lungs (e.g. DTPA) 1.o 1.0 1.0 hr Lungs 1.0 Kidneys 1.0 Bladder contents -1.0 1.0 l.Ohr Remaining tissues 0.99 1.67 hr 0.01 70 d (2) Substances with slow clearance from lungs (e.g. albumin) 1.0 1.0 l.Od Lungs -1.0 0.2 l.Od Liver 0.3 2.0 d 0.7 70 d -1.0 0.01 l.Od Spleen 0.3 2.0 d 0.7 70 d -1.0 0.3 l.Od Red marrow 0.3 2.0d 0.7 70 d -1.0 0.07 l.Od Kidneys 0.3 2.0 d 0.7 70 d -1.0 0.42 l.Od Remaining tissues 0.3 2.0 d 0.7 70 d

1.42 hr 5.5 min 1.71 hr 2.98 hr

54 min 1.7 min 24 min 46 min

1.06 d 8.96 hr

2.25 hr 1.8 min

26.9 min

5.5 s

13.4 hr

2.8 min

3.13 hr

39 s

18.8 hr

3.9 min

AICRP

la:l-4-r

245

In 49 AWXOl

BIOKINETIC MODELS AND DATA

In-LABELLED
Substances with fast 1llIn 2.83 days

AEROSOLS
from lungs (e.g. UTPA)

clearance

per Organ Adult Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue 9.3E-03 Z.lE-01 8.OB-03 8.2&03 8.3E-03 l . OE-02 9.2803 1.5B-02 1.7E-02 8. SE-03 5.3E-02 1.6B-02 9.9E-03 l . lE-02 8.8E-03 l . OE-02 5.1%03 2.9E-02 8.63-03

unit

Absorbed dose activity administered 15 year 1.3E-02 2.5E-01 9.6E-03 8.2E-03 9.9E-03 1.3E-02 l.ZE-02 Z .OE-02 Z. lB-02 l. lE-02 7.8E-02 Z . OE-02 l.ZE-02 1.3E-02 l. lE-02 1. SE-02 ?.7E-03 3.5E-02 l . OE-02 10 year 1.9E-02 3.7E-01 1. SE-02 1.4E-02 1.5E-02 Z . OB-02 1.8E-02 3.OE-02 3.OB-02 1.7E-02 l. lE-01 3 .OE-02 1.8E-02 1.9E-02 1.6E-02 2.6E-02 l. ZE-02 5.5&02 1.5E-02

(mGy/BRq) 5 year 3.OE-02 5.4E-01 2.2E-02 Z. lE-02 2.3E-02 3.1E-02 2.9E-02 4. SE-02 4.4E-02 2. SE-02 1.6E-01 4.3E-02 2.8E-02 2.6E-02 2. SE-02 4.1B-02 2 .OE-02 8.3B-02 2.4E-02 1 year 5.3E-02 9.6E-01 4.2E-02 3. SE-02 3.9E-02 5.5E-02 4.9B-02 7.7B-02 7.7E-02 4 * 5E-02 3.OB-01 7.5B-02 5.08-02 4.2&-02 4.6B-02 7.7B-02 3.7E-02 1.4E-01 4.3E-02

* * *

Bffective dose equivalent (mSv/ltes)

2.8B-02

3.6B-02

5.3B-02

7.9B-02

1.4B-01

ose 114mIn (49.51 d)

equivalent 3.OE-01

(mSv/BBq

of

the

impurity) 6.4E-01

4.2E-01

1 OB+OO

Z.OE+OO

246

In 49 Aerosol

In-LABELLED AEROSOLS
Substances with slow clearancefrom lungs (e.g. albumin) lllIn 2.03 days Absorbeddose per unit activityadministered (mGy/HBq) Organ Adult * Adrenals Bladderwall Bone surfaces Breast GI-tract Stomachwall Small intest ULI wall LLI wall * Kidneys * Liver Lungs Ovaries * Pancreas * Red marrow Spleen Testes Thyroid Uterus Other tissue Effective dose equivalent (mSv/nas) l.EE-01 4.9E-02 2.OE-01 1.2E-01 l.lE-01 9.1E-02 9.OB-02 7.33-02 5.2E-01 4.OE-01 9.6E-01 7.4&02 1.6E-01 3.8E-01 2.2E-01 3.1E-02 5.5B-02 7.33-02 8.4E-02 2.9E-01 15 year 10 year 5 year 1 year 2.5E-01 3.7E-01 5.4E-01 9.1E-01 6.6E-02 l.OE-01 1.5E-01 2.7E-01 2.8E-01 4.5E-01 7.7E-01 1.6E+OO 1.2!&01 2.1E-01 3.1E-01 4.98-01 1.4E-01 2.1E-01 3.1E-01 5.2E-01 l.lE-01 1.7E-01 2.5E-01 4.2E-01 l.lE-01 1.7E-01 2.7%01 4.5E-01 9.1E-02 1.3E-01 1.9E-01 3.3E-01 6.3E-01 8.8E-01 5.1E-01 7.4E-01 1.4E+OO 1.9E+OO 9.73-02 1.4E-01 2.1E-01 3.1E-01 4.9E-01 7.3E-01 2.9E-01 4.4E-01 4.33-02 6.6E-02 8.53-02 1.4E-01 8.63-02 1.3E-01 l.OE-01 1.3E+OO l.OBtOO 2.9E+OO 2.1E-01 4.6E-01 1.2EtOO 6.6E-01 l.OE-01 2.2E-01 1.9E-01 2.1EtOO 1.8E+OO 5.3E+OO 3.5E-01 7.9E-01 2.4EtOO l.lE+OO 1.9E-01 4.0%01 3.2%01 4.0&01 1.5B+OO

1.573-01 2.2E-01 8.4B-01

3.9E-01 5.6B-Of

ose equivalent (mSv/HBq of the impurity) 114mIn (49.51d) 7.8E+OO l.OE+Ol 1.6EcOl 2.7E+Ol 5.5EtOl

247

BIOKINETIC MODELS AND DATA

In-LABELLED AEROSOLS
Substances 113rnI 1.658 hours per Organ Adult * * Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intes t ULI vall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue 3.OE-03 9.53-02 2.2E-03 3.2E-03 2,6E-03 2.41-03 2.3E-03 3.1E-03 9.3E-03 2.8E-03 7.8E-02 3.1E-03 3.OE-03 2.6E-03 2.8E-03 2.5E-03 1.9E-03 4.8E-03 2.5E-03 15 year 4.OE-03 l. ZE-01 2.6E-03 3.2E-03 3.1E-03 3.OE-03 2,8E-03 3.9E-03 l.ZE-02 3.6E-03 l.ZE-01 3.9E-03 3.6E-03 3.3E-03 3.4E-03 3.2E-03 2.5E-03 5.9E-03 3.OE-03 10 year 6.33-03 l.BE-01 4.1E-03 5. ?E-03 4,8E-03 4.8E-03 4.53-03 6,OE-03 1.7E-02 5.5E-03 1.7E-01 6.OE-03 5.6E-03 4.8E-03 5.4E-03 5.5E-03 4.3E-03 9.6E-03 4.6E-03 unit Absorbed dose activity administered with fast clearance from lungs

(e.g.

DTPA)

(mGy/MBq) 5 year 9.9E-03 2.8E-01 6.6E-03 8.6E-03 7.5E-03 7.7E-03 7.3E-03 9.3E-03 2.5E-02 8.6E-03 2.6E-01 9.2E-03 9.OE-03 7.1E-03 8.53-03 8.8E-03 7 *0803 1.5E-02 7.3E-03 1 year 1.8E-02 5.3E-01 1.3%02 1.5E-02 1.4E-02 1.4E-02 1.4E-02 1.7E-02 4.5E-02 1.6E-02 5,2E-01 1.7E-02 1.7E-02 1.3E-02 1.6E-02 1.7E-02 1,3E-02 2.6E-02 1.4E-02

* *

Effective dose equivalent (q Sv/RBq)

1.8%02

2.5E-02

3.6E-02

5.6B-02

l.lB-01

Substances Organ * Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries

with

slow

clearance 15 year 5,OE-03 3.OE-04 3.6E-03 4.3E-03 2.9E-03 7.OE-04 7.7E-04 4.4E-04 5.6E-03 6.3E-03 2.9E-01 4.6E-04 3.9E-03 6.2E-03 4.6E-03 Z. lE-04 1.9E-03 4.2E-04 2.2%03

from

lungs

(e.g.

albumin) 1 year Z.lE-02 Z.OE-03 Z.lE-02 1,7E-02 l .OE-02 4.1E-03 4.6E-03 2.8E-03 2.2E-02 2.4E-02 1.3E+OO 2.8E-03 1.6E-02 3.2E-02 2.08-02 1.4E-03 9.4E-03 2.7E-03 8.6E-03

Adult 3.2E-03 2.4E-04 2,7E-03 4.3E-03 2.4E-03 5.3E-04 6,2E-04 3.3E-04 4.4E-03 4.6E-03 1.9E-01 3.9E-04 3.4E-03 4.3E-03 3.4E-03 1.7E-04 1.4E-03 3.1E-04 1.8E-03

10 year 7.7E-03 5.5E-04 5.8E-03 8.2E-03 4.1E-03 1.3E-03 1.4E-03 7. IE-04 8.1E-03 9.1E-03 4.2E-01 8.OE-04 5.7E-03 9.5E-03 7,OE-03 3.7E-04 3.3E-03 7.2E-04 3.1E-03

5 year

l.ZE-02
9.9E-04 l . OE-02 1.2E-02 6.1E-03 2.2E-03 2.3E-03 1.3E-03 1.2E-02 1.3E-02 6.4E-01 1.4E-03 9. IE-03 1.6E-02 l. lE-02 5.9E-04 5.5E-03 1.3E-03 4.7E-03

* *

Pancreas

Red marrow Spleen Testes Thyroid Uterus Other tissue Effective dose equivalent WV/W)

2.68-02

3.8%02

5.5E-02

8.5B-02

1.7E-01

248

RADIATION DOSE TO PATIENTS FROM RADIOPHARMACEUTICALS

In 49 Markers

INDIUM-LABELLED

NON-ABSORBABLE
In
l13mIn

MARKERS

Biokinetic Model Indium-labelled substances can be used as non-absorbable markers in studies of the gastrointestinal tract. For absorbed dose calculations a modified ICRP model for the gastrointestinal tract is used, as described in Appendix Section A.3. References
Heading, R. C., Tothill, P., Laidlaw, A. J. and Shearman, D. J. C. (1971). An evaluation of 3mindiumDTPA chelate in the measurement of gastric emptying by scintiscanning. Gut 12, 611-615. Wright, R. A., Thompson, D. and Syed, I. (1981). Simultaneous markers for fluid and solid gastric emptying: New variations on an old theme: Concise communication. J. Nucl. Med. 22, 772-776.

Biokinetic Data

Organ (S) (1) Oral administration of fluids (X-tract contents Stomach SI ULI LLI (2) Oral administration of solids (X-tract contents Stomach SI ULI LLI

1.0 1.0 1.0 1.0

32.8 min 3.82 hr 11.0 hr 16.3 hr

26.8 min 1.22 hr 36.9 min 6.2 min

1.0 1.0 1.0 1.0

2.06 hr 3.76 hr 10.8 hr 16.0 hr

1.12 hr 47.8 min 24.2 min 4.0 min

249

In 49 Markers

BIOKINETIC MODELS AND DATA

In-LABELLED
lllIn Organ Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrov Spleen Testes Thyroid Uterus Other tissue 2.03 days

NON-ABSORBABLEMARKERS
Oral administration of fluids Absorbed dose activity administered 15 year 2.8E-02 1.4E-01 3.81-02 3.6E-03 1.5E-01 6.3E-01 1.3E+OO 2.6E+OO 5.9E-02 4.1E-02 7.3E-03 5.OE-01 5.6E-02 l.lE-01 3.9E-02 4.OE-02 5.6E-04 2.2E-01 5.OE-02 3.7E-01 10 year 4.73-02 2.2E-01 5.5E-02 9.4E-03 2.2E-01 9.9E-01 2.2E+OO 4.3E+OO 9.1E-02 E . OE-02 1.4E-02 7.6E-01 9.OE-02 1.5E-01 6.7E-02 7.6E-02 1.9E-03 3.6E-01 7.6E-02 6.OB-01

per unit Adult 2.OE-02 1.2E-01 3.1E-02 3.6E-03 1.2E-01 5.OE-01

1.

(mGy/MBq) 1 year 1.4E-01 5.6E-01 1.7E-01 3.7E-02 6.5E-01 2.6E+OO 6.4E+OO 1.3E+Ol 2.2E-01 2.6E-01 5.3E-02 1.9E+OO 2.7E-01 2.2E-01 1.9E-01 2.3E-01 1.3E-02 9.OE-01 2.OE-01 1.7B+00

5 year 8,OE-02 3.3E-01 8.3E-02 1.9E-02 3.5E-01 1.5E+OO 3.5E+OO 6.8E+OO 1.4E-01 1.4E-0: 2.5E-02 l.lE+OO 1.5E-01 1.8E-01 l.lE-01 1.2.B-01 4.53-03 5.4E-01 1.2E-01 9.3B-01

* * * *

lE+OO

2.1E+OO 4.8E-02 3.4E-02 5.1E-03 4.2E-01 4.53-02 9.7E-02 3.2E-02 3.OE-02 4.6E-04 1.7E-01 4.23-02 3.08-01

Effective dose equivalent (=Sv/nas) IFpurifies; E fectlve 114mIn (49.51

ose equivalent d) 3.7E+OO

(mSv/HBq of

the impurity) 1. lE+Ol of solids 5 year 8.9B-02 3.2B-01 8.4E-02 2.2E-02 7.2B-01 1.5E+OO 3.4B+oO 6.7E+OO 1.5E-01 1.5E-01 3.0&02 l.lB+OO 1 year 1.6B-01 5.5&01 1.7B-01 4.3B-02 1.4B+OO 2.6E+OO 6.3B+OO 1.3E+Ol 2.3E-01 2.7E-01 6.2E-02 1.9E+OO 3.4E-01 2.2B-01 2.3B-01 2.2E-01 1.4E-02 9.OB-01 2.1E-01 1.7B+00 1.8E+Ol 3.6E+Ol

6.OE+OO

Organ Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red narrow Spleen Testes Thyroid Uterus Other tissue

Oral administration Adult 2.2E-02 l. lE-01 3.1E-02 4.8E-03 2.5E-01 5.OE-01 l.lE+OO 15 year 3.3E-02 1.3E-01 3.8E-02 4.8E-03 3.2E-01 6.2E-01 1.3E+OO 2.5E+OO 6.33-02 4.4E-02 9.6E-03 4.9E-01 7.9&02 l. lE-01 5.2E-02

10 year 5.43-02 2.2E-01 5.6E-02 1,2E-02 4.5E-01 9.8E-01 2.2E+OO 4.2E+OO 9.6B-02 8.5E-02 1.7E-02 7.5E-01 1.2E-01 1.5E-01 8.5B-02 7.4E-02 2.1E-03 3.5E-01 7.7E-02

* * * *

2.uB+oo
5.1E-02 3.5E-02 7.2E-03 4.2B-01 6. W-02 9.7E-02 4.4E-02 3.OE-02 6.OE-04 1.6E-01 4.3E-02

1.9E-01 l.BE-01 1.3B-01 l.lE-01 5.1B-03 5.33-01 1.2E-01 9.4B-01

3.9E-02 7.1s04 2.2E-01 5.1E-02

3.8B-01

Bffective dose equivalent WV/W)

3.1s01

6.1B-01

ose equivalent 114mIn (49.51 d) 3.8E+OO

(mSv/HBq of 6.2E+OO

the impurity) l.lE+Ol 1.8E+Ol 3.7E+Ol

250

RADIATION

DOSE TO PATIENTS FROM RADIOPHARMACEUTICALS

In 49 Markers

In-LABELLED NON-ABSORBABLE MARKERS

Oral administration of fluids 113mIn 1.658 hours per Organ Adult Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue 1e 7E-03 3.OE-03 l.OE-03 4.7E-04 8.5E-02 1.4E-01 1.4E-01 3.8E.-02 3.6E-03 2.4E-03 7.OE-04 l. lE-02 6.1E-03 3.OE-03 3.7E-03 4.8E-04 6.5E-05 7.6E-03 1.9E-03 15 year 2.4E-03 3.6E-03 1.3E-03 4.7E-04 l.lE-01 1.8E-01 1.7E-01 4.8E-02 4.2E-03 2.8E-03 8.3E-04 1.5E-02 6.8E-03 3.5E-03 4.2E-03 7.3E-04 7.3E-05 l.lE-02 2.2E-03 10 year 3.7E-03 5.9E-03 1.8E-03 9.3E-04 1.6E-01 3.2E-01 2,9E-01 8.2E-02 6.3E-03 5.3E-03 1.4E-03 2.2E-02 l .OE-02 4.6E-03 6.3E-03 1.5E-03 1.8E-04 1.8E-02 3.3E-03 5 year 5.9E-03 9.4%03 2.9E-03 1.7E-03 2.7E-01 5.2E-01 4.8E-01 1.3E-01 9.3E-03 9.2E-03 2.3E-03 3.4E-02 1.5E-02 5.6E-03 9.1E-03 2.6E-03 3.5E-04 2.7E-02 5.1E-03 1 year l .OE-02 1.6E-02 5.7E-03 3.1E-03 5.5%01 unit Absorbed dose activity administered (mGy/MBq)

*
* * *

1. OE+OO
9. SE-01 2.6E-01 1.5E-02 1.7E-02 4.4E-03 5.7E-02 2.5E-02 7.0E-03 1.5E-02 5.3&03 8. SE-04 4.6~-02 9.1E-03

Effective dose equivalent (=Sv/rn)

2.78-02

3.3E-02

5.6E-02

9.1B-02

1.8B-01

Oral Organ Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other Bffective tissue Adult 2.OE-03 2.1E-03 9.4E-04 7.9E-04 2.1E-01 9.6E-02 9.3E-02 2.5E-02 3.8E-03 2.4E-03 1.2E-03 7.43-03 1.28-02 2.4E-03 6.5E-03 3.3E-04 l .OE-04 5.3E-03 1.8E-03

administration 15 year 3.3E-03 2.5E-03 1.2E-03 ?.9E-04 2.6E-01 1.2E-01 l. lE-01 3.2E-02 4.4E-03 3.OE-03 1.4E-03 l .OE-02 1.2E-02 2.9E-03 7.2E-03 5.1E-04 1.2E-04 7.5E-03 2.2E-03

of

solids 5 year l year 1.2E-02 l.2E-02 5.3E-03 4.73-03 1.3E+OO 6.7E-01 6.3E-01 1 .?E-01 1.4E-02 1.8E-02 6.3E-03 4.0E-02 4.1E-02 6.1%03 2.2E-02 4.OE-03 1.2E-03 3.3E-02 8.7&03

10 year 5.OE-03 4.3E-03 1.7E-03 1.5E-03 3.8E-01 2.1E-01 2.OE-01 5.4E-02 6.4E-03 5.6E-03 2.1E-03 1.5E-02 1.9E-02 3.83-03 l .OE-02 l. lE-03 2.4E-04 1.2E-02 3.2E-03

?.5E-03
6.9E-03 2.6E-03 2.6E-03 6.6E-01 3.4E-01 3.2E-01 9.OE-02 9.1E-03 9.7E-03 3.4E-03 2.4E-02 2.6E-02 4.7E-03 l.4E-02 1.9E-03 5.OE-04 1.9E-02 4.9E-03

* * * *

dose equivalent (aSv/HBq)

2. EB-02

3.4B-02

5. SB-02

9.1E-02

l.BB-01

251

RADIATION

DOSE TO PATIENTS

FROM RADIOPHARMACEUTICALS

In 49 Platelets

INDIUM-LABELLED PLATELETS (THROMBOCYTES)

In
Biokinetic Model

After intravenous injection some of the platelets are rapidly taken up in the spleen and liver, due to equilibration with the marginating cell pool in these organs. The residual cells stay in the circulation for a period determined by the remaining lifetime of the platelets. The normal lifetime for a newly formed cell is 8-11 d. Dying cells are sequestered in various organs and tissues. There is a very slow excretion of the radioactive label. It is assumed that fractions of 0.30 and 0.10 are immediately deposited in spleen and liver, respectively. The remaining fraction (0.60) is cleared from the blood with a half-time. of 4 d, and is distributed in the red bone marrow (0.29, liver (0.20), spleen (0.05) and other tissues (0.10). During their retention in the blood the cells are considered to be distributed in organs according to their relative blood volumes. Elimination of activity from the body has been studied only for short periods after injection, and while it is clear that there is no rapid phase of elimination, it is assumed that there is a slow excretion with the same half-life as found for indium given in ionic form, i.e. 70 d (see model for ionic indium).
References
Goodwin, D. A., Bushberg, J. T., Doherty, P. N., Lipton, M. J., Conley, F. K., Diamanti, C. I. and Meares, C. F. (1978). Indium-11 l-labeled autologous platelets for location of vascular thrombi in humans. J. Nucl. Med. 19, 626-634. Klonizakis, I., Peters, A. M., Fitzpatrick, M. L., Kensett, M. L., Lewis, S. M. and Lavender, J. P. (1980). Radionuclide distribution following injection of Indium-labelled platelets. Br. J. Haematol. 46, 595-602. Robertson, J. S., Dewanjee, M. K., Brown, M. L., Fuster, V. and Chesebro, J. H. (1981). Distribution and dosimetry of In-labeled platelets. Radiology 140, 169-176. Scheffel, U., Tsan, M.-F., Mitchell, T. G., Camargo, E. E., Braine, H., Ezekowitz, M. D., Nickoloff, E. L., Hill-Zobel, R., Murphy, E. and McIntyre, P. A. (1982). Human platelets labeled with In-l 11 I-Hydroxyquinoline: Kinetics, distribution, and estimates of radiation dose. .I. Nucl. Med. 23, 149-156. Schmidt, K. G., Rasmussen, J. W. and Rasmussen, A. D. (1985). Kinetics of 'In-labelledplatelets in healthy subjects. &and. J. Haematol. 34, 370-317. Wessels, P., Heyns, A. du P., Pieters, H., Latter, M. G. and Badenhorst, P. N. (1985). An improved method for the quantification of the in vivo kinetics of a representative population of In-labelled human platelets, Eur. J. Nwcl. Med. 10, 522-527.

Biokinetic Data
Organ (S) Blood Liver Red marrow Spleen Fs 1.0 0.30 0.25 0.35 T 0 4d 0 4d 70 d 4d 70 d 0 4d 70d 4d 70 d a 0.40 0.60 -0.33 -0.67 1.0 - 1.0 1.0 -0.86 -0.14 1.0 -1.0 &IA, 34.4 hr 17.2 hr 9.76 hr 30.3 hr

Remaining tissues

0.10

3.90 hr

I .o

253

In 49

BIOKlNETIC

MODELS AND DATA

Platelets

In-LABELLED PLATELETS (THROMBOCYTES)

lll1 2.83 days

Organ

per Adult

unit

Absorbed dose activity administered 15 year 4.7E-01 9.2E-02 3.2E-01 1.1%01 4.1E-01 1.7E-01 1.8E-01 1.3E-01 4.8E-01 5.OE-01 9.1E-01 3.6E-01 1.3E-01 7.5E-01 4.6E-01 1 .OE+Ol 6.OE-02 l.lE-01 1.2E-01 1.4E-01 10 year 7.2E-01 1.4E-01 5.1E-01 1.8E-01 6.OE-01 2.7E-01 2.9E-01 Z .OE-01 7.1E-01 7.6E-01 1.3E+OO 5.5E-01 2 .OE-01 l.lE+OO 6.8E-01 1,5E+Ol 9.1E-02 1.8E-01 1.8E-01 Z. lE-01

(mGy/MBq) 5 year 1 year 1.8E+OO 3.9&01 1.8E+OO 4.9E-01 1.4E+OO 7.4E-01 E.OE-01 5 .OE-01 1*8E+OO 1.8E+OO 3.4E+OO 1.5E+OO 5.3E-01 2.6E+OO 2.1E+OO 4.1E+Ol 2.7E-01 5.4E-01 4.9E-01 5.6E-01

* * *

Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Heart Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue

3.7E-01 6.6E-02 2.3E-01 l . OE-01 3.5E-01 1.4E-01 1.4E-01 9.7&02 3.9E-01 4. IE-01 7.3E-01 2. EE-01 9.8E-02 6,6E-01 3.6E-01 7.5E+OO 4.3E-02 E. lE-02 9.5E-02 l.ZE-01

1.OE+OO
2,2E-01 8.7E-01 2.9E-01 8.3E-01 4.2E-01 4.7E-01 2.9E-01 1.OE+OO

1. lE+OO
1.9EtOO 8.5E-01 3.1E-01 1.6EtOO 1. lE+OO 2.3E+Ol 1.4!&01 2.9E-01 2.8E-01 3.1E-01

* *

Bffective dose equivalent (mSv/KBq)

l.OE-01

9.3%01

1.4B+oo

2.1E+oo

3.7E+oo

1;purities; E fective 114mIn (49.51

ose d)

equivalent 8.3EtO1,

(mSv/MBq of l.ZE+OZ

the

impurity) 2.OEt02 3,2E+02 6.2E+02

254

RADIATION

DOSE TO PATIENTS

FROM RADIOPHARMACEUTICALS

In 49 WBC

INDIUM-LABELLED WHITE BLOOD CELLS (LEUKOCYTES)

lllIn Biokinetic Model The fate of intravenously administered leukocytes depends to a great extent on details in the preliminary isolation and in vitro labelling of the cells. The cells may become activated and damaged to a varying degree, resulting in an immediate uptake predominantly in the lungs and liver. When modern, more innocuous methods are used, there is only a very short transient holdup in the lungs, and the initial uptake in organs is effected by equilibration with the pools of marginating leukocytes. Cells initially remaining in the circulation show a blood clearance which is exponential with a half-life between 5 and 10 hr. There is a very slow excretion of label in the urine. For absorbed dose calculations a model is proposed, where 60% of the cells are immediately distributed in liver, spleen, bone marrow and other tissues, and 40% circulate in the blood with a half-time of 7 hr, after which they are taken up in the same organs and tissues and in the same proportions as for the early uptake. The total uptake is taken to be 20% in the liver, 25% in the spleen, 30% in red bone marrow and 25% in other tissues. From all sites the activity is assumed to be eliminated with a half-time of 70 d, in analogy with the model proposed for ionic indium. The model chiefly refers to granulocytes, which normally form the majority of cells in a preparation of mixed leukocytes. It may be inappropriate for other types of white blood cells, such as lymphocytes, having somewhat different biokinetics. The actual white blood cell suspension used for labelling may also contain erythrocytes and thrombocytes, which become labelled at the same time, and there may also be some unbound activity. The dose contributions from these other fractions of activity thus have to be added appropriately. The l1 In-preparation may be contaminated with 114mInand its daughter 141n.The effective dose equivalent per unit activity of these radionuclides is therefore presented in the dosimetric table. References
Goodwin, D. A., Finston, R. A. and Smith, S. I. (1981). The distribution and dosimetry of In-l 11 labeled leucocytes and platelets in humans. In: Froc. Third Znt. Radiopharmaceutical Dosimetry Symposium, Oak Ridge, 1980 (FDA 81-8166), pp. 88-101. Oak Ridge National Laboratories, Oak Ridge, Tennessee. Mountford, P. J., Allsopp, M. J., Hall, F. M., Wells, C. P. and Coakley, A. J. (1985). Leucocyte and contaminant cell-bound activities resulting from the labelling of leucocytes with In-oxine. Eur. J. Nucl. Med. 10, 304307. Saverymuttu, S. H., Peters, A. M., Keshavarzian, A., Reavy, H. J. and Lavender, J. P. (1985). The kinetics of Indium distribution following injection of 1IIndium labelled autologous granulocytes in man. Br. J. Haematol. 61,67%85. Thakur, M. L., Seifert, C. L., Madsen, M. T., McKenney, S. M., Desai, A. G. and Park, C. H. (1984). Neutrophil labeling: Problems and pitfalls. Semin. Nucl. Med. 14, 107-117. Weiblen, B. J., Forstrom, L. and McCullough, J. (1979). Studies of the kinetics of indium-11 l-labeled granulocytes. J. ti. Clin. Med. 94, 246-255.

255

In
49 WBC

BIOKINETIC MODELS AND DATA

Biokinetic Data
Organ (S) Blood
Liver

Fs 1.0
0.20

a 0.60
0.40 -0.60 -0.40 1.0

UA, 3.66 hr
18.1 hr

0 I hr
0 7 hr 70 d

Red marrow

0.30
0.25

0 7 hr 70 d
0 7 hr

-0.60 -0.40 1.0

-0.60 -0.40

27.2 hr
22.7 hr

Spleen

Remaining tissues

0.25

70 d 0 7 hr 70d

1.0 -0.60 -0.40 1.0

22.7 hr

In-LABELLED WHITE BLOOD CELLS (LEUKOCYTES)

lll1 2.03 days

per Organ Adult * Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Heart Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other Effective tissue

unit

Absorbed dose activity administered 15 year 4,OE-01 l.OE-01 5.OE-01 9.OE-02 3.3E-01 1,9E-01 1.9E-01 1.6E-01 2.1E-01 3,9E-01 8.8E-01 2.1E-01 1.7E-01 6.1E-01 8. BE-01 7.6E+OO 6.43-02 9.OE-02 1.4E-01 1.4E-01 10 year 5.9E-01 1*6E-01 B.OE-01 l.SE-01 4.9E-01 2.9E-01 3.OE-01 2.4E-01 3.OE-01 6.OE-01 1.3E+OO 3.1E-01 2.4E-01 9.1E-01 1,3E+OO l.lE+Ol 9,9E-02 1.3E-01 2.1E-01 2.OE-01

(mGy/MBq) 5 year 8.2E-01 2,4E-01 1.4E+OO 2.3E-01 6.8E-01 4.3E-01 4.7E-01 3.3E-01 4.3E-01 8.7E-01 1. 8E+OO 4.6E-01 3. SE-01 1.3E+OO 2.3E+OO 1.7E+Ol 1.5B-01 2.lE-01 3.OE-01 3.OE-01 1

year

3.1E-01 7.2E-02 3.5E-01 9.OE-02 2.8E-01 1.6E-01

1.6E-01 1.3E-01 1.7E-01 3.3E-01 7.1E-01 1.6E-01 1.2E-01 5.2B-01 6.9E-01 5.5E+OO 4.5E-02 6.1E-02 1.2E-01 l.lE-01

1.4EtOO 4.1E-01 2.9E+OO 3.9E-01

1. lE+OO 7.1E-01 7.8E-01 5.4E-01 7.3E-01

1.4EtOO 3.2E+OO E . lE-01 5.6E-01 2.1E+OO 4. SE+00 3.OEtOl 2.8.B-01 3.8E-01 5.0%01 5.3E-01

* *

* *

dose equivalent (mSv/HBq)

5.9B-01

7.9B-01

1.2E+oO

1.8B+oO

3.2B+OO

ose 114mIn (49.51 d)

equivalent 6.9E+Ol

(mSv/HBq

of

the

impurity) 1.5E+02 2. SE+02 4.9Ec02

9.3E+Ol

256

RADIATION

DOSE TO PATIENTS

FROM RADIOPHARMACEUTICALS

INDIUM-LABELLED
lIn

BLEOMYCIN

Biokinetic Model The kinetics of In in the human body after intravenous injection of l1 In-bleomycin has been studied by Thakur et a/. (1973), Trott et al. (1974) and Williams et al. (1975). The initial distribution is similar to that of cobalt-labelled bleomycin with a rapid disappearance from the blood into most organs and tissues, an early uptake in the kidneys, and excretion of a large part during the first 24-48 hr. Later, presumably because of dissociation of the complex with release of ionic indium, there is a secondary slow uptake in the liver, bone marrow and spleen, with a long retention of the activity before its final excretion into the urine. It is assumed that after injection 10% is immediately taken up in the kidneys and that the rest is evenly distributed in the body. A large fraction (0.54 of injected activity) is excreted with a half-time of 10 hr. Smaller fractions are translocated to the liver (O.lO), bone marrow (0.06) and spleen (0.04) with an uptake half-time of 2 d. Activity is then retained in the body with the same half-times as assumed in the model for ionic indium, i.e. 2 d and 70 d. References
Thakur, M. L., Merrick, M. V. and Gunasekera, S. W. (1973). Some pharmacological aspects of a new radiopharmaceutical, In-bleomycin. In: Rudiopharmaceuticals and Labelled Compounds, Vol. II, pp. 183-193, International Atomic Energy Agency, Vienna. Trott, N. G., OConnell, M. E. A., Ross, H. A., Smith, P. H. S. and Taylor, D. M. (1974). Some studies of the dosimetry and safety ofradiophannaceuticals. In: Radioaktiue Isotope in Klinik und Forschung, Vol. 11, pp. 1-18. (HBfer, R. ed.) Urban and Schwarzenberg, Miinchen. Williams, E. D., Merrick, M. V. and Lavender, J. P. (1975). The distribution and dosimetry of In-bleomycin in man. 5r. J. Radiol. 48.275-278.

Biokinetic Data
Organ (S) Liver Red marrow 0.10 0.06 T 2d 2d 70 d 2d 2d 70 d 2d 2d 70d 2d 70d 10 hr 2d 70d a -1.0 0.3 0.7 -1.0 0.3 0.7 -1.0 0.3 0.7 0.7 0.3 0.60 0.28 0.12 &IA, 4.60 hr

2.76 hr 1.84 hr

Spleen Kidneys (uptake) Kidneys (excretion) Bladder contents Remaining tissues

0.04 0.10
1.0

5.67 hr 2.6 min 1.02 hr 1.14 d

1.0 0.90

257

BIOKINETIC MODELS AND DATA

In-LABELLED BLEOMYCIN
%n 2.83 days

Organ Adult * * Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue

per

unit

Absorbed dose activity administered 15 year 1.7E-01 Z. lE-01 l. lE-01 5.OE-02 l. lE-01 l .OE-01 l .OE-01 0.71-02 10 year 2.5E-01 3.1E-01 1.7E-01 7.4B-02 1.7E-01 1.6E-01 1.5E-01 1.3E-01 1.4E+OO 3. BE-01 l.ZE-01 1.4E-01 2.4E-01 2.4E-01 1. lE+OO 8.9%02 9.0E-02 1.5E-01 l. lE-01

(mGy/HBq) 1 year 6.5E-01 8.OE-01 5.4B-01 Z.ZE-01 4.OE-01 4.2E-01 4.1E-01 3.5E-01 3.4E+OO 9.3E-01 3.3E-01 3. BE-01 6.OE-01 6.9E-01 2. BE+00 2.6E-01 2.8E-01 4.OE-01 3.OE-01

5 year 3.7E-01 4.5E-01 2.7E-01 l.ZE-01 2.4E-01 2.4E-01 2.5E-01 Z.OE-01 2 . OE+OO 5.3E-01 1.8E-01 Z. ZE-01 3.6&01 3.7E-01 1.6E+OO 1.4B-01 1.6B-01 2.3E-01 1.6E-01

1.4E-01 1.7E-01 0.5E-02 5.OE-02 9.3E-02 8.5E-02 0.3E-02 6.8E-02 8.4E-01 Z.lE-01 6.3E-02 7.3E-02 1.4&01 1.3E-01 5.2E-01 4.3E-02 4.2E-02 8.3E-02 5.9E-02

* *

1. OE+OO 2.6E-01 8.3E-02 9.3E-02 1.6E-01

1.6E-01 7.1E-01 5. BE-02 6.2E-02 9.8E-02 7.1E-02

Effective dose equivalent (mSv/HBq)

1.6B-01

Z . OB-01

2.9%01

4.4B-01

7.7&01

?i!%%
E ect ve 114mIn (49.51

ose d)

equivalent,(mSv/MBq 2.5E+Ol

of 3.7E+Ol

the

impurity) 5.8E+Ol 9.5E+Ol 1.9E+02

258

RADIATION

DOSE TO PATIENTS

FROM RADIOPHARMACEUTICALS

I 53 Iodide

1231

IODIDE
1241 1251 1311

Biokinetic Model The kinetic behaviour of iodide has been studied extensively, and several physiological kinetic models exist (Berman, 1968; Riggs, 1952). These models contain all known flows and exchanges, but are unnecessarily detailed for dosimetry purposes. The mode1 used in the MIRD Dose Estimate Report No. 5 (1975) described organ and tissue retention in terms of exponential functions with up to four components. Normal values of fractional thyroid uptake used in that report varied between 0.0550.25 and were considered to encompass a range appropriate to the adult euthyroid population of the United States. For absorbed dose calculations, an appropriately simple model should include values of uptake in thyroid, stomach and intestines, together with a urinary excretion component. In defining such a model, use has been made here of the data in the more complicated models mentioned above and of other publications (e.g. Kaul et al., 1973). Thyroid uptake has been set at six different levels in the range 0.05-0.55, the higher values being appropriate to the increased uptakes which occur in regions of low iodine intake. The half-time of the thyroid uptake phase, which in the MIRD model is 6-8 hr, has been set at 8 hr, equal to the half-time of renal clearance. Fractional uptake values in the stomach and small intestine have been defined according to data given in the MIRD report and the half-time of elimination from these organs has been set at 8 hr, based on MIRD values and on the data of Takeda and Reeve (1962). The half-time for discharge from the adult thyroid has been taken to be 80 d, whilst values of 65,50, 40 and 30 d have been used for childr,en aged 15, 10, 5 and 1 yr, respectively (Stather and Greenhalgh, 1983). Iodide not taken up in the organs discussed above is assumed to be distributed uniformly throughout the remaining body and excreted by the renal system, with a half-time of 8 hr, according to the kidney-bladder model. The model describes the behaviour of administered iodide only and therefore does not include the effects of organically bound iodine, and iodide produced by catabolism of organically bound iodine, which is released to the body tissues following discharge from the thyroid. The amounts of organically bound iodine and recycled iodide produced depend on thyroid uptake values and discharge rates: they are negligible for short-lived 123I and greatest for rt51, which for the highest thyroid uptake considered (55%), shows an iodide recycling factor of about 1.18 for a discharge half-time of 80 d and of about 1.32 for a discharge half-time of 30 d. In particular, for a 55% thyroid uptake of 1251,the effects of circulating organic iodine and recycled iodide are to increase the self doses to body organs other than thyroid, GI tract and bladder by a factor of about 10 (80 d discharge half-time) to 17 (30 d discharge half-time). Corresponding values for 1311are 1.8 to 3 and, for 1241, 1.3 to 1.7. However, these effects on doses to body organs and tissues, other than the thyroid, have negligible influence on the effective dose equivalents of 1241, 121 and r311 for which the contribution to the effective dose equivalent from the thyroid dose alone is 95% or more. Although the model refers to intravenous administration, radioiodine tests of thyroid function are usually performed, for convenience, with oral administration. Since absorption of radioiodine is rapid and complete, the intravenous model is applicable in this case also, but there is a further radiation dose to the stomach in addition to that due to iodide in gastric and salivary secretions. Assuming a mean residence time in the stomach of 0.5 hr, the absorbed dose 259

I
53 Iodide

BIOKINETIC MODELS AND DATA

to the stomach wall is increased by about 40% for 231and by about 30% for 241, 251and i3 I, when compared with the intravenous model. Because of its short physical half-life, oral administration of 123I leads to a decrease of 3% in the absorbed dose to organs and tissues other than the stomach wall, as compared with the intravenous case. With the other radionuclides considered here, changes to organ and tissue absorbed doses are very small. The effective dose equivalent is virtually identical after oral or intravenous administration. The model for the case of a blocked thyroid is the same as that above, except that there is no specific uptake in any organ or tissue. Instead, a uniform distribution is assumed, together with an excretion half-time of 8 hr. Because blocking may not always be complete, calculations have also been performed with a small residual uptake, in the range 0 to 2%, in the thyroid. Results of these calculations are only presented with regard to the effective dose equivalent values obtained. For further information on the effects of blocking, reference should be made to the publication by Wootton and Hammond (1978). Hypothyroid patients have a low thyroid uptake, but a prolonged excretion half-time, resulting in a radiation dose to the thyroid a little larger than for a euthyroid subject with the same low fractional uptake. In the case of hyperthyroidism, the shorter than normal half-time of radioiodine in the thyroid leads to a smaller radiation dose than would be extrapolated from the dose values presented here. References
(1) Model for adults and children Berman, M., Hoff, E., Barandes, M., Becker, D. V., Sonenberg, M., Benua, R. and Koutras, D. A. (1968). J. C/in.
Endocrinol. Metab. 28, 1-14.

Kaul, A., Oeff, K., Roedler, H. D. and Vogelsang, T. (1973). Radiopharmaceuticals-Biokinetic Data and Results of Radiation Dose Calculations. Informationsdienst fur Nuklearmedizin, Berlin. MIRD Dose Estimate Report No. 5 (1975). Summary of current radiation dose estimates to humans from lz31, iz41, 12q 26I i3I, i3iI and 131 as sodium iodide. J. Nucl. Med. 16, 857-860. Riggs,D. S(1952). Quantitative aspects of iodine metabolism in man. Pharmacol. Rev. 4, 284370. Stather, J. W. and Greenhalgh, J. R. (1983). The Metabolism oflodine in Children and Adults, NRPB-R140. National Radiological Protection Board, Chilton. Takeda, Y. and Reeve, B. M. (1962). Distribution and excretion of 113-iodide in men on pharmacologic doses of iodides. J. Lab. Clin. Med. 60, 944953. Wootton, R. and Hammond, B. J. (1978). A computer simulation study ofoptimal thyroid radiation protection during investigations involving the administration of radioiodine-labelled pharmaceuticals. Br. J. Radiol. 51, 265-272. (2) Dosimetry of the fetal thyroid Aboul Khair, S. A., Buchanan, T. J., Crooks, J. and Turnbull, A. C. (1966). Structural and functional development of the human fetal thyroid. Clin. Sci. 31, 415424. Beierwaltes, W. H., Crane, R., Wegst, A., Stafford, N. B. and Carr, E. A. Jr. (1960). Radioactive iodine concentration in the fetal human thyroid gland from fallout. J. Am. Med. Assoc. 173, 18951902. Beierwaltes, W. H., Hilger, M. T. J. and Wegst, A. (1963). Radioiodine concentration in fetal human thyroid from fallout. Health Phys. 9, 1263-1266. Book, S. A. and Goldman, M. (1975). Thyroid radioiodine exposure of the fetus. Health Phys. 29, 874-877. Chapman, E. M., Gomer, G. W., Robinson, D. and Evans, R. D. (1948). The collection of radioactive iodine by the human fetal thyroid. J. Clin. Endocrinol. Metab. 8, 717-720. Costa, A., Cottino, F., Dellepiane, M., Ferraris, G. M., Lenare, L., Magro, G., Pat&o, G. and Zoppett, G. (1965). Thyroid function and thyrotropin activity in mother and fetus. Curr. Top. Thyroid Res. 5,738. Czerniak, P., Soferman, N. and Chajchik, S. (1965). The passage of I-131 and P-32 from mother to fetus (in Hebrew).
Harefiah 69, 158-161.

Dyer, N. C. and Brill, A. B. (1972). Maternal-fetal transport of iron and iodine in human subjects. Adu. Exp. Med. Viol.
27, 354-366.

Eisenbud, M., Mochizuku, Y. and Laurer, G. (1963). I-131 dose to human thyroids in New York City from nuclear tests in 1962. Health Phys. 9, 1291-1298. Evans, T. C., Kretschmar, R. M., Hodges, R. E. and Song, Ch. W. (1967). Radioiodine uptake studies of the human fetal thyroid. J. Nucl. Med. 8, 157-165.

260

RADIATION

DOSE TO PATIENTS

FROM RADIOPHARMACEUTICALS

I 53 Iodide

Hodges, R. E., Evans, T. C., Bradbury, J. T. and Keettel, W. C. (1955). The accumulation of radioactive iodine by human fetal thyroids. J. Clin. Endocrinol. Metabol. 15,661-667. Johnson, J. R. (1982). Fetal thyroid dose from intakes of radioiodine by the mother. Health Phys. 43, 573582. Lampe, L., Kertesz, L. and Dzvonyar, J. (1964). Uber die Jodspeicherung der Schilddriise des menschlichen Fetus. Zb. Gyniikol. 86,905-908.

Biokinetic Data

Organ (S)

Fs 8 hr 1.0 7.14 hr 10.7 hr 11.5 hr 11.1 hr

(1) Thyroid blocked, uptake 0% Total body 1.0 (excluding bladder contents) Kidneys 1.0 Bladder contents 1.0 (2) Thyroid uptake 5% Thyroid 0.05 Adult 15 yr old 10 yr old 5 yr old 1 yr old Stomach 0.15 SI 0.15 Kidneys 1.0 Bladder contents 1.0 Remaining tissues 0.7 (3) Thyroid uptake 15% Thyroid 0.15 Adult 15 yr old 10 yr old 5 yr old 1 yr old Stomach 0.15 SI 0.15 Kidneys 1.0 Bladder contents 1.0 Remaining tissues 0.7 (4) Thyroid uptake 25% Thyroid 0.25 Adult 15 yr old 10 yr old 5 yr old 1 yr old

5.0 min 1.10 hr 8 hr 80 d 65 d 50d 40d 30 d 8 hr 8 hr - 1.0 1.o 1.0 1.o 1.0 1.0 1.0 1.0

7.5 min 1.70 hr 6.37 hr 6.30 hr 6.19 hr 6.07 hr 5.88 hr 1.60 hr 1.60 hr 6.4 min 1.61 hr 7.48 hr

8.0 min 1.83 hr 2.46 d 2.24 d 1.96d 1.72 d 1.44 d 1.72 hr 1.72 hr 6.9 min 1.74 hr 8.04 hr

1.1 min 1.76 hr

35 min 35 min 35 min 35 min 35 min 1.08 hr 1.08 hr 4.3 min 1.05 hr

12.1 hr 11.9 hr 11.5 hr 11.1 hr 10.5 hr 1.66 hr 1.66 hr 6.6 min 1.67 hr 1.76 hr

8 hr 8 hr 80d 65 d 50 d 4Od 30 d 8 hr 8 hr

1.o -1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0

5.03 hr

1.77 hr 1.76 hr 1.76 hr 1.75 hr 1.75 hr 1.08 hr 1.08 hr 4.0 min 56 min

19.1 hr 18.9 hr 18.6 hr 18.2 hr 17.7 hr 1.60 hr 1.60 hr 5.9 min 1.44 hr 7.48 hr

7.39 d 6.72 d 5.88 d 5.19 d 4.31 d 1.72 hr 1.72 hr 6.4 min 1.55 hr 8.04 hr 12.3 d 11.2d 9.79 d 8.62 d 7.18 hr

1.52 d 1.49d 1.44d 1.39d 1.32 d 1.66 hr 1.66 hr 6.1 min 1.50 hr 1.76 hr

8 hr 8 hr 80 d 65 d 50d 40d 30d

1.0 -1.0 1.0 1.0 1.0 1.0 1.0

5.03 hr

2.94 hr 2.94 hr 2.93 hr 2.92 hr 2.91 hr

1.33 d 1.31 d 1.29 d 1.26d 1.23 d

2.53 d 2.48 d 2.40 d 2.32 d 2.20 d

continued

261

I
53 Iodide

BIOKINETIC MODELS AND DATA

Biokinetic Data (continued)

Organ (S)

Fs 8 hr 8 hr 1.0 1.0 1.08 hr 1.08 hr 3.7 min 50 min 8 hr 8 hr 80 d 65 d 50 d 40d 30 d 8 hr 8 hr 1.0 -1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 5.03 hr 1.60 hr 1.60 hr 5.5 min 1.27 hr 7.48 hr 1.72 hr 1.72 hr 5.9 min 1.37 hr 8.04 hr 1.66 hr 1.66 hr 5.7 min 1.32 hr 7.76 hr

Stomach 0.15 SI 0.15 Kidneys 1.0 Bladder contents 1.0 Remaining tissues 0.7 (5) Thyroid uptake 35% Thyroid 0.35 Adult 15 yr old 10 yr old 5 yr old 1 yr old Stomach 0.15 SI 0.15 Kidneys 1.0 Bladder contents 1.0 Remaining tissues 0.7 (6) Thyroid uptake 45% Thyroid 0.45 Adult 15 yr old 10 yr old 5 yr old 1 yr old Stomach 0.15 SI 0.15 Kidneys 1.0 Bladder contents 1.0 Remaining tissues 0.7 (7) Thyroid uptake 55% Thyroid 0.55 Adult 15 yr old 10 yr old 5 yr old 1 yr old Stomach 0.15 SI 0.15 Kidneys 1.0 Bladder contents 1.0 Remaining tissues 0.7

4.12 hr 4.12 hr 4.11 hr 4.09 hr 4.08 hr 1.08 hr 1.08 hr 3.4 min 43 min

1.86d 1.84 d 1.80d 1.77 d 1.72 d 1.60 hr 1.60 hr 5.0 min 1.10 hr 7.48 hr

17.2 d 15.7 d 13.7 d 12.1 d 10.1 d 1.72 hr 1.72 hr 5.4 min 1.19 hr 8.04 hr

3.54 d 3.47 d 3.36 d 3.25 d 3.07 d 1.66 hr 1.66 hr 5.2 min 1.14 hr 7.76 hr

8 hr 8 hr 80 d 65 d 50 d 40 d 30 d 8 hr 8 hr

1.0 -1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0

5.03 hr

5.30 hr 5.29 hr 5.28 hr 5.26 hr 5.24 hr 1.08 hr 1.08 hr 3.0 min 36 min

2.39 d 2.36 d 2.32 d 2.28 d 2.21 d 1.60 hr 1.60 hr 4.5 min 56 min 7.48 hr

22.2 d 20.2 d 17.6 d 15.5 d 12.9 d 1.72 hr 1.72 hr 4.9 min 1.01 hr 8.04 hr 27.1 d 24.7 d 21.5 d 19.0 d 15.8 d 1.72 hr 1.72 hr 4.4 min 49 min 8.04 hr

4.56 d 4.46 d 4.32 d 4.17 d 3.95 d 1.66 hr 1.66 hr 4.7 min 58 min 7.76 hr

8 hr 8 hr 80 d 65 d 50d 40 d 30 d 8 hr 8 hr

1.0 -1.0 1.0 1.o 1.0 1.0 1.0 1.0 1.0

5.03 hr 6.48 hr 6.47 hr 6.45 hr 6.43 hr 6.41 hr 1.08 hr 1.08 hr 2.7 min 30 min

2.92 d 2.89 d 2.84 d 2.78 d 2.70 d 1.60 hr 1.60 hr 4.1 min 46 min 7.48 hr

5.57 d 5.45 d 5.28 d 5.lOd 4.83 d 1.66 hr 1.66 hr 4.2 min 48 min 7.76 hr

8 hr

1.0

5.03 hr

262

RADIATION

DOSE TO PATIENTS FROM RADIOPHARMACEUTICALS

I 53 Iodide

IODIDE
Thyroid 1231 blocked, uptake 0% 13.2

hours

per Organ Adult Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue ? .OE-03 9.OE-02 8.1E-03 5.6E-03 6,9E-03 8.5E-03 8.OE-03 9.7E-03 l.lE-02 6.7E-03 6.1E-03 9.8E-03 7.6E-03 9.4E-03 7.OE-03 6.9E-03 5.1E-03 1.4E-02 6.4E-03

unit

Absorbed dose activity administered 15 year 8.7E-03 l.lE-01 9.7E-03 5.6E-03 8.5E-03 l .OE-02 9,9E-03 1 .ZE-02 1.4E-02 8.2E-03 7.8E-03 1.2E-02 9.1E-03 l.lE-02 8.3E-03 9.4E-03 7.7E-03 1.7E-02 7.7E-03 10 year 1.4E-02 1.6E-01 1.5E-02 8.1E-03 1.4E-02 1.6E-02 1.5E-02 1.9E-02 2.OE-02 1.3E-02 1.2E-02 1.9E-02 1.4E-02 1.7E-02 1.3E-02 1.5B-02 1.2E-02 2.83-02 1.2E-02

(mGy/MBq) 5 year 1 year 3.9B-02 4.5E-01 4.6E-02 2.5B-02 3.7E-02 4.6B-02 4.3E-02 5.4E-02 5.1E-02 3.7E-02 3.5E-02 5.3E-02 4.1E-02 4.7B-02 3.7E-02 4.8E-02 3.78-02 ?.6E-02 3.5E-02

2,1E-02 2.4E-01 2.4B-02 1.3B-02 2.lE-02 2.5E-02 2.4E-02 2.9E-02 2.9E-02 2.OE-02 1.9E-02 3.OE-02 2.2E-02 2.6E-02 2.OE-02 2,5E-02 2.OB-02 4.3B-02 1.9B-02

* * * *

Effective dose equivalent (mSv/HBq)

1.3E-02

1.6B-02

2.4B-02

3.7B-02

6.7B-02

Incomplete Effective uptake: uptake: uptake:

blockage: dose equivalent 0.5 1.0 2.0 % % %

(mSv/NBq)

at

small

uptake 3.1E-02 3.8E-02 5.2E-02

in

the

thyroid 9.6E-02 1.3E-01 1.8E-01

1.6E-02 1.9E-02 2.53-02

2.OE-02 2.5E-02 3.48-02

5.2E-02 6.7E-02 9.9E-02

263

BIOKINETIC MODELSANDDATA

IODIDE
Thyroid uptake 5% 1231 Organ Adult Adrenals * Bladder wall Bone surfaces Breast GI-tract * Stomachwall * Small intest * ULI wall LLI wall Kidneys Liver Lungs Ovaries * Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue Effective dose equivalent (mSv/H8q) 6.43-03 8.53-02 6.8E-03 4.63-03 6.83-02 4.33-02 1.9E-02 l.lE-02 1.2E-02 6.23-03 5.4E-03 1.2E-02 1.4E-02 9.23-03 9.63-03 5.53-03 6.3E-01 1.6E-02 6.3E-03 3.83-02 15 year 8.4E-03 l.lE-01 8.43-03 4.6E-03 8.53-02 5.5E-02 1.9E-02 1.5E-02 1.4E-02 7.63-03 6.7E-03 1.6E-02 1.6E-02 l.lE-02 l.lE-02 7.63-03 9.9E-01 2.OE-02 7.63-03 5.33-02 10 year 1.3E-02 1.6E-01 1.3E-02 6.93-03 1.2E-01 9.23-02 3.OE-02 2.3E-02 2.OE-02 1.3E-02 l.OE-02 2.63-02 2.43-02 1.7E-02 1.7E-02 1.3E-02 1.5E+OO 3.33-02 1.2E-02 8.OE-02 5 year 2.OE-02 2.3E-01 2.1E-02 l.lE-02 2.OE-01 1.5E-01 4.63-02 3.43-02 2.9E-02 2.1E-02 1.7E-02 4.OE-02 3.5E-02 2.43-02 2.53-02 Z.lE-02 3.3E+OO S.lE-02 1.9E-02 1.5B-01 1 year 3.73-02 4.3E-01 4.OE-02 2.23-02 3.8E-01 2.7E-01 7.83-02 6.2E-02 5.1E-02 3.83-02 3.1E-02 7.OE-02 6.1E-02 4.1E-02 4.4E-02 4.OE-02 6.2E+OO 9.OE-02 3.51-02 2.9E-01 13.2 hours Absorbeddose per unit activityadministered (mGy/MBq)

Thyroid uptake 15% Organ * Adrenals Bladderwall Bone surfaces Breast GI-tract * Stomachwall * Small intest * ULI wall LLI wall Kidneys Liver Lungs Ovaries * Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue Effective dose equivalent (=Sv/llBq) Adult 6.3E-03 7.63-02 7.1E-03 4.73-03 6.83-02 4.33-02 1.8E-02 l.lE-02 l.OE-02 6.23-03 5.7E-03 1.2E-02 1.4E-02 9.43-03 9.53-03 5.33-03 1.9E+OO 1.5E-02 6.83-03 7.5E-02 15 year 8.3E-03 9.53-02 9.1E-03 4.73-03. 8.53-02 5.43-02 1.9E-02 1.4E-02 1.3E-02 7.63-03 7.2E-03 1.6E-02 1.6E-02 10 year 1.3E-02 1.4E-01 1.4E-02 7.33-03 1.2E-01 9.1E-02 2.93-02 2.23-02 l.BE-02 1.3E-02 l.lE-02 2.53-02 2.43-02 1.7E-02 1.7E-02 1.2E-02 4.5E+OO 3.1E-02 1.3E-02 1.7E-01 5 year Z.OE-02 2.1E-01 2.23-02 1.2E-02 2.OE-01 1.4E-01 4.53-02 3.3E-02 2.7E-02 2.1E-02 1.8E-02 3.8E-02 3.53-02 2.53-02 2.53-02 2.OE-02 9.8E+OO 4.93-02 2.1E-02 3.53-01 1 year 3.7E-02 3.8E-01 4.1E-02 2.31-02 3.8E-01 2.7E-01 7.73-02 6.OE-02 4.63-02 3.83-02 3.41-02 6.8E-02 6.1E-02 4.33-02 4.4&02 3.8E-02 1.9E+Ol 8.6E-02 3.9E-02 6.5E-01

;. y;
7:23-03 3.OE+OO 1.9E-02 8.53-03 l.lE-01

264

RADIATIONDOSETOPATIENTSFROMRADIOPHARMACEUTICALS

53 Iodide

IODIDE
Thyroid uptake 25% 123I 13.2 hours Absorbeddose per unit activityadministered (mGy/MBq) Organ Adult Adrenals * Bladderwall Bone surfaces Breast GI-tract * Stomachwall * Small intest * ULI wall LLI wall Kidneys Liver Lungs Ovaries * Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue Effective dose equivalent (mSv/lfBq) 6.43-03 6.9E-02 7.53-03 5.OE-03 6.8E-02 4.33-02 1.8E-02 l.lE-02 l.lE-02 6.3E-03 6.1E-03 l.lE-02 1.4E-02 9.8E-03 9.63-03 5.2E-03 3.2E+OO 1.4E-02 7.4E-03 l.lE-01 15 year 8.43-03 8.5E-02 9.93-03 5.OE-03 8.53-02 5.43-02 1.9E-02 1.4E-02 1.3E-02 7.78-03 7.9E-03 1.6E-02 1.6E-02 1.3E-02 l.lE-02 7.OE-03 5.OE+OO l.BE-02 9.5E-03 1.7E-01 10 year 1.3E-02 1.3E-01 1.5E-02 7.9E-03 1.2E-01 9.1E-02 2.93-02 2.2E-02 1.9E-02 1.3E-02 1.2E-02 2.4E-02 2.48-02 1.8E-02 1.7E-02 1.2E-02 7.5E+OO 3.OE-02 1.5E-02 2.6E-01 5 year 2.lE-02 1.9E-01 2.33-02 1.3E-02 2.OE-01 1.4E-01 4.5E-02 3.2E-02 2.7E-02 2.1E-02 2.OE-02 3.83-02 3.63-02 2.6E-02 2.53-02 1.9E-02 1.6E+Ol 4.7E-02 2.43-02 5.48-01 1 year 3.83-02 3.5E-01 4.4E-02 2.53-02 3.8E-01 2.7E-01 7.7E-02 5.9E-02 4.73-02 3.9E-02 3.8E-02 6.8E-02 6.23-02 4.53-02 4.43-02 3.73-02 3.1E+Ol 8.33-02 4.43-02 l.OE+oo

Thyroid uptake 35% Organ Adrenals * Bladderwall Bone surfaces Breast GI-tract * Stomachwall * *all intest * ULI wall LLI wall Kidneys Liver Lungs Ovaries * Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue Effective dose equivalent (mSv/KBq) Adult 6.5E-03 6.OE-02 7.9E-03 5.23-03 6.83-02 4.23-02 1.8E--02 l.OE-02 9.1E-03 6.3E-03 6.5E-03 l.lE-02 1.4E-02 l.OE-02 9.63-03 5.OE-03 4.5E+OO 1.4E-02 8.OE-03 1.5E-01 15 year 8.4E-03 7.4E-02 l.lE-02 5.2E-03 8.53-02 5.43-02 1.9E-02 1.4E-02 l.lE-02 7.83-03 8.63-03 1.5E-02 1.6E-02 1.3E-02 l.lE-02 6.83-03 7.OE+OO 1.7E-02 l.OE-02 2.3B-01 10 year 1.3E-02 l.lE-01 1.6E-02 8.53-03 1.2E-01 9.OE-02 2.91-02 2.1E-02 1.6E-02 1.3E-02 1.4E-02 2.4E-02 2.4E-02 1.9E-02 l.?E-02 l.lE-02 l.lE+Ol 2.93-02 1.6E-02 3.5E-01 5 year 2.1E-02 1.6E-01 2.5E-02 1.5E-02 2.OE-01 1.4E-01 4.5E-02 3.23-02 2.43-02 2.1E-02 2.23-02 3.73-02 3.63-02 2.83-02 2.53-02 1.8E-02 2.3E+Ol 4.43-02 2.6E-02 7.4E-01 1 year 3.83-02 3.OE-01 4.63-02 2.73-02 3.8E-01 2.7E-01 7.63-02 5.83-02 4.1E-02 4.OE-02 4.2E-02 6.6E-02 6.2E-02 4.83-02 4.53-02 3.53-02 4.3E+Ol 7.9E-02 4.9E-02 1.4B+OO

265

BIOKINETIC MODELS AND DATA

43 Iodide

IODIDE
Thyroid 13.2 hours per Adult Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Snleen Testes Thyroid Uterus Other tissue 6.5E-03 S.lE-02 8.2B-03 5.4B-03 unit Absorbed dose activity administered 15 year 8.4E-03 6.4E-02 l. lE-02 5.4E-03 8.58-02 5.4B-02 1.9B-02 1.3E-02 1.2E-02 7.8E-03 9.1E-03 1.5E-02 10 year 1.3E-02 9.4E-02 1.7E-02 9.OE-03 (mGy/BRq) 1 year 3.9E-02 uptake 45%

Organ

5 year 2.1E-02 1.4E-01 2.6E-02 1.6E-02 Z.OE-01 1.4E-01 4.4E-02 3.1E-02 2.5E-02 2.2E-02 2.4E-02 3.6E-02 3.6E-02 2.9E-02 2.6E-02 1.7E-02 3.OE+Ol 4,2E-02 2.9E-02

2.6E-01 4.8L02 2.93-02 3.9E-01 2.7&01 7.63-02 5.63-02 4.33-02 4.OE-02 4.53-02 6.5E-02 6.33-02 4.9E-02
4.5E-02 3.3B-02 5.6E+Ol 7.5E-02 5.3E-02

*
*

6*8E-02
4.2E-02 1.8E-02 l .OE-02 9.5E-03 6.3E-03 6.8.R-03 l .lE-02 1.4B-02 l *OB-02 9.6E-03 4.8E-03 5.7E+OO 1.3E-02 8.6E-03

11ZE-01
9. IE-02 2.9E-02 2.OE-02 1.7E-02 1.3E-02 1.5E-02 2.3E-02 2. SE-02 2.OE-02 1.7E-02 l. lE-02 1.4E+Ol 2.7E-02 1.8E-02

1.6E-02
1.4E-02 l . lE-02 6.5E-03 9.OE+OO 1.7E-02 l . lE-02

Effective dose equivalent (mSv/WBq)

1.9E-01

2,9B-01

4.4B-01

9.4B-01

1.8B+00

Thyroid Organ Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue Adult 6.5E-03 4.3E-02 8.6E-03 5.6E-03 6.8E-02 4 *28-02 1. aR-02 9.8E-03 9.1E-03 6.4E-03 7.2E-03 l. lE-02 1.4E-02

uptake

55% 10 year 5 year 2.1E-02 l.ZE-01 2.8E-02 1,7E-02 2.0&01 1.4E-01 4,4E-02 3.OE-02 2.4E-02 2.2E-02 2.6E-02 3.6E-02 3.6E-02 3.OE-02 2.6B-02 1.6E-02 3.6E+Ol 4,OE-02 3. IE-02 1 year 3.9E-02 2.2&01 5.1E-02 3.lE-02 3.9E-01 2.7E-01 7.6E-02 5.5E-02 4.1E-02 4.1E-02 4.83-02 6.43-02 6.3E-02 5.2E-02 4.6E-02 3.2E-02 6.8B+Ol 7.2E-02 5.8B-02

15 year

8.51-03 5.33-02 1.2E-02 5.6E-03 8.s02 5.43-02 1.9E-02 1.3E-02

1.4E-02
7.9E-02 1.8E-02 9.5E-03 l. ZE-01 9. IE-02 2.9E-02 2.OE-02 1.6E-02 1.3E-02 1.6E-02 2.3E-02 2.5E-02 2.1E-02 1.7B-02 l . OE-02 1.7E+01 2.6E-02 1.9E-02

* *

l.lE-02 7.93-03 9.73-03 1.5E-02 1.6E-02 1.5E-02 1.13-02 9.7E-03 l.lE-02 4.6E-03 6.23-03 7.OE+OO l.lE+Ol l . ZE-02 l.dE-02
9.2E-03

1.2E-02
3 - 5B-01

Effective dose equivalent Wv/BBq)

2.3B-01

5.3E-01

l.lB+W

2.1&00

266

RADIATION

DOSE TO PATIENTS FROM RADIOPHARMACEUTICALS

I 53 Iodide

IODIDE
Thyroid 1241 blocked, uptake 0%

4.18

days

per Organ Adult * * Adrenals Bladder vail Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue 7.2E-02 7.8E-01 5.3E-02 5.2E-02 5.7E-02 7.1E-02 6. BE-M 8.7E-02 l .OE-01 5.8E-02 5.1E-CI2 7.90-02 6.1E-02 5.9E-02 5.83-02 7.4E-02 5.OE-02 1. IE-01 5.6E-02

unit

Absorbed done activity administered 15 year 7.3E-02 9.6E-01 6.2E-02 5.21-02 7 .OE-02 8.6E-02 B.OE-02 9.6E-02 1.2E-01 6.9E-02 6.3E-02 l.OE-01 7,7E-02 7.1E-02 7. IE-02 8.3E-02 6.4E-02 1.4E-01 6.7E-02 10 year l. lE-01 1.4E+OO 9.8E-02 7.7E-02 l.OE-01 1.3E-01 1.2E-01 1.5E-01 1.7E-01 l.lE-01 9.6E-02 1.5E-01 1.2E-01 l. lE-01 l.lE-01 1.4E-01 l .OE-01 2.2E-01 l.OE-01

(mGy/MBq) 5 year 1.8E-01 Z.ZE+OO 1.5E-01 l .ZE-01 1.7E-01 2.1E-01 2.OL01 2.3E-01 2.6E-01 1.7E-01 1.5E-01 2.4E-01 1. BE-01 1.6E-01 1. ?E-01 2,1E-01 1.7E-01 3.3E-01 1.6E-01 1 year 3.3E-01 4.OE+OO 2.9E-01 2.4E-01 3.OE-01 3.8E-01 3.5E-01 4.OE-01 4.5E-01 3.1E-01 2.8E-01 4.2E-01 3.4E-01 2.9E-01 3. IE-01 4.OE-01 3.1E-01 5.8E-01 3.OE-01

* * *

Effective dose equivalent Wv/BW

l. lB-01

1.3B-01

Z . OB-01

3.1E-01

5.6B-01

Incomplete Effective uptake: uptake: uptake:

blockage: dose equivalent 0.5 1.0 2.0 4; % %

(mSv/MBq)

at

small

uptake 5,3E-01 8.7E-01 1.5E+OO

in

the

thyroid 2 . OE+OO 3.4E+OO 6.2E+OO

2.5E-01 3.8E-01 6.6E-01

3.5E-01 5.7E-01 1. DE+00

1 . OE+OO 1.8E+OO 3.3EtOO

267

BIOKINETIC MODELS AND DATA

53 Iodide

IODIDE
Thyroid 124I 4.18 days per Organ Adult Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue 6.6E-02 7.4E-01 5.3E-02 5.2E-02 5.8E-01 3.7E-01 1.3E-01 9.3E-02 l.OE-01 5.6&02 5.7E-02 9.1E-02 l. lE-01 6.5E-02 7.9E-02 5.8E-02 4.2E+Ol 1.2E-01 6.9E-02 15 year 7.4E-02 9.1E-01 6,7E-02 5.2E-02 7.3E-01 4.6E-01 1.4E-01 l. lE-01 1.2E-01 6.7E-02 7.2E-02 1.3E-01 1.2E-01 8.1E-02 9.2E-02 6,8E-02 6.7E+Ol 1.5E-01 8.83-02 10 year l.lE-01 1.4E+OO 9.9E-02 8.5E-02 l*OE+OO 7.8E-01 2.2E-01 1.7E-01 1.7E-01 l. lE-01 l. lE-01 1.9E-01 1.9E-01 l. lE-01 1.4E-01 1. IE-01 l.OE+02 2.5E-01 1.4E-01 5 year 1.8E-01 2.1E+OO 1.5E-01 1.4E-01 1.7E+OO 1.3E+OO 3.3E-01 2.6E-01 2.6E-01 1.8E-01 1.8E-01 3.OE-01 2.8E-01 1.6E-01 2.1E-01 1.8E-01 2.2E+02 3.8E-01 2.1E-01 1 year 3.2E-01 3.8E+OO 2.7E-01 2.6E-01 3.4E+OO 2.4E+OO 5.7E-01 4.5E-01 4.4E-01 3.3E-01 3.2E-01 5.2E-01 4*8E-01 2.8E-01 3.6E-01 3.3E-01 4.OE+02 6.6E-01 3.9E-01 unit Absorbed dose activity administered (mGy/MBq) uptake 5%

* * *

Effective dose equivalent (mSv/lIBq)

1.4E+OO

2.2E+OO

3.3E+OO

7.OE+OG

1.3B+Ol

Thyroid Organ Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue Adult 7.2E-02 6.7E-01 7.2E-02 7,3E-02 5.8E-01 3.7E-01 1.3E-01 9.2E-02 9.4E-02 6.1E-02 8.6E-02 8.9E-02 l.lE-01 8.6E-02 8.3E-02 5.7E-02 1.3E+02 l.lE-01 l.lE-01

uptake

15% 10 year 1,3E-01 1.2E+OO 1.4E-01 1.3E-01 5 year 2.OE-01 1.9E+OO 2.1E-01 2.1E-01 1.7EtOO 1.3EtOO 3.4E-01 2.6E-01 2.5E-01 2.OE-01 2.9E-01 3.OE-01 3.OE-01 2.2E-01 2.3&01 1.7E-01 6.5Et02 3.7E-01 3.5E-01 1 year 3 * 6E-01 3.5EtOO 3.6E-01 3.8E-01 3.4EtOO 2.4EtOO 5.9E-01 4.5E-01 4.3E-01 3.8E-01 5.OE-01 5.2E-01 5.3E-01 3.6E-01 4.OE-01 3.3E-01 1.2Et03 6.4E-01 6.4E-01

15 year 8,1E-02 8.2E-01 l.OE-01 7.2E-02 7,3E-01 4.6E-01 1.4E-01 l.lE-01 l.lE-01 7.5E-02 l.lE-01 1.2E-01 1.3E-01 l.lE-01 9.8E-02 6.6E-02 2.OEc02 1.5E-01 1.4E-01

* * *

1.OE+OO 7.8E-01 2.2E-01 1.7E-01

1.7E-01 1.2E-01 1*8E-01 1.9E-01 2.OE-01 1.6E-01 1.5E-01 l. lE-01 3.OE+02 2.4E-01 2.2E-01

Effective dose equivalent (mSv/HBq)

4.OE+OO

6.2E+OO

9.3R+OO

2.OE+Ol

3.7E+Ol

268

RADIATION

DOSE TO PATIENTS FROM RADIOPHARMACEUTICALS 53 Iodide

IODIDE
Thyroid 1241 4.18 days per Organ Adult Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue 7.8E-02 6.OE-01 9.2E-02 9.3E-02 5.8E-01 3.7E-01 1.3E-01 9.OE-02 9.7E-02 6.6E-02 l.lE-01 8. t3E-02 1.2E-01 l.lE-01 8.7E-02 5.6E-02 2.1E+02 l. lE-01 1.4E-01 15 year 8.8E-02 7.3E-01 1.3E-01 9.2E-02 7.4E-01 4.6E-01 1.4E-01 l.lE-01 1.2E-01 8.2E-02 1. SE-01 1.2E-01 1.4E-01 1. SE-01 1 .OE-01 6.4E-02 3.3E+02 1.4E-01 2.OE-01 10 year 1.4E-01 l.lE+OO 1.8E-01 1.7E-01 1. lE+OO 7.9E-01 2.3E-01 1.7E-01 1.7E-01 1.4E-01 2. SE-01 1.9E-01 2.2E-01 1.9E-01 1.7E-01 l.lE-01 5.OE+02 2.3E-01 3.1E-01 5 year 2.2E-01 1.7E+OO 2.7E-01 2.8E-01 1. EE+OO 1.3E+OO 3. SE-01 2.6E-01 2.6E-01 2.2E-01 4.OE-01 3.OE-01 3.2E-01 2.7E-01 2. SE-01 1.7E-01 l.lE+03 3.6E-01 4.9E-01 1 year 4.1E-01 unit Absorbed dose activity administered (mGy/MBq) uptake 25%

3.1E+OO
4.5E-01 S.OE-01 3.5E+OO 2.4E+OO 6.OE-01 4. SE-01 4.6E-01 4.3E-01 6.7E-01 5.3E-01 5.7E-01 4.5E-01 4.4E-01 3.2E-01 2.OE+03 6.3E-01 8.8E-01

Effective dose equivalent (;mSv/EBq)

6.5E+OO

1 .OE+Ol

1.5E+Ol

3.3B+Ol

6.1E+Ol

Thyroid Organ Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Adult 8.3E-02 5.2E-01 l. lE-01 l. lE-01 5.9E-01 3.6E-01 1.3E-01 8.8E-02 9.5E-02 7.1E-02 1.4E-01 8.6E-02 1.2E-01 1.3E-01 9.OE-02 5.4E-02 3.OE+02 l.lE-01 1.8E-01

uptake

35% 10 year 1.6E-01 9.6E-01 2.3E-01 2.1E-01 l.lE+OO 7.9E-01 2.3E-01 1.6E-01 1.7E-01 1.5E-01 3.1E-01 1.9E-01 2.3E-01 2.3E-01 1.8E-01 l.OE-01 7.OE+OZ 2.2E-01 3.9E-01 5

15 year 9.5E-02 6.4E-01 1.7E-01 l. lE-01 7.4E-01 4.6E-01 1.4E-01 l.OE-01 1.2E-01 8.9E-02 1.9E-01 1.2E-01 1.4E-01 1.

year

1 year
4.5E-01 2.7E+OO 5.4E-01 6.2E-01 3.5E+OO 2.4E+OO 6.2E-01 4. SE-01 4.7E-01 4.7E-01 8.5E-01 5.3E-01 6.1E-01 5.3E-01 4.8E-01 3.1E-01 2.8E+03 6.2E-01 l.lE+OO

2.5E-01 1. SE+00 3.3E-01 3.4E-01 1.8E+OO 1.3E+OO 3. SE-01 2.6E-01 2.7E-01 2. SE-01 S. OE-01 3.OE-01 3. SE-01 3.2E-01 2.7E-01 1.7E-01 1. SE+03 3.5E-01 6.3E-01

* * *

Red marrow Spleen Testes Thyroid Uterus Other tissue

BE-01 l. lE-01
6.2E-02 4.7E+02 1.4E-01 2.5E-01

Effective

dose equivalent Wv/W)

9.1E+OO

1.4E+Ol

2.1B+Ol

4.6B+Ol

8.6E+Ol

269

BIOKINETIC MODELS AND DATA 53 Iodide

IODIDE
Thyroid 1241 4.18 days per Organ Adult Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue 8. BE-02 4.5E-01 1.3E-01 1.3E-01 5.9E-01 15 year l.OE-01 5.5E-01 2.OE-01 1.3E-01 7.5E-01 4.6E-01 1.5E-01 l .OE-01 1.2E-01 9.63-02 2.3E-01 l.ZE-01 1.5E-01 2.1E-01 1.2E-01 6.OE-02 6.OE+02 1.3E-01 3.OE-01 10 year 1.7E-01 8.2E-01 2.7E-01 2.5E-01 5 year 2.7E-01 1.3E+OO 3.9E-01 4.lE-01 1.8E+OO 1.3E+OO 3.6E-01 2.6E-01 2.7E-01 2.7E-01 6.1E-01 3.OE-01 3.7E-01 3.8E-01 2.9E-01 1.6E-01 2.OE+03 3.4E-01 7_7E-01 1 year 5.OE-01 2.3E+OO 6.2E-01 7.4E-01 3.6E+OO 2.4E+OO 6.3E-01 4. SE-01 4.7E-01 5.1E-01 1 . OE+OO 5.3E-01 6.5E-01 6.2E-01 5.1E-01 3.1E-01 3.6E+03 6.OE-01 1.4E+OO unit Absorbed dose activity administered (mGy/RBq) uptake 45%

*
*

3.6E-01
1.3E-01 8.6E-02 9.3E-02 7.6E-02 1.7E-01 8,5E-02 1.2E-01 1.5E-01 9.4E-02 5.2E-02 3.8E+02 l .OE-01 2.1E-01

1. lE+OO 7.9E-01 2.3E-01 1.6E-01

1.7E-01 1.6E-01 3.8E-01 1.9E-01 2.4E-01 2.7E-01 1.9E-01 9.9E-02 9.OE+02 2.2E-01 4.8E-01

Effective dose equivalent (q Sv/nBq)

1.2E+Ol

1.8B+Ol

2.7E+Ol

6.OK+Ol

l.lK+02

Thyroid Organ Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue Adult 9.3E-02 3.8E-01 1.5E-01 1.5E-01 6.OE-01 3.7E-01 1.3E-01 8.4E-02 7.5E-02 8.1E-02 2.OE-01 8.4E-02 1.3E-01 1.7E-01 9.8E-02 5.1E-02 4.7E+02 9.7E-02 2.5E-01

uptake

55% 10 year 1.8E-01 6.9E-01 3.1E-01 2.9E-01 5 year 2.9E-01 1 year 5.4E-01 2,OE+OO 7.1E-01 8.7E-01 3.6E+OO 2.4E+OO 6.5E-01 4.5E-01 4.1E-01 5.6E-01 1.2E+OO 5.3E-01 6.9E-01 7.OE-01 5.5E-01 3.OE-01 4.4E+03 5.9E-01 1*6E+OO

15 year l. lE-01 4.6E-01 2.3E-01 1.5E-01 7.6E-01 4.6E-01 1.5E-01 9.9E-02 9.63-02 l.OE-01 2.7E-01 1.2E-01 1.5E-01 2.5E-01 1.2E-01 5.7E-02 7.3E+02 1.3E-01 3.6E-01

1 . lE+OO
4.5E-01 4.8E-01 1.8EtOO 1.3E+OO 3.7E-01 2.5E-01 2.3E-01 2.9E-01 7.2E-01 3.OE-01 3.9E-01 4.3E-01 3.OE-01 1.6E-01 2.4E+03 3.3E-01 9*1E-01

* * *

1 .lE+OO
7.9E-01 2.3E-01 1.6E-01 1.4E-01 1.7E-01 4.4E-01 1.9E-01 2.5E-01 3.1E-01 2.OE-01 9.5E-02 1. x+03 .?. lE-01 5.7E-01

Kffective dose equivalent (mSv/ltKq)

1.4E+Ol

2.2K+Ol

3.3E+Ol

7.3K+01

1.3K+O2

270

RADIATION

DOSE TO PATIENTS FROM RADIOPHARMACEUTICALS 53 Iodide

IODIDE
Thyroid 125I blocked, uptake 0%

60.14

days

Organ

per Adult

unit

Absorbed dose activity administered 15 year 6.6E-03 1.3E-01 9.3E-03 5.1E-03 6.5E-03 6.8E-03 6. EE-03 E. lE-03 1.3E-02 6.43-03 6.9E-03 7. EE-03 6.7E-03 l .OE-02 6.5E-03 6.53-03 6.3E-03 1.2E-02 6.3E-03 10 year l. lE-02 1.9E-01 1.6E-02 7.4E-03 l .OE-02 1.2E-02 1.2E-02 1.3E-02 1.9E-02 l. lE-02 l. lE-02 1.4E-02 l . lE-02 1.7E-02 l. lE-02 1.2E-02 l. lE-02 2.2E-02 1 .OE-02

(mGy/MBq) 5 year 1.9E-02 2.9E-01 2.7E-02 l.ZE-02 1. EE-02 Z . OE-02 1.9E-02 2.3E-02 2. EE-02 1. EE-02 1.9E-02 2.4E-02 1.9E-02 2.9E-02 1. EE-02 2.1E-02 1. EE-02 3. EE-02 1.7E-02 1 year 3.7E-02 5.4E-01 5.7E-02 2.4E-02 3.5E-02 4.lE-02 3.9E-02 4.83-02 5.1E-02 3. SE-02 3.7E-02 4. EE-02 3.7E-02 5.9E-02 3.6E-02 4.4E-02 3.6E-02 7.5E-02 3.4E-02

* * * *

Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue

4.8E-03 l.OE-01 ?.4E-03 5.1E-03 5.3&03 5.8E-03 5.8E-03 6.7E-03 1 .OE-02 5.4E-03 5.5E-03 6.4E-03 5.6E-03 8.3E-03 5.6E-03 5.OE-03 4.7E-03 9.5E-03 5.2E-03

Bffective dose equivalent (mSv/lras) Bladder wall contributes

l . ZE-02

1.5E-02

2.3B-02

3.7E-02

7.3B-02

to 50.0

% of

the

effective

dose

equivalent.

Incomplete Effective uptake: uptake: uptake:

blockage: dose equivalent 0.5 1.0 2.0 % % X

(mSv/HBq)

at

small

uptake 3.6E-01 6.9E-01 1.4E+OO

in

the

thyroid 1.4E+OO 2.8EtOO 5.6EtOO

1.5E-01 3,OE-01 5.8E-01

2.4E-01 4.6E-01 9.OE-01

7.7E-01 1.5E+OO 3.OE+OO

271

BIOKINETIC MODELS AND DATA 53 Iodide

Thyroid 125I 60.14 days per Adult Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue 3.6E-03 9.5E-02 9.2E-03 4.OE-03 7.1E-02 4.2E-02 1.6E-02 7.6E-03 9.2E-03 4.2E-03 5.7E-03 7.OE-03 9.2E-03 l .OE-02 5.8E-03 3.7E-03 4.7E+Ol 9.6E-03 2.1E-02 unit

IODIDE

uptake

5%

Organ

Absorbed dose activity administered 15 year 10 year 8.8E-03 1.8E-01 2.6E-02 6.4E-03 1.3E-01 9.53-02 2.4E-02 1.6E-02 1.7E-02 9.OE-03 1.6E-02 1.8E-02 1.8E-02 2.7E-02 1.2E-02 9.1E-03 8.8E+Ol 2.5E-02 4.2E-02

(mGy/MBq) 1 year 3.1E-02 5.1E-01 7.7E-02 2.9E-02 4.3E-01 3.OE-01 7.6E-02 5.5E-02 4.7E-02 3.4E-02 6.4E-02 6.3E-02 5.5E-02 8.OE-02 3.9E-02 3.6E-02 2.7E+02 8.6E-02 1.2E-01

5 year 1.5E-02 2.7E-01 4.1E-02 1.2E-02 2.2E-01 l* bE-01 4.OE-02 2.7E-02 2.5E-02 1.6E-02 3.OE-02 3.2E-02 2.8E-02 4.2E-02 1.9E-02 1.7E-02 1,7E+02 4.3E-02 6.7E-02

5.1E-03 1.2E-01 1.8E-02 4.OE-03 9.OE-02 5.5E-02

*
*

1.4E-02
9,7E-03 l. lE-02 4.9E-03 7.8E-03 l.OE-02 l .OE-02 1.9E-02 6.6E-03 4,9E-03 6.7E+Ol 1.3E-02 2.7E-02

Effective dose equivalent (mSv/IW)

1.4E+O8

2 . OE+OO

2.7E+OO

S.lE+oo

8.1E+OO

Thyroid Organ Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Adult 3.6E-03 8.5E-02 1.6E-02 4.6E-03 7.1E-02 4.2E-02 1.6E-02 7.5E-03 8.6E-03 4.2E-03 8.7E-03 6.9E-03 9.2E-03 1.7E-02 5.8E-03 3,6E-03 1.4E+02 9.2E-03 5.3E-02

uptake

15% 10 year 8.9E-03 l.bE-01 5.3E-02 8.5E-03 1.3E-01 9.5E-02 2.4E-02 1.6E-02 1.6E-02 9.4E-03 3.1E-02 1.8E-02 1.8E-02 5.1E-02 1.2E-02 8.83-03 2.6E+02 2.4E-02 l.lE-01 5 year 1.5E-02 2.4E-01 8.OE-02 1.9E-02 2.2E-01 1.6E-01 3.9E-02 2.7E-02 2.4E-02 1.7E-02 6.2E-02 3.1E-02 2.9E-02 7.7E-02 1.9E-02 1.6E-02 5.1E+02 4.1E-02 1.7E-01 1 year 3.3E-02 4.6E-01 1.4E-01 5,1E-02 4.4E-01 3.OE-01 7.6E-02 5.4E-02 4.6E-02 3.8E-02 1.3E-01 6.2E-02 5.7E-02 1.4E-01 4.3E-02 3.4E-02 7.9E+02 8.2E-02 2.9E-01

15 year 5.1E-03 l. lE-01 4.1E-02 4.5E-03 9.OE-02 5.53-02 1.4E-02 9.5E-03 l. lE-02 4.9E-03 1.3E-02 9.8E-03 l.OE-02 3.9E-02 6.6E-03 4.7E-03 2.OE+02 1.2E-02 7.OE-02

* * *

Red marrow Spleen Testes Thyroid Uterus Other tissue

Effective dose equivalent b-/m)

4.33+00

6.OB+OU

8.OB+OO

1. SE+01

2.4B+Ol

272

RADIATION

DOSE TO PATIENTS FROM RADIOPHARMACEUTICALS 53

Iodide

Thyroid 125I 60.14 days Per Organ Adult Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other Effective tissue 3.6E-03 unit

IODIDE
uptake

25%

Absorbed dose activity administered 10 year 9.OE-03 1.4E-01 8.OE-02 l.lE-02 1.3E-01 9.5E-02 2.4E-02 1.6E-02 1.5E-02 9.9E-03 4.6E-02 1.8E-02 1.8E-02

(mGy/RBq) 1 year 3.5E-02 4.1E-01 2.OE-01

15 year 5.1E-03 9.5E-02 6.4E-02 5.2E-03 9.OE-02 5.5E-02 1.4E-02 9.3E-03 9.9E-03 5.OE-03 1.8E-02 9.8E-03 l.OE-02 5.9E-02 6.7E-03 4. JE-03 3.3E+OZ 1.2E-02 l.lE-01

5 year 1.6E-02 2.2E-01 1.2E-01 2.6E-02 2.2E-01 1.6E-01 3.9E-02 2.6E-02 2.3E-02 1.8E-02 9.3E-02 3,1E-02 2.9E-02 l. lE-01 2.OE-02 1.6E-02 8.4E+02 3.9E-02 2.8E-01

7.6E-02
2.4E-02 5.3E-03

7.3E-02
4.4E-01 3.OE-01

* * *

J.lE-02
4.2E-02 1,6E-02

7.4E-03
E. lE-03 4.2E-03 1.2E-02 6.9E-03 9.2E-03 2.3E-02 5.9E-03 3.6E-03 2.4E+02 8.8E-03 8.6E-02

7.6E-02
5.3E-02 4.5E-02 4.1E-02 2.OE-01 6.2E-02 6 .OE-02 2.1E-01 4.7E-02 3.3E-02 1.3E+03 7.8E-02 4.6E-01

7.5E-02
1.2E-02 8.6E-03 4.4E+02 2.3E-02 1.8E-01

dose equivalent (mSv/l!Bq)

7.1E+OO

l.OE+Ol

1.3E+Ol

2.5E+Ol

4.OE+Ol

Thyroid Organ Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue Adult 3.5E-03 6.6E-02 3.1E-02 5.9E-03

uptake

35% 10 year 5 year 1.6E-02 1.9E-01 1.6E-01 3.2E-02 2.2E-01 1.6E-01 3.9E-02 2.6E-02 2.2E-02 1.9E-02 1.2E-01 3.OE-02 2.9E-02 1.5E-01 2.OE-02 1.5E-02 1.2E+03 3.7E-02 3.8E-01 1 year 3.7E-02 3.6E-01 2. JE-01 9.5E-02 4.4E-01 3.OE-01 7.5E-02 5.1E-02 4.4E-02 4.5E-02

15 year

5.OE-03 8.3E-02 8.61-02 5.73-03 9.OE-02 5.53-02 1.4E-02 9.1E-03 9.33-03 5.OE-03 2.33-02 9.63-03 l.OE-02
7.9E-02

8.93-03 1.2E-01 l.lE-01

1.3E-02 1.3E-01 9. SE-02 2.4E-02 1.5E-02 1.4E-02 1 .OE-02 6.1E-02 1.7E-02 1.8E-02 9.9E-02 1.2E-02 8.2E-03 6.2E+02 2.1E-02 2.4E-01

*
*

J.lE-02
4.2E-02 1.6E-02

7.2E-03
7.6E-03 4.2E-03 1.5E-02 6. JE-03

9.23-03 3.OE-02 5.83-03 3.53-03 3.3E+02 8.31-03 1.2E-01 9.9B+oo

2.8E-01 6.OE-02 6.1E-02

2.7E-01 5.1E-02 3.1E-02 1.9E+03 7.4E-02 6.4E-01

6.63-03 4.53-03 4.7E+02 l.lE-02 1.6E-01 1.4B+Ol

Effective dose equivalent Wv/ltBq)

1.9B+Ol

3.6B+Ol

5.6B+Ol

273

BIOKINETIC MODELS AND DATA 53 Iodide

Thyroid 12SI 60.14 days per Adult Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Snleen Tbs tes Thyroid Uterus Other tissue 3.6E-03 5.6E-02 3.83-02 6.6E-03 ?. lE-02 4.2B102 1,6E-02 7.1E-03 7.0!3-03 4.2E-03 1.8B-02 6.7E-03 9.2E-03 3.7E-02 5. BE-03 3.4E-03 4.2E+02 E.OE-03 1.5E-01 unit

IODIDE
uptake

45%

Organ

Absorbed dose activity administered 15 year 5.1B-03 7.OE-02 l. lE-01 6.43-03 9.OE-02 5.5B-02 1.4E-02 9.OE-03 8.6E-03 5.OE-03 2.8B-02 9.5E-03 l .OE-02 10 year 9.1B-03 l. lE-01 1.3!3-01 1.5E-02 1.3E-01 9.5E-02 2.4E-02 1.5E-02 1.3E-02 l. lE-02 7.6E-02 1.7B-02 1.8E-02 l.ZE-01 1.2E-02 8.OB-03 7.9E+02 2.OE-02 3.1E-01

(mGy/MBq) 5 year l.dE-02 1.6E-01 2.OE-01 3.9E-02 1 year 3.9E-02 3.1E-01 3.3E-01 1.2E-01 4.4B-01 3.OE-01 7. SE-02 5.OE-02 4.4E-02 4.8E-02 3.4E-01 5.9E-02 6.4E-02 3.3E-01 5.5E-02 3.OE-02 2.43+03 7.1E-02 8.1E-01

*
*

2.2B-01 1. !iE-01 3.9E-02 2.5E-02 2.0B-02 2.1E-02 1.6B-01 3.OE-02 3.OE-02 1.8E-01 2.OB-02 1.4B-02 1. SE+03 3.5B-02 4.8B-01

9.9B-02 6.6E-03 4.5E-03 6.OE+02 l. lE-02 2.OE-01

Bffective dose equivalent (m.Sv/HBq)

1.3B+Ol

1.8B+Ol

2.4B+Ol

4.6B+Ol

7.lE+Ol

Thyroid Organ Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest IJLI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other Effective tissue Adult 3.6E-03 4.7B-02 4.5E-02 7.3E-03 7.1E-02 4.2E-02 1.6E-02 7.OE-03 6.4E-03 4,2E-03 2.1E-02 6.6E-03 9.2E-03 4.3E-02 5.8B-03 3.4E-03 5.2Et02 7.5B-03 1.8E-01

uptake

55% 10 year 9.2E-03 8.0B-02 1. CE-01 1.7E-02 1.3E-01 9.5E-02 2.4E-02 1.5E-02 1.2E-02 l. lE-02 9. U-02 1.7E-02 1,8E-02 1.5E-01 1.2E-02 7.7E-03 9.7E+02 1.9E-02 3. BE-01 5 year 1.7E-02 1.3B-01 2.4E-01 4.6E-02 2.2E-01 1.5B-01 3.9E-02 2.4E-02 1.9E-02 2.2E-02 1.9E-01 2.93-02 3.OE-02 2.2E-01 2.OE-02 1.4E-02 1.9E+03 3.3E-02 5.9B-01 1 year 4.1B-02 2.5B-01 4.OE-01 1.4E-01 4.5E-01 3.OE-01 7.5E-02 4.9E-02 4.3E-02 5.2E-02 4.2E-01 5.8E-02 6.6E-02 4.OE-01 5.9E-02 2.8E-02 2.9Et03 6.7E-02 9.9E-01

15 year 5.1E-03 5.8E-02 1.3E-01 7.OE-03 9.OE-02 5.5B-02 1.4B-02 8.83-03 7.9B-03 5.1E-03 3.41-02 9.4E-03 l.OE-02 1.2E-01 6.63-03 4.4E-03 7.4E+02 l.OE-02 2.4E-01

* * *

dose equivalent (=Sv/llBq)

1.6B+Ol

2 . ZB+Ol

2.9B+01

5.6B+Ol

8.8E+Ol

274

RADIATION

DOSE TO PATIENTS FROM RADIOPHARMACEUTICALS 53 Iodide

Thyroid 131I

IODIDE:
blocked,

uptake

0%

8.04

days

Organ

per Adult

unit

Absorbed dose activity administered 15 year 4.2E-02 ?.5E-01 3.8E-02 3.3E-02 4.OE-02 4.7E-02 4.5E-02 5.2E-02 8.OE-02 4.OE-02 3.8E-02 5.4E-02 4.3E-02 4.2E-02 4.OE-02 4.5E-02 3.8E-02 6.7E-02 3.9E-02 10 year 6.7E-02 l.lE+OO 6.1E-02 5.2E-02 6.4E-02 7.5E-02 7.OE-02 8.2E-02 1.2E-01 6.5E-02 6.OE-02 8.4E-02 6.9E-02 6.5E-02 6.5E-02 7.5E-02 6.3E-02 l.lE-01 6.2E-02

(atGy/MBq) 5 year l. lE-01 1.8E+OO 9.7E-02 8.5E-02 l .OE-01 1.2E-01 1.2E-01 1.3E-01 1.7E-01 l.OE-01 9.6E-02 1.3E-01 l.lE-01 l.OE-01 l .OE-01 1.2E-01 l.OE-01 1.7E-01 l .OE-01 1 year 2.OE-01 3.4EtOO 1.9E-01 1.7E-01 1.9E-01 2.2E-01 2.1E-01 2.3E-01 3.1E-01 2.OE-01 1.9E-01 2.4E-01 2.1E-01 1.9E-01 2.OE-01 2.3E-01 2.OE-01 3.OE-01 1.9E-01

*
*
*

Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other Effective tissue

3.7E-02 6.1E-01 3.2E-02 3.3E-02 3.4E-02 3.83-02 3.7E-02 4.3E-02 6.5E-02 3.3E-02 3.1E-02 4.2E-02 3.5E-02 3.5E-02 3.4E-02 3.7E-02 2.9E-02 5.4E-02 3.2E-02

dose equivalent Wv/llBq)

Bladder wall contributes

7.213-02
to 50.8

8.83-02
% of the

1.4B-01
effective

2.1E-01
dose

4.OE-01

equivalent.

Incomplete Effective uptake: uptake: uptake:

blockage: dose equivalent 0.5 1.0 2.0 % % %

(mSv/HBq)

at

small

uptake 6.9E-01 1.2E+OO 2.4E+OO

in

the

thyroid 2.8E+OO 5.3E+OO 1. OEcOl

3.OE-01 5.2E-01 9.7E-01

4.5E-01 E.lE-01 1.5E+OO

1.5E+OO 2.7E+OO 5.3E+OO

275

I 53 Iodide

BIOKINETIC MODELS AND DATA

IODIDE
Thyroid 131I 8.04 days Per Adult Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue 3.2E-02 5.8E-01 3.2E-02 3.1E-02 4.5E-01 2.8E-01 5.9E-02 4.3E-02 6.3E-02 3.OE-02 3.4E-02 4.4E-02 5.OE-02 3.83-02 3.9E-02 2.9E-02 7.2E+Ol 5.5E-02 4.OE-02 unit Absorbed dose activity administered 15 year 3.9E-02 7.2E-01 4.2E-02 3. IE-02 5.8E-01 3.5E-01 6.43-02 5.43-02 7.7E-02 3.6E-02 4.3E-02 6.OE-02 5.9E-02 4.9E-02 4.6E-02 3.5E-02 l.lE+02 7.OE-02 5.2E-02 10 year 6.3E-02 1. lE+OO 6.3E-02 5.43-02 8.4E-01 6.2E-01 l.OE-01 8.3E-02 l. lE-01 6.OE-02 7.OE-02 9.2E-02 9.2E-02 7.OE-02 7.2E-02 5.9E-02 1.7E+02 l. lE-01 8.lE-02 (mGy/MBq) 1 year 1.9E-01 3.2E+OO 1.8E-01 1.7E-01 2.9E+OO 2. OEcOO 2.7E-01 2.3E-01 2.9E-01 1.9E-01 2.lE-01 2.6E-01 2.5E-01 1.8E-01 Z.OE-01 1.8E-01 6.8E+02 3. IE-01 2.4E-01 uptake 5%

Organ

5 year l.OE-01 1.7E+OO 9.7E-02 8.8E-02 1.4E+OO 1.OE+OO 1.6~-01 1.3E-01 1.7E-01 l.OE-01 1 elE-01 1.4E-01 1.4E-01 l.OE-01 l.lE-01 9.5E-02 3.7E+02 1.7E-01 1.3E-01

*
*

*
*

Effective dose equivalent Wv/lW)

2.3E+OO

3.5E+OO

5.3E+OO

1,lE+Ol

2.1E+Ol

Thyroid Organ Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Soleen Testes Thyroid Uterus Other tissue Adult 3.6E-02 5.2E-01 4.7E-02 4.3E-02 4.6E-01 2.8E-01 5.9E-02 4.213-02 6.OE-02 3.2E-02 5.3E-02 4.3E-02 5.2E-02 5.4E-02 4.2E-02 2.8E-02 2.lE+02 5,4E-02 6.5E-02

uptake

15% 10 year 7.1E-02 9.8E-01 9.4E-02 8.lE-02 8.4E-01 6.2E-01 l .OE-01 8.21-02 l.lE-01 6.8E-02 1.2E-01 9.2E-02 l .OE-01 9.9E-02 8.lE-02 5.8E-02 5.1E+02 l.lE-01 1.4E-01 5 year l. lE-01 1.5E+OO 1.4E-01 1,3E-01 1.5E+OO 1.OE+OO 1.6E-01 1.3E-01 1.7E-01 l.lE-01 1.9E-01 1.4E-01 1.5E-01 1.4E-01 1.2E-01 9.4E-02 l.lE+03 1.7E-01 2.2E-01 1 year 2.2E-01 2.9E+OO 2.4E-01 2.5E-01 2.9EtOO 2.OE+OO 2.8E-01 2.3E-01 2.9E-01 2.2E-01 3.3E-01 2.6E-01 2.7E-01 2.4E-01 2.3E-01 1.8E-01 2.OE+03 3.1E-01 4.OE-01

15 year 4.3E-02 6.4E-01 6,7E-02 4.3E-02 5.8E-01 3.5E-01 6.5E-02 5.3E-02 7.5E-02 4.1E-02 7.lE-02 5.9E-02 6.2E-02 7.4E-02 5.lE-02 3.5E-02 3.4E+02 6.83-02 8.9E-02

*
* *

Effective dose equivalent (mSv/HBq)

6.6B+OO

l.OE+Ol

1.5E+Ol

3.4E+Ol

6.2E+Ol

276

RADIATION

DOSE TO PATIENTS FROM RADIOPHARMACEUTICALS

1 53 Iodide

Thyroid 1311 8.04 days per Adult Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue 3.9E-02 4.6E-01 6.1E-02 5.5E-02 4.6E-01 2.8E-01 5.9E-02 4.1E-02 5.8E-02 3.5E-02 7.2E-02 4.3E-02 5.3E-02 ? . OE-02 4.4E-02 2.78-02 3.6Et02 5.2E-02 9.OE-02 unit

IODIDE
uptake

25%

Organ

Absorbed dose activity administered 10 year 8.OE-02 8.7E-01 1.3E-01 l.lE-01 8.5E-01 6,2E-01 l .OE-01 8.1E-02 l.lE-01 7.5E-02 1.6E-01 9.1E-02 l.lE-01 1.3E-01 8.9E-02 5.6E-02 8.4E+02 l.lE-01 Z .OE-01

(mGy/MBq) 1 year 2.5E-01 2.6E+OO 3 .OE-01 3.2E-01 3.OE+OO 2 .OE+OO 2.9E-01 2.4E-01 2.7E-01 2.5E-01 4.4E-01 2.6E-01 3.OE-01 2.9E-01 2.5E-01 1.8E-01 3.4E+03 3.OE-01 5.5E-01

15 year 4.7E-02 5.7E-01 9.2E-02 5.4E-02 5.8E-01 3.5E-01 6.5E-02 5.2E-02 7.4E-02 4.5E-02 9.8E-02 5.8E-02 6.6E-02 9.9E-02 5.5E-02 3.4E-02 5.6E+02 6.6E-02 1.3E-01

5 year 1.3E-01 1.4E+OO 1.9E-01 1.8E-01 1.5E+OO

* * *

1.OE+OO
1.6E-01 1.3E-01 1.5E-01 1.3E-01 2.6E-01 1.4E-01 1.7E-01 1.8E-01 1.4E-01 9.2E-02 1.9E+03 1.7E-01 3.1E-01

Effective dose equivalent (mSv/llBq)

1 .lE+Ol

1.7E+Ol

2.5B+Ol

5.6E+Ol

1 .OE+OZ

Thyroid Organ Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue Adult 4.2E-02 4.OE-01 7.6E-02 6.7E-02 4.6E-01 2.8E-01 5.8E-02 4.OE-02 5.6E-02 3.7E-02 9.OE-02 4.2E-02 5.4E-02 8.6E-02 4.6E-02 2.6E-02 5.OE+02 5.OE-02 l.lE-01

uptake

35% 10 year 8.7E-02 7.6E-01 1.6E-01 1.3E-01 8.5E-01 6,2E-01 l .OE-01 8.OE-02 l.lE-01 8.2E-02 Z. lE-01 9.OE-02 l.lE-01 1.6E-01 9.6E-02 5.4E-02 l.ZE+03 1 .OE-01 2.6E-01 5 year 1.4E-01 1 . ZE+OO 2.3E-01 Z.ZE-01 1.5E+OO 1 .OE+OO 1.7E-01 1.3E-01 1.7E-01 1.4E-01 3.3E-01 1.4E-01 1.8E-01 Z .ZE-01 1.5E-01 8.9E-02 2.6E+03 1.6E-01 4.1E-01 1 year 2.8E-01 2.3E+OO 3.5E-01 4.OE-01 3.OE+OO 2 .OE+OO 3.OE-01 2.4E-01 2.9E-01 2.7E-01 5.6E-01 2.7E-01 3.2E-01 3.5E-01 2.8E-01 1.8E-01 4.7E+03 3.OE-01 7.1E-01

15 year 5.OE-02 5.OE-01 l. ZE-01 6.6E-02 5.9E-01 3.5E-01 6.5E-02 5.1E-02 7.2E-02 4.9E-02 l.ZE-01 5.7E-02 6.9E-02 l .ZE-01 5.9E-02 3.2E-02 7.9E+02 6.3E-02 1.6E-01

Effective dose equivalent (mSv/RW

1.5E+Ol

2.4E+Ol

3.6E+Ol

7.8E+Ol

1.4E+02

b.ICilP 18:1-4-J

277

I 53 Iodide

BIOKINETIC MODELS AND DATA

IODIDE
Thyroid 131I 8.04 days per Organ Adult Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue 4.6E-02 3.4E-01 9.1E-02 7.9E-02 4.6E-01 2.8E-01 5,9E-02 4.OE-02 5.3E-02 4.OE-02 l. lE-01 4.2E-02 5.6E-02 l.OE-01 4.9E-02 2.6E-02 6.4E+02 4. BE-02 1.4E-01 15 year 5.6E-02 4.3E-01 1.4E-01 7.9E-02 5.9E-01 3.5E-01 6.83-02 5.2E-02 7.OE-02 5.5E-02 1.5E-01 5,8E-02 7.4E-02 1.5E-01 6.5E-02 3.3E-02 l.OE+03 6.3E-02 Z.OE-01 10 year 9.9E-02 6.5E-01 1.9E-01 1.6E-01 8.6E-01 6.2E-01 l.lE-01 8.2E-02 l .OE-01 9.2E-02 2.6E-01 9.3E-02 1.3E-01 1.9E-01 l.lE-01 5.6E-02 1.5E+03 l .OE-01 3.2E-01 5 year 1.6E-01 l.OE+OO 2.8E-01 2.7E-01 1.5EtOO l.OE+OO 1. BE-01 1.3E-01 1.7E-01 1.6E-01 4.1E-01 1.5E-01 Z.OE-01 2.6E-01 1.7E-01 9.2E-02 3.3E+03 1.7E-01 5.OE-01 1 year 3.2E-01 1.9E+OO 4.2E-01 4.9E-01 3.OE+OO 2 .OE+OO 3.2E-01 2.5E-01 2.9E-01 3.1E-01 6.9E-01 2.8E-01 3.6E-01 4.1E-01 3.1E-01 1. EE-01 6.1Et03 3.1E-01 8. EE-01 unit uptake 45%

Absorbed dose activity administered

(mGy/MBq)

Effective dose equivalent (mSv/lfBq)

1.9E+Ol

3.1E+Ol

4.6B+Ol

l.OB+O2

1. BE+02

Thyroid Organ Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue Adult 4.9E-02 2.9E-01 l.lE-01 9.1E-02 4,6E-01 2. BE-01

uptake

55% 10 year l. lE-01 5,4E-01 2.2E-01 1.9E-01 8.6E-01 6.2E-01 l. lE-01 7. BE-02 l.OE-01 9.7E-02 3.OE-01 5 year 1.7E-01 8.5E-01 3.2E-01 3.1E-01 1 year

15 year

5.8E-02 3.6E-01 1.7E-01 8.93-02 5.9E-01 3.5E-01 6.73-02 4.93-02 6.8E-02 5.83-02 1.8E-01 5.63-02 7.63-02 1.8E-01 6.83-02 3.1E-02 1.2E+03 6.OE-02 2.4E-01 3.7E+Ol

3.4E-01 1.6E+OO 4.8E-01 5.6E-01 3.OE+OO Z.OE+OO 3.2E-01 2.4E-01 2.9E-01 3.3E-01 8.OE-01 2.7E-01 3.8E-01 4.6E-01 3.3E-01 1.7E-01 7.43+03 3.OE-01 l.OE+OO 2.23+02

1.5E+OO
1.OE+OO
1.8E-01 1.3E-01 1.7E-01 1.7E-01 4. BE-01

5.83-02 3.91-02 5.1E-02 4.33-02 1.3E-01 4.1E-02 5.03-02 l.ZE-01 5.1E-02 2.63-02 7.93+02 4.63-02 1.6E-01 2.4E+Ol

9.OE-02 1.3E-01 2.2E-01 l.lE-01 5.2E-02 1.9E+03 9.93-02 3.7E-01 5.6B+Ol

1.5E-01 Z.lE-01 2.9E-01 1.7E-01 8.73-02 4.1E+03 1.6E-01 5.9E-01

1.21+02

Effective dose equivalent (mSv/HBq)

278

RADIATION

DOSE TO PATIENTS

FROM RADIOPHARMACEUTICALS 53 Amphetamine

IODOAMPHETAMINE
1231

(IMP)

Biokinetic Model N-isopropyl-p-iodoamphetamine (IMP) is a lipophilic amine developed for brain studies (Winchell et al., 1980). A related diamine substance called HIPDM (Kung et al., 1983) has the same field of application. Its kinetics are similar enough to motivate the use of the same biokinetic model as for IMP. Quantitative kinetic data from studies in humans have been published by Magistretti et al. (1982), Kuhl et al. (1982), Moretti et al. (1982) and Wicks et al. (1983). Holman et al. (1983) have reviewed both human and animal data. After intravenous injection of IMP there is an immediate first-pass uptake of 70-100% in the lungs, most of which is rapidly washed-out again into the blood and taken up in the brain, liver, lungs and other tissues. The uptake in the brain is 6-9%, and the activity is essentially constant during the first hour. The substance is slowly metabolized in the body with release of free iodine, which enters the iodide pool and is excreted in the urine. 23-28% is excreted after 24 hr, and 40% after 48 hr. In certain animal species, uptake into the eyes has been observed, due to incorporation into melanin produced by melanocytes. No such uptake has been found in man (Holman et al., 1984), where synthesis of melanin in the eyes is presumed to cease at birth or shortly thereafter. It is assumed that after the initial brief hold-up of the intravenous bolus in the lungs there is cellular uptake of the substance in the brain (0.08), liver (0.35) and lungs (0.35), with a uniform distribution of the remainder in all other organs and tissues. The substance is retained with half-times of 12 hr (0.33) and 2.5 d (0.67) in all organs and tissues. It is further assumed that thyroid uptake of iodide has been blocked. The released iodine is then excreted via the kidneys and bladder with a half-time of 8 hr.

References
B. L., Hill, T. C., Lee, R. G. L., Zimmerman, R. E., Moore, S. C. and Royal, H. D. (1983). Brain imaging with radiolabeled amines. In: Nuclear Medicine Annual 2983, pp. 131-165. (Freeman, L. M. and Weissmann, H. S. eds) Raven Press, New York. Holman, B. L., Wick, M. M., Kaplan, M. L., Hill, T. C., Lee, R. G. L., Wu, J. L. and Lin, T. H. (1984). The relationship of the eye uptake of N-isopropyl-p-(iz31) iodoamphetamine to melanin production. J. Nucl. Med. 25,315319. Kuhl, D. E., Barrio, J. R., Huang, S-C., Selin, C., Ackermann, R. F., Lear, J. L., Wu, J. L., Lin, T. H. and Phelps, M. E. (1982). Quantifying local cerebral blood flow by N-isopropyl-p-(iz31) iodoamphetamine (IMP) tomography. J. Nucl. Med. 23, 196-203. Kung, H. F., Tramposch, K. M. and Blau, M. (1983). A new brain perfusion imaging agent: (I-123) HIPDM: N,N,N-Trimethyl-N-(2-hydroxy-3-methyl-5-iodo~~yl)-1,3-propanediamine. J. Nucl. Med. 24,66-72. Magistretti, P., Uren, R., Shomer, D., Blume, H., Holman, B. and Hill, T. (1982). Emission tomographic scans of cerebral blood flow using Iiz3 iodoamphetamine in epilepsy. In: Nuclear Medicine and Biology, Proc. Third World Congr. Nucl. Med. Eiol., Vol. 1, pp. 139-143. (Raynaud, C. ed.) Pergamon, Oxford. Moretti, J. L., Askienaxy, S., Raynaud, C., Mathieu, E., Sanabria, E., Cianci, G., Bardy, A. and Leponcin-Lafitte, M. (1982). Brain single photon emission tomography with isopropyl-amphetamine I-123: Preliminary results. In: Nuclear Medicine and Biology, Proc. Third World Congr. Nucl. ,Med. Biol., Vol. 1, pp. 135-138. (Raynaud, C. ed.) Pergamon, Oxford. Wicks, R., Billings, J., Kung, H. F., Steinbach, J. S., Ackerhalt, R. and Blau, M. (1983). Biodistribution in humans and radiation dose calculations for the brain perfusion imaging agent I-123 HIPDM. J. Nuci. Med. 24, 95-96. Winchell, H. S., Baldwin, R. M. and Lin, T. H. (1980). Development of I-123-labeled amines for brain studies: Localization of I-123 iodophenylalkyl amines in rat brain. J. Nucl. Med. 21, 94G946.
Holman,

279

I
53 Amphetamine

BIOKINETIC MODELS AND DATA

Biokinetic Data
Organ (S) IMP-bound iodine Brain Liver Lungs Remaining tissues Released iodine (iodide) Total body (excluding bladder contents)
Kidneys Bladder contents

FS 0.08 0.35 0.35 0.22

U% 1.08 hr 4.71 hr 4.71 hr 2.96 hr

12hr 2.5 d 12 hr 2.5 d 12 hr 2.5 d 12 hr 2.5 d 12 hr 2.5 d 8 hr

0.33 0.67 0.33 0.67 0.33 0.67 0.33 0.67 -0.33 -0.67
1.0

1.0
1.0 1.0

2.10 hr
1.47 min 19.4 min

IODINE-LABELLED
123I 13.2 hours per Organ Adult * * * Adrenals Bladder wall Bone surfaces Brain Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue 1.7E-02 2.9E-02 l. lE-02 2.9E-02 1.2E-02 1.2E-02 8.7E-03 l .OE-02 6.4E-03 1.4E-02 l. lE-01 1.2E-01 6.83-03 1.7E-02 1.4E-02 l. lE-02 4.5E-03 5.9E-03 8.2E-03 8.9E-03 unit

AMPHETAMINE
Absorbed dose activity administered

(mGy/MBq) 1 year 9.7E-02 1.5E-01 6.9E-02 4,9E-02 5.7E-02 7.4E-02 5.8E-02 6.9E-02 4.3E-02 6.6E-02 5.1E-01 7.3E-01 4.7E-02 l. lE-01 6. EE-02 6.4E-02 3.2E-02 4.7E-02 5.3E-02 4.9E-02

15 year 2.5E-02 3.6E-02 1.4E-02 3.1E-02 1.2E-02 1.5E-02 l. lE-02 1.2E-02 E. lE-03 1.7E-02 1.3E-01 1. EE-01 8.9E-03 2.3E-02 1. EE-02 1.3E-02 5.9E-03 8.9E-03 l .OE-02 l. lE-02

10 year 3. EE-02 5.4E-02 2.2E-02 3.3E-02 2.2E-02 2.4E-02 1. EE-02 2.2E-02 1.3E-02 2.6E-02 2.OE-01 2.5E-01 1.5E-02 3.63-02 2.63-02 2.1E-02 9.6E-03 1.5E-02 1.7E-02 1.6E-02

5 year 5.7E-02 8.2E-02 3.51-02 3.613-02 3.3E-02 4.OE-02 3.OE-02 3.83-02 2.2E-02 3.9E-02 2. EE-01 3. EE-01 2.4E-02 5. EE-02 3.83-02 3.4E-02 1.6E-02 2.5E-02 2. EE-02 2.6E-02

Effective dose equivalent (mSv/lras)

3.21-02

4.3E-02

6.2E-02

9.4B-02

1.7E-01

ose 1241 1251 (4.18 (60.14 d) d)

equivalent 5.6E-01 9.4E-02

(mSv/MBq of 7.6E-01 1.3E-01

the

impurity) 1. lE+OO 1.9E-01 1.7E+OO Z.EE-01 3.1E+OO 5.5E-01

280

RADIATION

DOSE TO PATIENTS

FROM RADIOPHARMACEUTICALS

I 53 Fibrinogen

IODINE-LABELLED
1231

1251

1311

FIBRINOGEN

Biokinetic

Model

Reports on the biokinetics of fibrinogen, published during the years 1964-1976 and covering 138 normal cases, have shown a mean value of the biological half-life of 3.85 d (range 3.14.6 d), with 67-82% circulating in the blood. It is assumed here that, after intravenous injection, 25% leaves the blood with a half-time of 8 hr, to be uniformly distributed in the extra-vascular space. The biological half-life is set to 4 d in all tissues. It is further assumed that the thyroid is blocked. Iodine released on catabolism of the fibrinogen molecule is then excreted by the kidneys.
Reference
Regoeczi. E. (1971). Iodine-labelled fibrinogen: A review. Br. J. Haematol. 20, 649663.

Biokinetic Data

Organ (S) (1) Fibrinogen-bound Total body Blood iodine

Fs 1.0 1.0 4d 8 hr 4d 4d 8 hr 1.0 0.25 0.75 -1.0 1.0 16.5 hr 14.2 hr 5.41 d 4.18 d 3.85 d 3.01 d

(2) Released iodine (iodide) Total body (excluding bladder contents) Kidneys Bladder contents

1.0 1.0 1.0

51 min 36 s 7.9 min

10.8 hr 7.0 min 1.59 hr

7.41 hr 5.1 min 1.18 hr

281

I 53 Fibrinogen

BIOKINETIC

MODELS

AND DATA

IODINE-LABELLED
123I 13.2 hours

FIBRINOGEN

per Organ Adult * Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Heart Kidneys Liver Lungs Ovaries Pancreas Bed marrow Spleen Testes Thyroid Uterus Other tissue 2,7E-02 2 .OE-02 3.OE-02 1.5E-02 1.6E-02 1.5E-02 1.4E-02 1.3E-02 7 *2E-02 2.7E-02 2.4E-02 4.7E-02 1.4E-02 2.OE-02 2.4E-02 5.OE-02 9.93-03 1. EE-02 1.5E-02 1.3E-02

unit

Absorbed dose activity administered 15 year 3.4E-02 2.63-02 4.3E-02 1,5E-02 Z .OE-02 1. EE-02 1. EE-02 1.7E-02 8.7E-02 3.3E-02 2.9E-02 6.OE-02 1. EE-02 2.3E-02 3,OE-02 5.9E-02 1.3E-02 2.4E-02 1. EE-02 1.5E-02 10 year 5.5E-02 3.83-02 7. EB-02 2.4E-02 3 .OE-02 2. EB-02 2.7E-02 2,6E-02 1*3E-01 5.3E-02 4,6E-02 9.6E-02 2.7E-02 3.6E-02 4.5E-02 9.4&02 1.9E-02 4.08-02 2. EE-02 2.3E-02

(mGy/MBq) 5 year 8,7E-02 5.6E-02 1.3E-01 3. EE-02 4.6.E-02 4.3.E-02 4.48-02 3. WI-02 2.OE-01 8.4E-02 7.2B-02 1.5E-01 4.28-02 5.6E-02 7.2E-02 1.5E-01 3.OE-02 6.5E-02 4.38-02 3.6E-02 1 year 1.7B-01 l.OE-01 2.7E-01 6.9E-02 8.3E-02 7.9B-02 7.7E-02 7.5&02 3.5E-01 1.6E-01 1.3E-01 2.9E-01 7.7E-02 l .OE-01 1.3E-01 2.9B-01 5.7B-02 1.2B-01 7. EE-02 6. EB-02

* * *

Bffective dose equivalent (=Sv/llBq)

2.7B-02

3.3B-02

5.3B-02

8.3B-02

1.6B-01

i!!Fi%%ose lz41 1251 (4.18 (60.14 d) d)

aquivalent, 6.5E-01 1.2E-01

(mSv/MBq

of

the

impurity) 1.9E+OO 3.9E-01 3.6E+OO 7.7E-01

7.8E-01 1.5E-01

1. lE+OO
2.4E-01

282

RADIATION

DOSE TO PATIENTS FROM RADIOPHARMACEUTICALS 53 Fibrinogen

IODINE-LABELLED FIBRINOGEN
125I 60.14 days per Organ * * Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Heart Kidneys Liver Lungs Ovaries Pancreas Red marrow Soleen Testes Thyroid Uterus Other tissue Adult l .OE-01 1.2E-01 9.4E-02 5.5E-02 5.6E-02 5.5E-02 5.6E-02 5.5E-02 3.2E-01 1.2E-01 9.9E-02 2.3E-01 5.3E-02 6.5E-02 l. lE-01 2.4E-01 4.3E-02 8.4E-02 5.5E-02 5.2E-02 unit Absorbed dose activity administered 15 year 1.4E-01 1.5E-01 1.3E-01 5.6E-02 6.9E-02 6.6E-02 6.6E-02 6.5E-02 3.7E-01 1.4E-01 1.2E-01 2.9E-01 6.7E-02 7.7E-02 l .bE-01 2.8E-01 5.5E-02 l.lE-01 6.9E-02 6.2E-02 10 year 2.3E-01 2.2E-01 2.2E-01 9.3E-02 l.lE-01 l.lE-01 1.IE-01 l.OE-01 5.8E-01 2.4E-01 2.OE-01 4.8E-01 l, lE-01 1.3E-01 2.4E-01 4.6E-01 8.7E-02 1.8E-01 1.2E-01 (mGy/MBq) 5 year 3.9E-01 3.5E-01 3.8E-01 1,5E-01 1.9E-01 1. BE-01 1.8E-01 1.7E-01 9.1E-01 3.9E-01 3.3E-01 7.8E-01 1.8E-01 2.2E-01 4.OE-01 7.4E-01 1.4E-01 3.OE-01 1.9E-01 1.6E-01 1 year 7.8E-01 7 .OE-01 8.OE-01 3.1E-01 3.8E-01 3.6E-01 3.6E-01 3.5E-01 1.6E+OO 7.7E-01 6.4E-01 1.5EtOO 3.6E-01 4.5E-01 E. OE-01 1.4E+OO 2.9&01 5.9E-01 3.8E-01 3.3E-01

* *

l.OE-01
2.4E-01

Effective dose equivalent (mSv/HLtq)

1.2E-01

1.5B-01

3.9B-01

7.7E-01

131I

8.04

days

Organ * * Adrenals Bladder wall Bone surfaces Breast

Adult 6 .OE-01 5.5E-01 6.6E-01 2.8E-01 2.7E-01 2 *6E-01 2.6E-01 2.5E-01 1.5E+OO 5.5E-01 4.4E-01 l.lE+OO 2.4E-01 3.OE-01 3.9E-01 l.lE+OO 2 *2E-01 4.3E-01 2.6E-01 2.4E-01

15 year 7.1E-01 6.9E-01 9.9E-01 2.9E-01 3.3E-01 3.2E-01 3.1E-01 3.OE-01 1.9EtOO 6.6E-01 5.1E-01 1.3E+OO 3.2E-01 3.7E-01 4.8E-01 1.3E+OO 2.7E-01 5.4!3-01 3.3E-01 2 *8E-01

10 year
1.2E+OO

5 year 1.9E+OO 1.6EtOO 3.3E+OO 7.4E-01 E.OE-01 7.9E-01 7.9E-01 7.5E-01 4.6E+OO 1.8E+OO 1.4E+OO 3.7E+OO 7.8E-01 9.1E-01 1.4E+OO 3.5E+OO 6.7E-01 1.58+00 8.OE-01 7. HI-01

1 year 3.7E+OO 3.OE+OO 6.8E+OO 1.4E+OO

1. OB+OO
1.9E+OO 4.6E-01 5.1E-01 S,OE-01 4.8E-01 4. EE-01 2.9E+OO

GI-tract
Stomach wall Small intest ULI wall LLI wall Heart Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue

1.5E+OO
1.5E+OO 1.5E+OO 1.4E+OO 8.2E+OO 3.5E+OO 2.7E+OO 7,3E+OO 1.5E+OO 1.7E+OO 2.6E+OO 6.8E+OO 1,3E+OO 2.9E+OO 1.5B+OO 1.4E+OO

* *

1. lE+OO
8.6E-01 2.2E+OO 5.OE-01 5.8E-01 7.8E-01 2tlE+OO 4.2E-01 9.OE-01 5.1E-01 4.5E-01

Effective dose equivalent (mSv/RBq)

5.6B-01

6.9B-01

l.lB+oO

1.8B+oo

3.6B+OO

283

RADIATION DOSE TO PATIENTS FROM RADIOPHARMACEUTICALS

53 Albumin

IODINE-LABELLED ALBUMIN (HSA) 1231 1251 1311

Biokinetic Model Extensive studies of the metabolism and distribution of human serum albumin (HSA) in man have been performed by Takeda and Reeve (1963). The blood disappearance curve could be described as the sum of three exponential components, having half-times of 6.8 hr (O&l), 1.29 d (0.22) and 19.4 d (0.38). Weber et al. (1976) derived a whole body curve from the same study. These values are used in the present model. Uniform distribution of activity outside the blood pool is assumed. Iodine released when the albumin molecule is catabolized is rapidly excreted in the urine if thyroid uptake is blocked and is not considered in the adopted model.

(1) Adopted model Takeda, Y. and Reeve, E. B. (1963). Studies of the metabolism and distribution of albumin with autologous 113-albumin in healthy men. J. Lab. Clin. Med. 61, 183202. Weber, D. A., King, M. A. and OMara, R. E. (1976). Brain dosimetry-A review and update. In: Rot. Second Int. Radiopharmaceutical Dosimetry Symposium, Oak Ridge 1976, HEW Publication FDA 76-8044, pp. 376-389. Oak Ridge National Laboratories, Oak Ridge, Tennessee. (2) Diaplacental transfer Evans, T. C., Kretzschmar, R. M., Hodges, R. E. and Song, Ch. W. (1967). Radioiodine uptake studies of the human fetal thyroid. J. Nucl. Med. 8, 157-165. Hibbard, B. M. and Herbert, R. J. T. (l!XO).Foetal radiation dose following administration of radioiodinated albumin. Clin. Sci. 19, 337-344.

Biokinetic Data

Organ (S) Total body

Fs 1.0

T 6.8 hr 1.29 d 19.4 d 6.8 hr 1.29 d 19.4 d

a 0.015 0.035 0.95 0.40 0.22 0.38

1231

1251

,311

17.9 hr

20.4 d

7.88 d

Blood

1.0

12.4 hr

8.75 d

3.67 d

JAICW

18:1-4-J

285

BIOKINETIC MODELS AND DATA 53 Albumin

IODINE-LABELLED
123I 13.2 hours

ALBUMIN (HSA)

per Organ Adult * Adrenals Bladder wall Bone surfaces Breast CI-tract Stomach vall Small intest ULI vall LLI vall Beart Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue 2.6&-02 1.4B-02 2.9B-02 1.53-42 1.6B-02 1.6B-02 1.5B-02 1.4B-02 6.4B-02 2.73-02 2.4B-02 4.43-02 1.5E-02 2 .OB-02 2.4B-02 4.6B-02 1 .OB-02 1 . ?B-02 1. SE-02 1.3B-02

unit

Absorbed dose activity administered 15 year 3.3B-02 1.8B-02 4.1B-02 1.5B-02 2.OB-02 1.9B-02 1.9B-02 1. BE-02 7. EB-02 3.2B-02 2.8B-02 5.53-02 1.9B-02 2.4B-02 3.OB-02 5.4B-02 1.4B-02 2.4B-02 1.9B-02 1.6B-02 10 year 5.3B-02 2.7B-02 7.3B-02 2.4B-02 3.1B-02 2.9B-02 2.9B-02 2. EB-02 1.2B-01 S. lB-02 4.5B-02 8. EB-02 2.9B-02 3.73-02 4.6B-02 8.7B-02 2 *OB-02 4.OB-02 2.9E-02 2.4B-02

(mGy/MBq) 5 year 8.4B-02 4 .OB-02 1*2B-01 3. EB-02 4.8B-02 4. !iB-02 4.63-02 4.1B-02 l.EE-01 E.lB-02 7.OB-02 1.4B-01 4.43-02 5.7B-02 7.2B-02 1.4B-01 3.2B-02 6.4B-02 4.4E-02 3. ?B-02 1 year 1.6E-01 7.6B-02 2.5E-01 7.OB-02 8.6B-02 8.3B-02 E . lB-02 7.9B-02 3.1B-01 1.5B-01 1.3B-01 2.7B-01 E. lB-02 l . OB-01 1.3B-01 2.6B-01 6.OB-02 1,2B-01 E . lB-02 7.1B-02

* * *

Effective dose equivalent (=Sv/llBq)

2.6B-02

3.2B-02

5.OB-02

8.OB-02

1.5B-01

ose 1241 1251 (4.18 (60.14 d) d)

equivalent, 8.4B-01 3.4B-01

(mSv/HBq

of

the

impurity) 2. SE+00 4.6B+OO 2.2BtOO

1.OB+OO
4.1B-01

1*6B+OO 6.8B-01

1. lB+OO

286

RADIATION

DOSE TO PATIENTS FROM RADIOPHARMACEUTICALS 53 Albumin

IODINE-LABELLED
125I 60.14 days per Adult 3.OE-01 2.OE-01 3.2E-01 2.OE-01 2.1E-01 2.1E-01 2.1E-01 2.OE-01 6.9E-01 3.3E-01 3.OE-01 5.7E-01 2.OE-01 2.3E-01 3.7E-01 5.9E-01 1.6%01 2.6E-01 2.OE-01 1.9E-01 unit

ALBUMIN (HSA)

Organ * Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Aeart Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue

Absorbed dose activity administered (mGy/MBq) 1 year 15 year 10 year 5 year 3.9%-01 2.5E-01 4.2E-01 2 *lE-01 2.6E-01 2.5%01 2.5E-01 2.4E-01 8.OE-01 4.1E-01 3.5E-01 7.2E-01 2.5E-01 2.7E-01 4.6E-01 6.9E-01 2.1%01 3.3E-01 2 *5%01 2.3E-01 6.7%01 3.8E-01 7.3%01 3.2E-01 4.0%01 4.2E-01 4.2%01 3.8E-01 1.3%+00 6.8E-01 6.OE-01 1,2E+OO 4.2E-01 4.6E-01 7.8&01 1. lE+OO 6.5E-01 1.2E+OO 5.4E-01 7.0%01 6.9%-01 6.7E-01 6.3%-01 2.0%+00 2.3E+OO 1.4E+OO 2.6E+OO l.lE+OO 1.4E+OO 1*4E+OO 1.4%+00 1.3%+00 3.6E+OO 2.2E+OO 1.9E+OO 3.8E+OO 1.4E+OO 1.6%+00 2.6E+OO 3.6E+OO

* * *

1. lE+OO
9.8%01 1.9E+OO 6.9E-01 7. BE-01 1.3E+OO 1.8E+OO 5.4E-01 9.3E-01 6.8E-01 6.OE-01

1. lE+OO
3 * 3%-01 5.6E-01 4.2%-01 3.7E-01

1. lE+OO
1. BE+00 1.4E+OO 1.2%+00

%ffective dose equivalent (=Sv/llBq)

3.41-01

4.1E-01

6.8E-01

l.lB+00

2.2E+0O

131I

0.04

days

Organ * Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Heart Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue 9.4E-01 4.9E-01 9.7E-01 5.5E-01 5.3E-01 5.2E-01 5.2%01 5.0E-01 1.9%+00 8,8E-01 7.2E-01 1.5E+OO 4.9E-01 5.7E-01 6.6E-01 1.5E+OO 4.6E-01 7.OE-01 5.1E-01 4.7E-01

1.lE+OO 6.OE-01 1.4E+OO 5.5%01

6.4E-01 6.4E-01 6.3%-01 6.OB-01 2.4E+OO

1.8E+OO 9.4%-01 2.6E+OO 8.9E-01

2.9E+OO 1.5EtOO 4.5EtOO 1.4E+OO 1.6EtOO 1.6E+OO 1.6EtOO 1. SE+00 5.7E+OO 2.8EtOO 2.3E+OO 5.OE+OO 1.6E+OO 1.8E+OO 2.2EtOO 4.8E+OO 1.4EtOO 2.4EtOO 1.6EtOO 1.48+00

5.7E+0O 2.8E+OO 9.2E+OO 2.7E+OO 2.9EtOO 3. OEtOO 3.OE+OO 2.9E+OO 5. SE+00 4.4E+00 l.OE+Ol 3.OE+O0 3.3EtOO 4.3EtOO 9.5E+O0 2.6E+O0 4.7EtOO 3.OE+OO 2.8E+OO

1 .OE+OO 1. OB+OO
9.7E-01 9.7E-01 3.6E+OO 1.7E+OO 1.4E+OO 3.1E+OO

* * *

1.OE+Ol

1. lE+OO
8.6E-01 1.9E+OO 6.4E-01 7.1E-01 8.28-01 1.8E+OO 5.4E-01 8.8E-01 6.4%01 5.6E-01

1 . OE+OO 1.lE+OO
1.3E+OO 2.9E+OO 8.5E-01 1.5E+OO

1. OE+OO
8.9E-01

Effective dose equivalent (mSv/lmq)

8.6E-01

1 .lB+OO

1.7K+00

2.8B+00

5.4B+00

287

RADIATION DOSE TO PATIENTS FROM RADIOPHARMACEUTICALS

I 53 Albumin

IODINE-LABELLED ALBUMIN (INTRATHECAL ADMINISTRATION)

1231 1311

Biokinetic Model The model has been defined in Appendix Section A.lO. Two sites of intrathecal administration are considered, viz ,lumbar injection (region A) and cisternal injection (region C). It is assumed that activity reaching the blood is metabolized according to the model for intravenously administered albumin (HSA). Blocking of the thyroid is also assumed. Reference
Di Chiro, G., Reames, P. M. and Matthews, W. B. Jr (1964). RISA-ventriculography Neurology 14, 185-191. and RISA-cistemography.

Biokinetic Data

Organ (S) (1) Lumbar injection Cerebrospinal fluid space (A) Cistema terminalis (B) Spinal cord space (C) Brain cisterns Blood Total body (2) Cisternal injection Cerebrospinal fluid space (A & B) Cisterna terminalis and spinal cord space (C) Brain cisterns Blood Total body

1.0 0.5 0.25 1.0 1.0

7.05 hr 3.94 hr 51.4 min 4.68 hr 18.6 hr

12.9 hr 12.8 hr 6.71 hr 3.24 d 39.4 hr

0.5 1.0 1.0 1.0

2.37 hr 11.1 hr 3.63 hr 18.7 hr

13.5 hr 26.7 hr 3.14 d 8.42 d

289

I 53
Albumin

BIOKINETIC MODELS AND DATA

IODINE-LABELLED ALBUMIN (Intrathecal administration)

Lumbar injection 123I 13.2 hours Absorbed dose per unit activity administered (mGy/MBq) 7.OE-02 ? .lE-03 2.6E-02 1.9E-02 6.83-03 1.6E-02 Z.OE-02 1.6E-02 8.3E-03 3.OE-02 4.1E-02 1.7E-02 Z.ZE-02 l .ZE-02 2.5E-02 2.3E-01 7.3E-02 2.6E-02 4.43-03 9.4E-03 l . lE-02 9.5E;03 3.9E-02

Organ *

* *

Adrenals Bladder wall Bone surfaces Brain Breast GI-tract Stomach wall Small intest ULI wall LLI wall Heart Kidneys Liver Lungs Ovaries Pancreas Spinal cord Red marrow Spleen Testes Thyroid Uterus Other tissue Effective dose equivalent (mSv/Wq)

* *

E ect ve %FEl lz41 lz51 (4.18 (60.14

ose equivalent d) d)

(mSv/MBq of

the impurity)

1. lE+OO
4,1E-01

290

RADIATION DOSE TO PATIENTS FROM RADIOPHARMACEUTICALS

I 53 Albumin

IODINE-LABELLED ALBUMIN (Intrathecal administration)

Cisternal 123I injection 13.2 hours Absorbed dose per unit activity administered (mGy/HBq) 1.9E-02 4.3E-03 2.5E-02 5.4E-03 l.?E-01 1.4E-02 6.2E-03 5. EE-03 4.5E-03 2.2E-02 1.2E-02 8.31-03 1.5E-02 5.1E-03 9.OE-03 9.OE-02 3.3E-02 1.5E-02 3.1E-03 1.2E-02 5.1E-03 5.5E-03

Organ * Adrenals Bladder wall Bone surfaces Breast Brain GI-tract Stomach wall Small intest ULI wall LLI wall Heart Kidneys Liver Lungs Ovaries Pancreas Spinal cord Red marrow Spleen Testes Thyroid Uterus Other tissue

* *

Effective dose equivalent (mSv/RBq)

2.8E-02

Iqnrities: E ectrve 1241 124I (4.18 (4.18

dose d) d)

equivalent

(mSv/MBq of 1 .OE+OO 4.1E-00

the

impurity)

291

I 53 Albumin

BIOKINETIC MODELS AND DATA

IODINE-LABELLED ALBUMIN (Intrathecal administration)

Lumbar injection 131I
8.04

days *

Organ Adrenals Bladder wall Bone surfaces Brain Breast GI-tract Stomach wall Small intest ULI wall LLI wall Heart Kidneys Liver Lungs Ovaries Pancreas Spinal cord Red marrow Spleen Testes Thyroid Uterus Other tissue Bffective dose equivalent Wv/nss) Cisternal injection Organ * * Adrenals Bladder wall Bone surfaces Brain Breast GI-tract Stomach wall Small intest ULI wall LLI wall Heart Kidneys Liver Lungs Ovaries Pancreas Spinal cord Red marrow Spleen Testes Thyroid Uterus Other tissue Effective dose equivalent (mSv/lIBq)

Absorbed dose per unit activity administered (mGy/MBq) 9.6E-01 4.4E-01 9.3E-01 5.?E-01 4.9%01 5.1E-01 5.2E-01 5.OE-01 4.6E-01 1.7E+OO 9.2E-01 6.8E-01 1.3E+OO 4.6E-01 6.0%01 1.9E+OO 8.3E-01 1.4E+OO 4.1E-01 6.4E-01 4.7E-01 4.4E-01 9.OE-01

* *

* *

8.8E-01 4.2E-01 9.1E-01 1. lE+OO 4.8E-01 4.7&01 4.7E-01 4.6E-01 4.3E-01 1.7E+OO 8.1E-01 6.4E-01 1.3E+OO 4.3E-01 5.3E-01 1.4E+OO 7.2E-01 1.3E+OO 3.9E-01 6.4E-01 4.4%01 4.2E-01 8.4B-01

* *

292

RADIATION DOSE TO PATIENTS FROM RADIOPHARMACEUTICALS

I 53
MAA

IODINE-LABELLED MACROAGGREGATED ALBUMIN 1311

Biokinetic Model Aggregates produced from human serum albumin having a diameter of 10-l 50 pm, typically around 50 pm, are immediately and completely trapped in the arterioles and capillaries of the lungs after intravenous injection. The elimination of the activity from the lungs is effected in two ways. Most of the activity is released from the aggregate as free iodide. Part of the MAA is broken down to smaller labelled fragments which are transported in the blood to the liver, where they are slowly metabolized with release of the iodine. Quantitative data on the metabolism of iodine- and technetium-labelled MAA in the literature show a wide variation. Pulmonary clearance is described either as a monoexponential process with a biological half-time of l-20 hr, or as a bi-exponential process with half-times of 3.3-6 hr for the dominating rapid phase and about 3 d for the slower phase. Liver uptake is reported in the range of (X50% and excretion in urine as 2040% (24 hr) and 42-95% (48 hr). In the model adopted here the activity is assumed to leave the lungs with hall-times of 6 hr (0.85) and 3 d (0.15). The liver takes up a fraction of 0.25 with an uptake half-time of 6 hr and an elimination half-time of 5 d. Iodide released from the lungs and the liver is excreted by the kidney according to the iodide model with blocked thryoid. References
Chandra, R., Shamoun, J., Braunstein, P. and Du Hov, 0. L. (1973). Clinical evaluation of an instant kit for preparation of p9mTc-MAA for lung scanning. 1. NW!. Med. 14,102-105. Deland, F. H. (1966). The fate of macroaggregated albumin used in lung scanning. J. Nucl. Med. 7,883~895. Furth, E. D., Okinaka, A. J., Focht, E. F. and Becker, D. V. (1965). The distribution metabolic fate and radiation dosimetry of 1 labeled macroaggregated albumin. J. Nucl. Med. 6, 506-518. Gait, J. M. and Tothill, P. (1973). The fate and dosimetry of two lung scanning agents, 1311MAA and 99mTcferrous hydroxide. Br. J. Radio/. 46,272-276. Malone, L. A., Malone, J. F. and Ennis, J. T. (1983). Kinetics of technetium 99m labelled macroaggregated albumin in humans. 3r. J. Radiol. 56,109-l 12. Monroe, L. A., Thompson, W. L., Anderton, N. S. and Burdine, J. A. (1974). Evaluation of an improved ppmTc-stannous aggregated albumin preparation for lung imaging. J. Nucl. Med. 15,192-194. Subramanian, G., Arnold, R. W., Thomas, F. D. and McAfee, J. G. (1972). Evaluation of an instant 99Tc-labeled lung scanning agent (Abstract). J. Nucl. Med. 13, 790. Tow, D. E., Wagner, H. N., Lopez-Majano, V., Smith, E. and Migita, T. (1966). Validity of measuring regional pulmonary arterial blood flow with macroaggregates of human serum albumin. Am. J. Roentgenol%,664676.

Biokinetic Data
Organ (S) Total body (excluding bladder contents) Lungs Liver Kidneys Bladder contents Fs 1.0 1.0 0.25 1.0 1.0 T a &IA, 2.24 d 18.5 hr 26 hr 6.5 min 2.48 hr

6 hr 3d 6 hr 5d

0.85 0.15 -1.0 1.0

293

I
53 MAA

BIOKINETIC MODELS AND DATA

131I

IODINhLABELLED MACROAGGREGATED ALBUMIN

8.04 days

per Organ Adult * * Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes, Thyroid Uterus Other tissue 1.6E-01 5.2E-01 5.81-02 l .OE-01 9.3E-02 6.8E-02 8.6E-02 4.4E-02 1.4E-01 2.1EtOO 2.3E+OO 4.4E-02 1.5E-01 7.2E-02 ?.9E-02 3.4E-02 4.4E-02 5.6E-02 6.81-02

unit

Absorbed dose activity administered 15 year 2.3E-01 6.4E-01 7.2E-02 1 .OE-01 1.2E-01 8.3E-02 l .OE-01 5.4E-02 1,8E-01 2.7E+OO 3.5E+OO 6.3E-02 2.OE-01 9.6E-02 1 .OE-01 4.lE-02 5.8E-02 7.3E-02 8.3E-02 10 year 3.3E-01 9.8E-01 l. lB-01 1.9E-01 2,OE-01 1.5E-01 1. BE-01 8.9B-02 2.6E-01 4.2B+OO 5 *OE+OO l. lB-01 3.1B-01 1.4E-01 1.7E-01 6.9E-02 9.93-02 1.2B-01 1.2E-01

(mGy/MBq) 5 year 4.7E-01 1.5B+OO 1.7B-01 2.8&01 3.2E-01 2.4E-01 3.OE-01 1.5E-01 3.9E-01 6.2EtOO 7.7BiOO 1.8E-01 4.9B-01 1.9E-01 2.6E-01 l.lE-01 1.7%01 2.OE-01 1.9E-01 1 year 7.7B-01 2.9B+OO 3.4B-01 4.7B-01 6.2&01 4.5E-01 5.7B-01 2. BE-01 6.3%01 1.2E+Ol 1.5E+Ol 3.4E-01 8.5%01 3.2B-01 4. BE-01 2.2B-01 3.1E-01 3.8E-01 3.6E-01

* *

Effective dose equivalent (mSv/W)

S.OB-01

7.OB-01

l.OB+OO

1.6E+OO

3.1E+oo

294

RADIATION DOSE TO PATIENTS FROM RADIOPHARMACEUTICALS

I 53 Markers

IODINE-LABELLED

NON-ABSORBABLE 1251 1311

Biokinetic Model

MARKERS

Iodine-labelled substances can be used as non-absorbable markers in studies of the gastrointestinal tract. For absorbed dose calculations, a modified ICRP model of the gastrointestinal tract is used, as described in Appendix Section A.3. References
Carryer, P. W., Brown, M. L., Malagelada, J. R., Carlson, G. L. and McCall, J. T. (1982). Quantification of the fate of dietary fiber in humans by a newly developed radiolabeled fiber marker. Gastroenterology 82, 1389-1394. Gordon, R. S. (1959). Exudative enteropathy. Abnormal permeability of the gastrointestinal tract demonstrable with labelled polyvinylpyrrolidone. Lancet i, 325-326. Wright, R. A., Thompson, D. and Syed, I. (1981). Simultaneous markers for fluid and solid gastric emptying: New variations on an old theme: Concise communication. J. Nucl. Med. 22, 772-776.

Biokinetic Data

Organ (S) (1) Oral administration of fluids GI-tract contents Stomach SI ULI LLI (2) Oral administration of solids GI-tract contents Stomach SI ULI LLI

Fs

125I

1317

1.0 1.0 1.0 1.0

33.0 min 3.99 hr 12.9 hr 23.5 hr

32.9 min 3.94 hr 12.2 hr 20.8 hr

1.0 1.0 1.0 1.0

2.10 hr 3.99 hr 12.9 hr 23.5 hr

2.08 hr 3.91 hr 12.2 hr 20.7 hr

295

BIOKINETIC MODELS AND DATA 53 Markers

IODINE-LABELLED NONABSORBABLE MARKERS

Oral 125I 60.14 days per Organ Adult Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red tnarrow Spleen Testes Thyroid Uterus Other tissue 4.3E-04 1.4E-02 8.3E-03 2.2%05 3.2E-02 1.8E-01 5.6E-01 1.4E+OO 2.6E-03 2.4E-03 1.2E-04 1.2E-01 2.8E-03 3.3E-02 1.5E-03 2.1E-03 8.6E-08 1.9E-02 6.7E-03 15 year 4.83-04 1.9E-02 l. lE-02 2.2E-05 3.9E-02 2.3E-01 6.9E-01 1.8E+OO 2.9E-03 3.1E-03 1.3E-04 1.7E-01 3.4E-03 4.2%02 1.8E-03 3.4E-03 1.8E-07 2.9E-02 8.3E-03 10 year 1.4%Q3 4.7E-02 2.OE-02 6.9E-05 6.2E-02 4.0&01 1.2E+OO 3.1E+OO i . m-03 9.7E-03 3.5E-04 2.9E-01 7.9E-03 6,8E-02 4.9E-03 7.3E-03 1.4E-06 6.3E-02 1.5E-02 5 year 3.9E-03 8.1E-02 3.6E-02 3.OE-04 l. lE-01 6.5E-01 2.OE+OO 5.OB+OO 1.4B-02 2.3E-02 1. m-03 4.8E-01 1.8E-02 9.7E-02 l.OE-02 1.9E-02 9.9E-06 1.3E-01 2.7E-02 1 year unit administration of fluids Absorbed dose activity administered

(mGy/HBq)

l. lE-02
1.7E-01 9 - m-02 1.3E-03 2.4E-01 1.2E+OO 3.8E+OO 9.7E+OO 3.1E-02 5.4E-02 3.8E-03 8.9E-01 4.7E-02 1.4E-01 2.9E-02 4.9E-02 9.3E-05 3.1E-01 5.6E-02

* * * *

Effective dose equivalent (=Sv/nBq)

1.5%01

1.9E-01

3.31-01

5.4B-01

l.OB+OO

Oral

administration 15 year 7,4E-04 1.9E-02 l. lE-02 6.OE-05 1.2E-01 2.3E-01

of 10

solids

Organ
* Adrenals Bladder wall

Adult 5.4E-04 1.4E-02 8.4E-03 6.OE-05 9.3E-02 1.8E-01 5.6E-01 1.4E+OO 2.8E-03 2.6E-03 3.8E-04 1.2E-01 7.5E-03 3.3%02 3.1E-03 2.1E-03 1.6E-07 1.9e-02 6.9E-03

year

5 year 4.9E-03 8.1E-02 3.7E-02 5.2E-04 3.OE-01 6.5E-01 2.OE+OO 5.OE+OO 1.5E-02 2.5E-02 2.OE-03 4.8E-01 3 .OE-02 9.8E-02 1.5&02 1.9E-02 1.6E-05 1.3E-01 2.7%02

1 year 1.3B-02 1.7E-01 9.2E-02 2.OE-03

Bone surfaces Breast

*

2,OE-03 4.7g-02 2.OE-02 1.3&04 1,7E-01 4.OE-01 1.2E+OO 3.1E+OO

*
* *

GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue

6.9E-01 1.8E+OO 3.23-03 3.33-03

3.8E-04 1.7E-01 8.3E-03 4.2%02 3.53-03 3.4E-03 3.3E-07 2.9E-02 8.6E-03

6.1E-01 1.2E+OO 3.8E+OO 9.7E+OO 3.33-02 5.83-02 5.9E-03

8.9E-01 7 .OE-02 1.4E-01 3.9E-02 4.9E-02 1.3E-04 3.1E-01 5.8E-02

7.63-03 l.OE-02
7.6E-04 2.9E-01 1.6E-02 6,8E-02 8.2E-03 7.3E-03 2.4E-06 6.4E-02 1.6&02

Effective dose equivalent Wv/ltes)

1.6%01

2.OE-01

3.4B-01

5.6E-01

l.lB+oo

296

RADIATION

DOSE TO PATIENTS FROM RADIOPHARMACEUTICALS

I 53 Markers

IODINE-LABELLED NONABSORBABLE MARKERS

Oral administration of fluids 131I 0.04 days per Organ Adult Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intes t ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other Effective tissue Z.ZE-02 l. ZE-01 2.9E-02 4. n-03 Z .ZE-01 9.4E-01 3.6EtOO 9.4E+OO 5.OE-02 3.5E-02 6.23-03 4,2E-01 4.4E-02 a. 7E-02 3.5E-02 3.7E-02 7.4E-04 1.7E-01 4.6E-02 15 year 3.OE-02 1.5E-01 3.5E-02 4.7E-03 2*7E-01 1.2EtOO 4.5E+OO l.ZE+Ol 6.3E-02 4.3E-02 8.6E-03 5.3E-01 5.7E-02 9.9E-02 4.2E-02 4.5E-02 9.3E-04 2.3E-01 5.5E-02 10 year 5.OE-02 2.6E-01 5.OE-02 l.ZE-02 4,OE-01 2.OE+OO 7.9E+OO Z.OE+Ol 5 year 8.6E-02 3.7E-01 7.5E-02 Z . ZE-02 6.8E-01 3.1E+OO 1.3EtOl 3.4E+Ol 1.5E-01 1.4%01 2.8E-02 1 year 1.6E-01 6.3E-01 1.5E-01 4.4E-02 1.3EtOO 5.9E+OO 2.6E+Ol 6.7E+Ol 2.3E-01 2.6E-01 6.1E-02 1.9EtOO 2.7E-01 l.EE-01 Z .OE-01 2.7E-01 1.6E-02 9.6E-01 Z. ZE-01 unit Absorbed dose activity administered

(mGy/MBq)

* * * *

9.0E-02
8.3E-02 1.6E-02 7.8E-01 9.3E-02 1.3E-01 7.3E-02 9.OE-02 2.7E-03 3.7E-01 8.3E-02

1. l&00
1.5E-01 1.5E-01 l.ZE-01 1.4E-01 6.1E-03 5.7E-01 1.3E-01

dose equivalent wv/lIBq )

9.3E-01

l.lBtOO

2.OB+oo

3.2B+OO

6.3E+OO

Oral Organ Adrenals Bladder Adult 2.4E-02 l. ZE-01 2.9E-02 6.1E-03 6.1E-01 9.3E-01 3.6E+OO 9.3EtOO 5.43-02 3.7E-02 8.3E-03 4.2E-01 6.5E-02 8. BE-02 4.6E-02 3.7E-02 9.OE-04 1.7E-01 4. Eg-02

administration 15 year 3.5E-02 1.5E-01 3.6E-02 6.1E-03 7. EE-01 1 . ZE+OO 4.5E+OO l.ZEtOl 6.7E-02 4.7E-02 l. lB-02

of

solids 5 year 9.6E-02 3.7E-01 7.7E-02 2.6E-02 1.9EtOO 3.1EtOO 1.3EtOl 3.4E+Ol 1.6E-01 1.5E-01 3.3E-02 1. lE+OO 1.9E-01 1.6E-01 1.4E-01 1.4E-01 6. EB-03 5.8E-01 1.3E-01 1 year

10 year 5.?E-02 2.6E-01 5.1E-02 1,5E-02

l. ?E-01
6.3E-01 1.5E-01 5.1E-02 3.9E+OO 5. EE+OO 2.6EtOl 6.6EtOl 2.4E-01 2.7E-01 7 .OE-02 1.9E+OO 3.3E-01 1.9E-01 2.4E-01 2.7E-01 1.7E-02 9.6E-01 2.3E-01

wall

* * * *

Bone surfaces Breast GI-tract Stomachwall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue Effective
dose equivalent Wv/l(Bq)

l.lE+OO
2 . OE+OO 7.9E+OO 2. OEtOl l .OE-01 8. EE-02 1.9E-02 7.8E-01 l.ZE-01 1.3E-01 9.0%02 9.OE-02 3.OE-03 3.7E-01 8.5E-02

5.3E-01 7,9E-02
1.0s01

5.48-02 4.53-02 l. lE-03 2.3E-01

5.7E-02

9.5E-01

1.2E+OO

2.OBtOO

3.3E+Oo

6.5B+OO

297

RADIATION

DOSE TO PATIENTS

FROM RADIOPHARMACEUTICALS

I 53 Colloid

IODINE-LABELLED

MICROAGGREGATED 1231 1311

Biokinetic Model

ALBUMIN

This substance behaves as a colloid and is taken up preferentially in the liver, spleen and red bone marrow. The model used is set out in Appendix Section A.8. Total blocking of the uptake of free iodide by the thyroid is assumed.

Biokinetic Data

Organ (S) (1) Normal liver condition Liver Spleen Red marrow Remaining tissues (colloid) Kidneys Bladder contents Remaining tissues (iodide) (2) I$;:

Fs 0.70 0.10 0.10 0.10 1.0 I.0 1.0 3.0 hr 5.0 d 3.0 hr 5.0d 3.0 hr 5.0 d 3.0 hr 5.0d 3.0 hr 5.0 d 8.0 hr 3.0 hr 5.0d 3.0 hr 5.0 d 3.0 hr 5.0 d 3.0 hr 5.0d 3.0 hr 5.0 d 8.0 hr 3.0 hr 5.0 d 3.0 hr 5.0 d 3.0 hr 5.0 d 3.0 hr 5.0d 3.0 hr 5.0 d 8.0 hr 0.8 0.2 x.; 0:s 0.2 0.8 0.2 -0.8 -0.2 1.0 0.8 0.2 0.8 0.2 0.8 8:: 0.2 -0.8 -0.2 1.0 8,: 0:s 0.2 0.8 8:: 0.2 -0.8 -0.2 1.0 4.34 hr 37.2 min 37.2 min 37.2 min 3.4 min 44.2 min 4.83 hr 17.4 hr 2.48 hr 2.48 hr 2.48 hr 7.7 min 1.57 hr 10.1 hr

to intermediate diffuse parenchymal liver disease 0.50 0.20 0.15 0.15

3.10 hr 1.20 hr 0.93 hr 0.93 hr 3.4 min 44.2 min 4.83 hr

l

12.4 hr 4.96 hr 3.72 hr 3.72 hr 7.7 min 1.57 hr 10.1 hr

Spleen Red marrow Remaining tissues (colloid) Kidneys Bladder contents Remaining tissues (iodide) (3) kFeydiate Spleen Red marrow Remaining tissues (colloid) Kidneys Bladder contents Remaining tissues (iodide)

I .o
1.0 1.0

to advanced diffuse parenchymal liv;3iseas 0.30 0.25 0.15 1.0 1.0 1.0

1.86hr
1.86 hr 1.55 hr 0.93 hr 3.4 min 44.2 min 4.83 hr

7.44 hr 7.44 hr 6.20 hr 3.72 hr 7.7 min 1.57 hr 10.1 hr

299

53 Colloid

123I

IODINE-LABELLED MICROAGGREGATED ALBUMIN

13.2 hours

Organ

per Adult

unit

Absorbed dose activity administered 15 year 2.OE-02 7.6E-02 1.6E-02 6.5E-03 1.4E-02 1.2E-02 1.3E-02 l .lE-02 2.OE-02 1.2E-01 1.3E-02 l.lE-02 2.3E-02 2.4802 1.4E-01 7.3E-03 6.6E-03 1.4E-02 8.8E-83 10 year 3. N-02 l.lE-01 2.6E-02 1 .OE-02 2.2E-02 2.08-02 2.2E-02 1.7E-02 3.OE-02 l.EE-01 1.9&02 1. EB-02 3.6E-02 3.6E-02 2.2E-01 1.2E-02 l . lE-02 2.3%02 1.3E-02

(mGy/~q)
1 year 7.3E-02 3.1E-01 9 slE-02 3. x-02 6.6E-02 5.7E-02 6.6E-02 4. BE-02 ?.2E-02 4.6E-01 5.4E-02 5.1E-02 9.7E-02 l. lE-01 5.9E-01 3.8E-02 3.3E-02 6.5E-02 3.9E-02

5 year 4.3E-02 1.7E-01 4.4E-02 1.7E-02 3.6E-02 3.1E-02 3.7B-02 2.6E-02 4.4%02 2.5E-01 2.9E-02 2.8B-02 5.6E-02 5.9E-02 3.3E-01 2 .OB-02 1. EB-02 3.6E-02 2.1E-02

Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue

1. SE-02 6.1E-02 1.2E-02 6.6%03 l. lE-02 9.7E-03 l.lE-02 8.4E-03 1.7E-02 9.5B-02 9.8&03 8.7E-03 1. EE-02 1. EE-02 l . OE-01 5.5&03 4.5%03 l. lE-02 7.3E-03

* *

* *

Effective dose equivalent Wv/llBg)

2.4B-02

3.1B-02

4.?B-02

7.2E-02

1.3B-01

mose
l

equivalent, (4.18 (60.14 d) d) 3.7E-01 6. EE-02

(mSv/MBq of 4. EE-01 9.OE-02

the

impurity) l.lE+OO 2,2E-01 2. OEcOO 4.1E-01

1241 1251

7.3E-01 1.4E-01

300

RADIATION

DOSE TO PATIENTS

FROM RADIOPHARMACEUTICALS

I 53

Colloid

Early

to intermediate

IODINE-LABELLED MICROAGGREGATED ALBUMIN

diffuse parenchymal

liver

disease

1231

13.2 hours *

Organ Adrenals Bladder wall

Absorbed dose per unit activity administered (mGy/MBq) 1.5E-02

Bone surfaces Breast GI-tract Stomachwall Small intest ULI wall LLI wall * Kidneys * Liver Lungs Pancreas Red marrow * Spleen Testes Thyroid Uterus Other tissue Bffective dose equivalent (mSv/lIBq)
* Ovaries

6.1&02 1.4E-02 6.5B-03 1.2B-02 9.93-03 l.OE-02 9.OE-03 1.7E-02 5.2E-02 9.51-03 9.23-03 2.1E-02 2.33-02 1.3E-01 5.8B-03 4.73-03 1.2E-02 7.53-03 2.53-02

Interdiate to advanceddiffuseparenchymal disease

Adrenals * Bladdervail Bone surfaces Breast GI-tract Stnmachvall Small intest ULI vall LLI vall * Kidneys * Liver Lungs Ovaries * Pancreas * Red marrow Spleen Testes Thyroid Uterus Other tissue Bffective dose equivalent bSv/lres)

1.4B-82 6.28-82 1.91-02 6.4B-03 1.4B-02 l.OB-02 l.OB-02 9.7B-03 1.8B-02 5.5B-02 9.1B-03 9.8B-03 2.5B-02 3.3B-02 1.3B-01 5.83-03 4.8B-03 1.2B-02 7.7B-03 2.6B-02

301

BIOKINETIC MODELS AND DATA

53
Colloid

131*

IODINE-LABELLED MICROAGGREGATED ALBUMIN

8.04 days

per

unit

Absorbed dose activity administered 15 year 1.6E-01 6.9E-01 l.BE-01 5.9E-02 l .OE-01 8. BE-02 9.8E-02 7.1E-02 1.7E-01 1. BE+00 9.8E-02 7. BE-02 1.7E-01 3.2E-01 2.6E+OO 5.3E-02 5.1E-02 B.7E-02 6.9E-02 10 year 2.4E-01 1. OE+OO 3.OE-01 9.873-02 1.78-01 1.5E-01 1.7E-01 l. lE-01 2.5E-01 2.8E+OO 1.5%01 1.3E-01 2.7E-01 5.3%01 4.OE+OO 0.9E-02 8.3E-02 1.4E-01 1.1%01

(mGy/MBq) 5 year 3.3E-01 1.6E+OO 5.4E-01 1.6E-01 2.7e-01 2,4E-01 2.7E-01 1.8E-01 3.6E-01 4.lE+OO 2.2%01 2.0%01 4.1E-01 9.6E-01 6.4E+OO 1.4E-01 1.4E-01 2.3%01 1.7E-01 I year 5.6E-01 3.1E+OO

Organ
Adult Adrenals Bladder wall Bone surfaces Breast U-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other l.ZE-01 5. SE-01 1.4E-01 5,9E-02 8.5E-02 7,3E-02 8.2E-02 5.8E-02 1.4E-01 1.4E+OO

1. lE+OO
3.OE-01 5.2E-01 4.3E-01 5.1E-01 3.3E-01 5.8E-01 7.9E+OO 4.OE-01 3.7E-01 7.OE-01 2.OE+OO 1.2E+Ol 2.8E-01 2.7E-01 4. LE-01 3.2E-01

* *

7.5E-02
5, SE-02 1*4E-01 2. x-01 1.8E+OO 4. SE-02 3.9E-02 6.0B-02 5.7E-02

* *

tissue

Effective dose equivalent Wv/lre4)

3.1E-01

4-l&01

6.41-01

1. og+Oa

1.9B+oo

302

RADIATION DOSE TO PATIENTS FROM RADIOPHARMACEUTICALS

53 Colloid

Early to Intermediate
131I

IODINE-LABELLED MICROAGGREGATED ALBUMIN

diffuse parcnchymal

liver

disease

8.04

days *

Organ

Abeorbed dose per unit activity administered (mGy/MBq) 1.2%01 5.6E-01 1.9E-01 6.1E-02 l.OE-01 ?.6E-02 0.1E-02 6.5E-02 1.4E-01 7.5E-01 7.4E-02 6.53-02 1.6E-01 3.3&01 2.5E+OO 4.0B-02 4.3E-02 7.3E-02 6.OE-02 3.88-01

Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue

* * * *

dose equivalent
(=Sv/RB@

Effective

Intermediate to advanceddiffuseparenchymal dineaae Organ Adrenals * Bladderuall Bone surfaces Breast GI-tract Stomachuall Small intest ULI vall LLI vall * Kidneys * Liver Lungs Ovaries * Pancreas Red marrov * Spleen Testes Thyroid Uterus Other tissue gffective doae equivalent (=Sv/lIBq) 1.2B-01 5.6B-01 Z.SB-01 5.9%02 l.lg-001 7.7B-02 7.SB-02 7.1B-02 1.5B-01 B.OE-01 7.1E-02 7.1%02 1.8B-01 5.3%01 2.3B+OO 4.9B-02 4.41-02 7.7B-02 6.1K-02 3.4B-01

303

RADIATION

DOSE TO PATIENTS FROM RADIOPHARMACEUTICALS

53

Hippuran

HIPPURAN 1231 1251 1311

Biokinetic Model Following intravenous administration, the substance is rapidly distributed in the extracellular fluid and excreted entirely by the renal system according to the kidney-bladder model. Total body retention is described by a monoexponential function with a half-life of 25 min (1.0) and the renal transit time is 4 min. When renal function is bilaterally impaired, it is assumed that the clearance rate of the substance is one tenth of that for the normal case (total body half-life 4.2 hr), that the renal transit time is increased to 20 min, and that a fraction of 0.04 is retained in the liver with a half-life of 4.2 hr. As an example of unilateral renal blockage, it is assumed that a fraction of 0.5 of the administered radiopharmaceutical is taken up by one kidney and slowly released to the blood with a half-time of 5 d and subsequently excreted by the other kidney, which is assumed to function normally. It is emphasized that Hippuran preparations usually contain free iodide, which has to be taken into account in the absorbed dose estimation. References
(1) Adopted model Blaufox, M. D. (1972). Compartment analysis of the radiorenogram and kinetics of I-Hippuran. In: Progress in Nuclear Medicine, Vol. 2, Evoluution of Renal Function and Diseases with Radionuclides. University Park Press. London. Elliott, A. T. and B&ton, K. E. (1978). A review of the physiological parameters in the dosimetry of 1 and 311-labelled Hippuran. ht. J. Appl. Radiat. Isot. 29, 571-573. Henk, J. M., Cottrall, M. F. and Taylor, D. M. (1967). Radiation dosimetry of 1311-Hippuran renogram. Br. J. Radio/.
40. 327-334.

OReilly, P. H., Herman, K. J., Lawson, R. S., Shields, R. A. and Testa, H. J. (1977). lL310dine: A new isotope for functional renal scanning. Br. J. 001. 49, 15-21. OReilly, P. H., Shields, R. A. and Testa, H. J. (1979). Nuclear Medicine in Urology and Nephrology, Butterworths, London. (2) Diaplacental transfer Laakso, L., Rekonen, A. and Holopainen, T. (1965). Suitability of isotope renography for study of the kidney in pregnancy. Stand. J. Clin. Lab. Invest. 17, 395-397. Evans, T. C., Kretzschmar, R. M., Hodges, R. E. and Song, Ch. W. (1967). Radioiodine uptake studies of the human fetal thyroid. J. Nucl. Med. 8, 157-165.

305

I
53

BIOKINETIC MODELS AND DATA

Hippuran

Biokinetic Data

Organ (S) Normal renal function Total body (excluding bladder contents) Kidneys Bladder contents Abnormal renal function Total body (excluding bladder contents) Kidneys Liver Bladder contents Unilateral renal blockage Total body (excluding bladder contents) Normal kidney Abnormal kidney Bladder contents

Fs 1.0 1.0 1.0 1.0 1.0 0.04 4.17 hr 1.0 25 min 1.0 35.0 min 4 min 2.62 hr 4.55 hr 16.1 min 11 min 1.41 hr 8.87 hr 2.2 min 8.58 hr 1.4 hr 36.0 mm 4.2 min 2.91 hr 6.0 hr 21.5 min 14.4 min 1.91 hr 3.34 d 3.9 min 3.33 d 2.26 hr 36.0 min 4.2 min 2.89 hr 5.89 hr 21.1 min 14.1 min 1.87 hr 2.24 d 3.3 min 2.22 d 1.98 hr

4.17 hr

1.0

1.o
1.0 25 min 5d 5d 0.5 0.5 1.0

HIPPURAN
123I
Organ Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue

13.2 hours
per Adult 9.2E-04 2.OE-01 1.3E-03 4.4E-04 7.9E-04 3.2E-03 2.5E-03 7.X-03 6.4E-03 7.2E-04 4.8B-04 7.3E-03 8.9E-04 2. SE-03 8.2E-04 4.6E-03 3.7E-04 1,7E-02 2.2E-03 unit 15 year

Absorbed

dose (mCy/MBq) 1 year 5.8E-03 1 .OE+OO 8.OE-03 2.5E-03 5.7E-03 1.9E-02 1.6E-02 3.9E-02 2.9E-02 5.2E-03 3.2E-03 3,6E-02 6.1E-03 8.7E-03 5.5E-03 4.41-02 2.9E-03 9.2E-02 l. lE-02 5 year 2.9E-03 5. SE-01 3.9E-03 1.2E-03 3.OE-03 l. lE-02 8.9E-03 2.2E-02 1.6E-02 2.7E-03 1.6E-03 2.1E-02 3.1E-03 5. BE-03 2.8E-03 2.2E-02 1. SE-03 5.3E-02 6.3E-03

activity

administered
10 year 1.813103 3.7E-01 2. SE-03 7.OE-04 1.8E-03 6. SE-03 5.3E-03 1.5E-02 l.lE-02 1.6E-03 9.0E-04 1.4E-02 1.9E-03 4.3E-03 1.7E-03 1,4E-02 9.1E-04 3.5E-02 4.OE-03

l. lE-03 2. SE-01 1.6E-03 4.4&04 9.7E-04 3.9E-03 3.2E-03 9.83-03 7.9E-03 9.OE-04 6.2E-04 9.OE-03 l .OE-03 3.OE-03 l .OE-03 7.1E-03 5.63-04 2.1E-02 2,6E-03

Bffective dose equivalent

1.5s02

1.9E-02

2.0E-02

4.3E-02

7 .a~-02

(mSv/MBq)
Bladder wall contributes to 80.0 % of the effective dose equivalent.

?F=Y E ective 1241 1251 (4.18 (60.14

ose d) d)

equivalent 9.4E-02 l.OE-02

(mSv/RBq

of

the

impurity) 1.7E-01 2 .OE-02 2.7E-01 3.1E-02 4.9E-01 6.OE-02

l.ZE-01 1.3E-02

306

RADIATION

DOSE TO PATIENTS FROM RADIOPHARMACEUTICALS

I 53 Hippuran

123I

Abnormal 13.2 hours per unit

HIPPURAN
renal

function

Absorbed dose activity administered 15 year 6.5E-03 1.4E-01 6.2E-03 3.4E-03 5.5E-03 7.3E-03 6.93-03 l .OE-02 3.23-02 7.6E-03 4.8E-03 9.83-03 6.3E-03 7. EE-03 5.9E-03 7.43-03 4.5E-03 1.6E-02 5.3E-03 10 year l.OE-02 2.OE-01 9,7E-03 5 .OE-03 8.83-03 1.2E-02 l. lE-02 1.6E-02 4.5E-02 l. lE-02 7,3E-03 1.5E-02 9.9E-03 1.2E-02 9.3E-03 1.3E-02 7.4E-03 2.7E-02 B.3E-03

(mGy/MBq) 5 year 1.6E-02 3 .OE-01 1.5E-02 8.1E-03 1.3E-02 1.8E-02 1. JE-02 2.3L02 6.53-02 1.6E-02 1.2E-02 2.4E-02 1.5E-02 1. JE-02 1.5E-02 2. IE-02 1.2E-02 4.1E-02 1.3E-02 1 year 2.9B-02 5.5E-01 3.OE-02 1.6E-02 2.4E-02 3.3E-02 3.1E-02 4.2E-02 l. lE-01 3.OE-02 2.2E-02 4.2E-02 2. BE-02 3.OE-02 2.6E-02 4.OE-02 2.2E-02 7.2E-02 2.4E-02

Organ Adult Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue 5.3E-03 l. lE-01 5.1E-03 3.41-03 4.43-03 6.OE-03 5.6E-03 7.8E-03 2. JE-02 5.9E-03 3.8E-03 7.9E-03 5.1E-03 6.4E-03 4.9E-03 5.3E-03 3.OE-03 1.3E-02 4.5E-03

* * * *

Hffective dose equivalent @Sv/nW Bladder wall contributes

I. 3B-02

1,6E-02

2.4E-02

3. JR-02

6. ?B-02

to

50.0

% of

the

effective

dose

equivalent.

Unilateral Organ * * Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue Adult 4.OE-02 l. lE-01 5.OE-03 1.2E-03 l.lE-02 l .OE-02 9. JE-03 6.2E-03 7 I EE-01 1.2E-02 2.7E-03 7.1E-03 2.OE-02 1.3E-02 3.1E-02 Z.BE-03 3.6E-04 1.2E-02 5.8E-03

renal 15 year 4.4E-02 1.3E-01 6. JE-03 1.2E-03 l. lE-02 1.3E-02 1.2E-02 E .OE-03 9.4E-01 1.5E-02 4.1E-03 8.5E-03 2.4E-02 1.5E-02 3.9E-02 4 .OE-03 5.4E-04 1.4E-02 6.93-03

blockage 10 year 7 .OE-02 Z .OE-01 l.lE-02 2.7E-03 1.9E-02 2.1E-02 1.8E-02 1.3E-02 1.3E+OO 2,4E-02 6.5E-03 1.4E-02 3.8E-02 2,2E-02 6.1E-02 7..8E-03 l .OE-03 2.4E-02 l.OE-02 5 year l. lE-01 3.0E-01 1 I BE-02 4.2E-03 2.5E-02 3.1E-02 2.8E-02 2.1E-02 1.9E+OO 3.4E-02 l.lE-02 2.3E-02 5.5E-02 3.OE-02 9.1E-02 1.3E-02 2.1E-03 3.8E-02 1.6E-02 1 year 2.OE-01 5.4E-01 3.9E-02 J. lE-03 3.5E-02 5.4E-02 4.5E-02 3.4E-02 3.3E+OO 5.3E-02 2.1E-02 4.1E-02 0.9E-02 4.3E-02 1.4E-01 2 . ?E-02 3. BE-03 6.5E-02 2.8E-02

* *

Bffective dose equivalent @Sv/l(Bq)

6.21-02

7.5E-02

l . lB-01

1.6B-01

2. JR-01

307

I 53 Hippuran

BIOKINETIC MODELS AND DATA

HIPPURAN
L25I 60.14 days Absorbed dose activity administered 15 year 4.3B-04 1.9E-01 5.5B-04 2.3B-04 3.2B-04 ?.4B-04 5.9B-04 3.1B-03 5.63-03 3.23-04 3.2B-04 2.2B-03 3.5B-04 0.43-04 4.2B-04 1.8B-03 2.91-04 9.1E-03 l.OB-03 10 year 7e 5B-04 2.9E-01 l . OE-03 3 s4E-04 5.3E-04 1.6B-03 1.3E-03 5.9E-03 7. aB-03 5.6E-04 5.3B-04 4. ?B-03 6.1E-04 1.6E-03 7.3E-04 5.1B-03 5.OE-04 1.9&-02 l.EB-03

per unit

(mGy/MBq) 1 year 2.6B-03

Organ
Adult * Adrenals Bladder wall Bone surfaces Breast U-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Bed marrow Spleen Testes Thyroid Uterus Other tissue 3.6B-04 1.6E-01 4,2B-04 2 *3E-04 2.5E-04 5.7E-04 4.5E-04 2.3B-03 4.6B-03 2. ?B-04 2.5E-04 1.8E-03 2.9B-04 6.3B-04 3.53-04 l. lB-03 2.2B-04 6.93-03 0.5E-04 5 year 1.38-03

4.4E-01
1.9E-03 5. ?B-04 9.6B-04 3.4E-03 2,6E-03 l. lB-02 l . lB-02 9.8B-04 %.0E-04 9.2E-03 l . OB-03 Z.BE-03 l. ZE-03 1, LB-02 0,3B-04 3.3E-02 3.1B-03

0.2s01
4.9e-03 l . lB-03

* * * *

Z . OB-03 a. 9s03 6.3B-03 Z . ZB-02 2 *OR-O2 Z .OE-03 l . EE-03 Z . OB-02 2.2B-03 5.6E-03 2.4E-03 2.5E-02 1.6B-03 6.4B-02 6.3B-03

Bffectiwe doue equivalent Wv/ltas)

Bladder wall contributes

l.OE-02

1.3B-02

z.oE-02

3.1E-02

6.OB-02

to 96.0 X of

the effective

dose equivalent.

308

RADIATION

DOSE TO PATIENTS FROM RADIOPHARMACEUTICALS

I 53 Hippuran

Abnormal 1251 Organ Adult Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue 3.OE-03 l .OE-01 3.7B-03 2.5E-03 2.6E-03 2.9E-03 2.9E-03 4.OE-03 2.4E-02 4.1E-03 2.7E-03 3.6E-03 2 * 9E-03 4e 2E-03 3.1E-03 2.7E-03 2.2E-03 7.OE-03 2.0E-03 60.14 days per unit

HIPPURAN

renal function
(mGy/RBq) 5 year l. lE-02 2.9E-01 1.4E-02 6.0&03 0.93-03 l . lE-02 l . OB-02 1.5E-02 6.1E-02 1.2E-02 9.2E-03 1.4E-02 9.9E-03 1. SE-02 l .OE-02 1.4E-02 8,7E-03 3.OE-02 9.3E-03 1 year 2.2%02 5.5%01 2.9E-02 1.2E-02 1.8E-02 2,3E-02 2.1E-02 3.OE-02 l . lE-01 2.3E-02 1.8E-02 3.OE-02 2.OE-02 3.OE-02 2.OE-02 3.OE-02 1.7E-02 5.8E-02 1.8E-02

Absorbed dose activity administered 15 year 3.9E-03 1.3E-01 4.6E-03 2.4E-03 3.2E-03 3. SE-03 3.4e-03 4.9E-03 2.9E-02 5.2E-03 3.4E-03 4.4E-03 3.4E-03 5.3E-03 3.7E-03 3.7E-03 3.OE-03 8.9E-03 3.4E-03 10 year 6.6E-03 1,9E-01 B . OE-03 3.6E-03 5.1E-03 6.2E-03 6.OE-03 a. 4E-03 4.2E-02 7.9E-03 5.6E-03 8.1E-03 5.9E-03 9.OE-03 6.3E-03 7.4E-03 5.2E-03 1.7E-02 5.6E-03

* * *

Effective dose equivalent Wv/lres) Bladder wall contributes

l . OE-02

1.3E-02
X of the

2.0&02

3.2B-02

6.OE-02

to 60.0

effective

dose

equivalent.

Unilateral Organ * * Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue Adult 1.7E-01 1.2E-01 I. 3E-02 2.1E-04 1.3E-02 l .lE-02 l . OE-02 2.8E-03 5.3E+OO 2.6E-02 2.OE-03 2.2E-03 4.OE-02 3.4E-02 1.2E-01 7.6E-04 5.8E-05 5. BE-03 1.7E-02

renal 15 year 1.6E-01 1.5E-01 2.OE-02 2.1E-04 1.3E-02 1.3E-02 l. lE-02 3.4E-03 6.3E+OO 3.1E-02 3.7E-03 2.7E-03 4. BE-02 4.7E-02 1,5E-01 1.3E-03 E.OE-05 E.OE-03 2.OE-02

blockage 10 year 2.9E-01 2.3B-01 4.OE-02 1.3E-03 3.1E-02 3.OE-02 2.4E-02 0.7E-03 .3.8E+OO 6.5E-02 8.8E-03 7.2E-03 1.OE-01 8.6E-02 2.7E-01 3.8E-03 1.5E-04 1,7E-02 3.1%02 5 year 5.OE-01 3.4E-01 8.1E-02 2.6E-03 4.7E-02 6.1E-02 4.83-02 1.7E-02 1,3E+Ol l. lE-01 1.9E-02 1.5E-02 1,8E-01 1.4E-01 4.5E-01 0.5E-03 3.4E-04 3.3E-02 5.OE-02 1 year

1 .OE+OO 6.4E-01
2.2E-01 E.OE-03 8.9E-02 1.3E-01 9.6E-02 4.1E-02 2.2E+Ol 1.9E-01 6.2E-02 S.OE-02 3.3E-01 2.4E-01 7.8E-01 2.1E-02 2.2E-03 7.2E-02 9. EE-02

* *

Effective dose equivalent Wv/W)

AICRP 18: I-4-K

3.58-01

4.2E-01

6.OB-01

8.8B-01

1.6B+Oo

309

I 53 Hippuran

BIOKINETIC MODELS AND DATA

HIPPURAN
131I 8.04 days

per Organ Adult Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue 2.83-03 9.6E-01 3.OE-03 1.7E-03 2.5E-03 7.8E-03 6.93-03 1.7E-02 3.OE-02 2.3E-03 1.6E-03 1.7E-02 2.6E-03 4.9E-03 2.4E-03 1.2E-02 1.4E-03 3.5&02 5.4E-03

unit

Absorbed dose activity administered 15 year 3.1E-03 1.2E+OO 3.6E-03 1.7E-03 3.OE-03 l .OB-02 0.4E-03 2.2&02 3.7E-02 2.8E-03 2.OE-03 2.1E-02 3.1E-03 5.9%03 3.1E-03 1.7E-02 1.9E-03 4,3E-02 6.5E-03 10 year 5.OR-03 1.0E+OO 5. SE-03 2.9E-03 5.3E-03 1.6&02 1.3E-02 3.2g-02 5.3E-02 4.9E-03 3.2E-03 3.OE-02 5. SE-03

(mGy/MBq) 5 year 8.6E-03 2.8E+OO 8.5B-03 4.9E-03 0.63-03 2.5E-02 2.1E-02 4.7E-02 7.9E-02 8. SE-03 5.4E-03 4.4E-02 9.2E-03 l. lE-02 0.1E-03 4.9E-02 5.2E-03 l .OE-01 1.5E-02 1 year 1.6%02 5.4E+OO 1.6E-02 l .OE-02 1.7&02 4.5E-02 3.6B-02 7.6E-02 1.4E-01 1.6E-02 l-l&02 7.4E-02 1.8E-02 1.7E-02 1.6E-02 9.0&02 l .OE-02 1.7E-01 2.7E-02

* * * *

a.

3E-03 4.9E-03 3. HI-02 3.1E-03 6.8B-02 9 *9E-03

Effective dose equivalent (=Sv/W) Bladder wall contributes

6.6B-02

8.3%02

1.3B-01

1.9%01

3.7E-01

to 87.3

X of

the

effective

dose

equivalent.

310

RADIATION DOSETOPATIENTSFROM

RADIOPHARMACEUTICALS 53 Hippuran

HIPPURAN
131I Abnormalrenal function a.04 days Absorbeddose per unit activityedministered (mGy/MBq) Organ Adult Adrenals * Bladderwall Bone surfaces Breast GI-tract Stomachwall * Small intest ULI wall * LLI wall
l

15 year 2.4B-02
?.9B-01

10 year

5 year

1 year l.lE-01 3.5E+OO 9.?B-02 8.53-02

2.1E-02 6.3B-01 l.?B-02 1.6B-02 l.aE-02 2.23-02 2.1B-02 2.?B-02 l.SE-01 2.53-02 l.SB-02 2.6E-02 1.9E-02 1.9E-02 1.9B-02 2.23-02 1.4B-02 3.9B-02 1.aB-02 6.5B-02

3.83-02 6.OE-02 1.2E+oo 1.9B+OO 2.OE-02 3.1E-02 S.OB-02 2.6B-02 4.3B-02 1.6&02

2.1E-02 3.43-02 5.413-02 l.OE-01 2.?E-02 4.3B-02 6.8E-02 1.3B-01 2.5E-02 4.0%02 6.4%02 1.2&01 3.33-02 5.1E-02 7.83-02 1.4%01 1.9E-01 3.2B-02 1.9E-02 3.33-02 2.4B-02 2.7B-01 3.9B-01 4.8B-02 7.21-02 3.OB-02 4.93-02 5.1E-02 ?.9B-02 3.83-02 5.93-02 J.lE-01 1.4B-01 9.411-02 1.4E-01 l.lE-01

* Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue Bffective dose equivalent Wv/l(Bq)

2.33-02 3.53-02 5.33-02 9.aB-02 2.2&02 3.6E-02 5.73-02 l.lB-01 2.73-02 4.73-02 7.43-02 1.4B-01 1.9E-02 3.1E-02 S.lE-02 9.aB-02 4.?B-02 7.63-02 1.2E-01 2.OE-01 2.1E-02 8.OB-02 3.4E-02 5.41-02 1.2B-01 1.9B-01 l.OB-01 3.68-01

Bladderwall contributes to 58.2 X of the effective dose equivalent. Unilateral renal blockage Organ * Adrenals * Bladderwall Bone surfaces Breast CI-tract Stomachwall Small intest ULI wall LLI wall * Kidneys Liver Lungs Ovaries * Pancreas * Red marrow Spleen Testes Thyroid Uterus Other tissue
Effective

Adult 4.?B-01 6.?B-01 4.5E-02 1.8B-02 1.4E-01 1.2E-01 1.2E-01 4.73-02 2.2E+Ol 1.6E-01 3.83-02 6.1E-02 2.?E-01 l.lE-01 3.5B-01 1.4E-02 4.6B-03 6.2B-02 6.2B-02 l.%+OO

15 year

10 year

5 year

1 year 2.1Btoo 3.8Btoo 2.9B-01 9.9E-02 4.5E-01 5.9E-01 4.9E-01 2.3E-01

S.lE-01 a.o~-01 1.2B+OO 8.4B-01 1.3E+OO 2.OB+oo 5.83-02 6.9B-02 1.4B-01 1.8B-02 4.3E-02 6.3B-02 1.5%01 l.SB-01 1.4E-01 5.68-02 2.?E+Ol 1.9E-01 5.?E-02 ?.2E-02 3.1E-01 1.3E-01 4.4B-01 1.8B-02 6.6E-03 ?.4E-02 ?.3B-02 2.5E-01 3.2E-01 2.4&01 3.6E-01 2.2E-01 3.1E-01 9.OE-02 l.SE-01

3.aE+ol S.JE+Ol l.OE+02 2.9E-01 4.1E-01 6.OE-01 8.53-02 1.4E-01 2.6E-01 1.2E-01 1.9E-01 3.4E-01 4.?E-01 6.6E-01 1. OEtOO 1.8E-01 6.?E-01 3.28-02 l.lB-02 1.3B-01 l.lB-01 2.3B-01 3.1B-01 9.7B-01 l.SB+OO 5.6B-02 1.2B-01 2.SB-02 4.5B-02 2.1B-01 3.4B-01 1.6B-01 3.8Btoo 2.88-01 6.0B+OO

dome equivalent (=svmlq)

1.8B.KKl 2.6B+OO

311

RADIATION

DOSE TO PATIENTS

FROM RADIOPHARMACEUTICALS

IODOANTIPYRINE
1251 1311

Biokinetic Model The distribution of antipyrine almost exactly parallels that of body water (Campbell et al., 1981). Significant quantities of the radioactive label detach from the molecule within 15 min, according to animal studies (Sullivan and Rose, 1961), and, within 24 hr, 70% of the label is distributed and excreted as iodide (Flora et al., 1962). Essentially all of the administered radioactivity is excreted in urine, with an estimated half-time of 6 to 12 hr (Reinmuth et al., 1965; Talso et al., 1955). It is assumed that, after intravenous administration, the substance is distributed uniformly in the body and that the label is eliminated entirely by renal excretion, with a half-time of 10 hr. The thyroid is assumed to be blocked. References
Campbell, J. A., Finn, R. D., Boothe, T. E., Djermouni, B., Ginsberg, M. D., Lockwood, A. H., Gilson, A. J. and Ache, H. J. (1981). Synthesis of C-l 1 Iodoantipyrine for positron emission tomography. J. Nucl. Med. 22, 538-541. Flora, J. H., Phillips, D. F., Arcidiacono, F. and Sapirstein, L. A. (1962). Distribution of 4-iodoantipyrine after intravenous injection in the rat. Circ. Res. XI, 252-256. Reinmuth, 0. M., Scheinberg, P. and Bourne, B. (1965). Total cerebral blood flow and metabolism. Arch. Neural. 12, 49-66. Sullivan, J. M. and Rose, J. C. (1961). Loss of s*I tag from radioiodinated 4-iodoantipyrine after its injection in the rat.
J. Lab. Clin. Med. 57,955-960.

Talso, P. J., Lehr, T. N., Spafford, N., Ferenzi, G. and Jackson, H. R. 0. (1955). A comparison of the volume of distribution of antipyrine, N-acetyl-4-amino-antipyrine and 1311-labeled4-iodo-antipyrine in human beings. J. Lab. Clin. Med. 46. 619623.

Biokinetic Data

Organ (S) Total body (excluding bladder contents) Kidneys Bladder contents

Fs 1.0 1.0 1.0 10 hr 1.0 14.3 hr 8.9 min 1.81 hr 13.7 hr 8.7 min 1.73 hr

JAICRP

IS:

l-4-L

313

I
53 Antipyrine

BIOKINETIC MODELS AND DATA

125I

IODOANTIPYRINE
60.14 days per Adult unit Absorbed dose activity administered 15 year 8. HZ-03 1.3E-01 l.lE-02 6.2E-03 8.OE-03 8.3E-03 8.3E-03 9.5E-03 1.48-02 7.8E-03 8.5E-03 9.3E-03 8.2E-03 1.3E-02 8.OE-03 7.7E-03 7.8E-03 1.3E-02 7.6E-03 10 year 1.4E-02 1.9E-01 2.OE-02 9.1E-03 1.3%02 1.4%02 1.4E-02 1.6E-02 2.1E-02 1.3E-02 1.4E-02 1.6E-02 1.4E-02 2.1E-02 1.3E-02 1.4B-02 1.3E-02 2.5E-02 1.3&02 (mGy/MBq) 5 year 2.3E-02 2 *9E-01 3.3E-02 1.5E-02 2.2E-02 2.4%02 2.3E-02 2.7B-02 3.1E-02 2.2E-02 2.3E-02 2.8E-02 2.3B-02 3.5E-02 2.2E-02 2.5E-02 2.2E-02 4.2B-02 2.1E-02 1 year 4.5E-02 5.4B-01 7.OB-02 3.0&02 4.3B-02 4.9E-02 4.73-02 5.53-02 5.83-02 4.3B-02 4.5E-02 5.6E-02 4.6B-02 7.2E-02 4.3E-02 5.1E-02 4.4B-02 8.3B-02 4.lE-02

Organ

* * * *

Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue

5.8E-03 l . OE-01 9.1E-03 6.2E-03 6.4E-03 7.1E-03 7.1E-03 8.OE-03 1.2E-02 6.78-03 6.7E-03 7.6E-03 6.9L03 l . OE-02 6.8E-03 5.9E-03 5.7E-03 l. lE-02 6.2E-03

Effective dose equivalent (=Sv/llBq)

1.331-02

1.6B-02

2.6B-02

4.1B-02

8.OB-02

131*

8.04

days

Organ Adult * * Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue 4.5E-02 6.OE-01 3.9E-02 4.08-02 4.1E-02 4.6E-02 4.5E-02 5.OE-02 7.5&02 4.OE-02 3.7E-02 4.9B-02 4.2E-02 4.2B-02 4.lE-02 4.4E-02 3.6&02 6.1E-02 3.9E-02 15 year 5.1E-02 7.5B-01 4.6E-02 4.OE-02 4.9E-02 5.6B-02 5.4E-02 6.OE-02 9.2&02 4.98-02 4.61-02 6.3E-02 5.3E-02 5.OE-02 4.98-02 5.3E-02 4. JE-02 7.6E-02 4.7B-02 10 year 8.lE-02 l.lE+OO 5 year 1.3E-01 1.8E+OO 1.2E-01 l.OE-01 1.3E-01 1.4E-01 1.4B-01 1.5E-01 1.9E-01 1*3E-01 1.2E-01 1.5E-01 1.3B-01 1.2E-01 1.3E-01 1.4B-01 1.3E-01 1.9E-01 1.2E-01

1 year 2.5E-01 3.4E+OO 2.3E-01 2.OE-01 2.3E-01 2. JE-01 2.6E-01 2.8E-01 3.5E-01 2.4B-01 2.3E-01 2.9E-01 2.5E-01 2.3E-01 2.4B-01 2. JE-01 2.4%01 3.4B-01 2.3E-01

7.4E-02
6.3E-02 7.8E-02 9.OE-02 8.4E-02 9.6B-02 1.3E-01 7.83-02 7.3E-02 9.8E-02 8.4E-02 7.9E-02 8. JE-02

* * *

7.9E-02
1.2E-01 7.5E-02

7. JE-02

Bffective dose equivalent Wv/llBq)

7.88-02

9.5B-02

1.5B-01

2.3B-01

4.4%01

314

RADIATION

DOSE TO PATIENTS

FROM RADIOPHARMACEUTICALS

I 53

Iothalamatc

IOTHALAMATE
1251

Biokinetic Model After intravenous administration and initial distribution in the extracellular fluid, the substance is excreted exclusively by the renal system according to the models for GFR substances and the kidney-bladder (see Appendix Sections A.6 and AS, respectively). In the normal case, total body retention is described by a double exponential function with half-times of 100 min (0.99) and 7 d (0.01). The fraction excreted by the kidneys is 1.O,and the renal transit time is 5 min. For the abnormal case, it is assumed that the retention half-time of the major component is 1000 min and that the renal transit time is increased to 20 min. References
Klopper, J. F., Hauser, W., Atkins, H. L., Eckelman, W. C. and Richards, P. (1972). Evaluation of 99mTc-DTPA for the measurement of glomerular filtration rate. J. Nucl. Med. 13, 107-l 10. Silkalns, G. I., Jeck, D., Earon, J., Edelmann, C. J., Chervu, L. R., Blaufox, M. D. and Spitzer, A. (1973). Simultaneous measurement of glomerular filtration rate and renal plasma flow using plasma disappearance curves. J. Pediat. 83,
749-751.

Biokinetic Data
Organ (S) Normal renal function Total body (excluding bladder contents) Kidneys Bladder contents Abnormal renal function Total body (excluding bladder contents) Kidneys Bladder contents Fs 1.0 1.0 1.0 1.0 1.0 1.0 16.7 hr 7d 0.99 0.01 T a &IA, 4.55 hr 6.2 min 2.15 hr 1.07d 26.6 min 1.77 hr

1.61 hr 7d

0.99 0.01

315

BIOKINETICMODELSANDDATA

53
Iothalamate

IOTHALAMATE
125I 60.14 days per Organ Adult Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue 15 year 2. JB-03 1.4E-01 3.6B-03 2sOE-03 10 year 5 year 1 year 1.5E-02 6.1E-01 2.33-02 9.4B-03 1.4E-02 1.9B-02 1.7%02 2.93-02 3.4B-02 1.4E-02 1.4E-02 2.83-02 1.5E-02 2.4E-02 1.4B-02 2.9E-02 1.4E-02 6 .OE-02 1.5E-02 unit Absorbed dose activity administered (mGy/MBq)

2.OB-03
1.2E-01 2.9&03 2 .OE-03 2.OE-03 2.4E-03 2.3B-03 3.6&03 7.4B-03 2.1B-03 2.1B-03 3.3%03 2.2B-03 3.3B-03 2.2B-03 2.4g-03 1.8B-03 7 .OE-03 2.3B-03

4.53-03 2.2E-01 6.3B-03 2.93-03

J.SE-03 3.3E-01
l.lE-02

4.JE-03
7 s OB-03 9 .OE-03 8.2B-03 1.4B-02
1.9E-02 6.93-03

* * * *

2.53-03 4.0&03 2.93-03 5.1E-03

2.8B-03 4.5E-03 4a 9E-03 7.9B-03 1.3E-02 4.2E-03 4.4E-03 7.4E-03 4.4E-03

9.OE-03 2.5%03 2.?E-03 3.9E-03 2.63-03 4.2B-03 2.63-03 3.33-03 2.43-03 9.OB-03 2.83-03 1.2B-02
X of the

7.2%03
1.3E-02

7.3E-03
1.2B-02

7.2&03
4.4B-03 6.9E-03 4.2E-03 1. EE-02 4. JE-03

7.2E-03
1.3&02 6.9E-03 3.1E-02

7. EE-03

Bffective dose equivalent WV/W)

Bladder wall contributes

9. JB-03

1.9B-02 3.OB-02 5.73-02

dose equivalent.

to

74.2

effective

Abnormal Organ Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue Adult l. lE-02 l .OE-01 1.6E-02 l. lE-02 1.2E-02 1.3E-02 1.3E-02 1.3E-02 3.3E-02 1.2E-02 1.2E-02 1.3E-02 1.2E-02 1. EB-02 1.2E-02 l . OE-02 1 .OB-02 1.6E-02 l. lE-02

renal 15 year 1.5E-02 1.3E-01 2.OE-02 l. lE-02 1.4E-02 1.5E-02 i. 5E-02 1,6E-02 4.OE-02 1.4E-02 1.5E-02 1.6E-02 1.5E-02 2.2E-02 1.5E-02 1.3E-02 1.4E-02 2.OE-02 1.3E-02

function 10 year 2.5E-02 1.9B-01 3.5B-02 1.6E-02 2.3E-02 2. SE-02 2.5E-02 2.5E-02 5. JE-02 2.4E-02 2.5E-02 2. JE-02 2.5E-02 3. EE-02 2.5E-02 2.2E-02 2.4E-02 3.5E-02 2.21-02 5 year 4.2E-02 2.9B-01 5.93-02 2.7E-02 3.9E-02 4.2E-02 4.OE-02 4.3E-02 8. SE-02 3.9E-02 4.1E-02 4.6E-02 4. IE-02 6.3E-02 4.OE-02 3. EE-02 3.93-02 5.9E-02 3.6E-02 1 year

8.3B-02 S.bE-01
1.2E-01 5.3E-02

* * * *

8.4E-02 E.lE-02 8. EE-02 1.5E-01 7.7E-02 E.lE-02 9.1E-02 8.2E-02 1.3E-01

7.7E-02

7.9E-02 7.9E-02 7. EE-02

1.2E-01

J . lE-02
1.2B-01

Bffective dose equivalent bBv/lli)g)

1.9B-02

2.4B-02 3.7B-02

6.OB-02

316

RADIATION

DOSE TO PATIENTS

FROM RADIOPHARMACEUTICALS 53 NP 59

IODOMETHYL-19-NORCHOLESTEROL 1311
Biokinetic Model

(NP 59)

Total-body retenti,on measurements of iodomethyL19norcholesterol (Kletter et al., 1978) have shown biological half-lives of 1.4 d (0.2) and 13 d (0.8). The mean fractional uptake of NP 59 in the adrenals was 0.003 in normal volunteers and patients without evidence of adrenal disease, but was 0.006 to 0.008 in patients with Cushings disease (Ryo et al., 1978; Carey et al., 1979). Uptake and elimination half-times in human adrenal glands have been reported as 25 hr (Ice et al., 1976; Carey et al., 1979) and 13 d (Kletter et al., 1978), respectively. Kletter et al. (1978) measured an uptake of 0.18 in the liver, with elimination half-times of 1.4 d (0.75) and 13 d (0.25). After administration of 19-iodocholesterol, OConnor et al. (1979) observed an uptake of 0.039 to 0.049 in the thyroids of two patients. Barbarino et al. (1975) observed a thyroid uptake of 0.08 in one patient, in spite of attempts to block the thyroid. Thus, for the thyroid, a fractional uptake of 0.05 and elimination half-times of 2 d (0.6) and 12 d (0.4), based on the studies of OConnor et al. (1979), are assumed. References
Barbarino, A., Troncone, L., Salvo, D. and Pasargiklian, E. (1975). Thyroidal accumulation of 131-I during adrenal gland scintigraphy with I 131-iodocholesterol: Effects of thyroid blocking agents. J. Clin. Endocrinol. Metab. 41,
4os.407.

Carey, J. E., Thrall, J. H., Freitas, J. E. and Beierwaltes, W. H. (1979). Absorbed dose to the human adrenals from Iodomethvl-norcholesterol (I-131) NP-59: Concise communication. J. Nucl. Med. 20. 6&62. Ice, R. D., K&cos, L. T., Coffey, J. L.: Watson, E. E., Beierwaltes, W. H. and Sarkar, S. D. (1976). Radiation dosimetry of 6-1311-iodomethyl-19-norcholesterol, NP-59. RudiopftnrmaceuticuI f)usimerry Symposium, Oak Ridge, 1976, HEW Publication (FDA) 76-8044, pp. 246-255. Oak Ridge National Laboratories, Oak Ridge, Tennessee. Kletter, K., Herkner, K., Kallinger, W. and Nowotny, R. (1978). Strahlenbelastung bei Nebennierenszintigraphie mit dem neuen Radiopharmakon J-131-NP-59. In: Nuklearmedizin und Biokybernetik, pp. 225-230. (Oeff, K. and Schmidt, H. A. E. eds) Medico-Informationsdienste, Berlin. OConnor, M. K., Cullen, M. J. and Malone, J. F. (1979). High thyroid radiation dose associated with 311-19-iodocholesterol NP 59 adrenal scanning. &. J. Radio/. 52, 13&133. Ryo, U. Y., Johnston, A. S., Kim, J. and Pinsky, S. M. (1978). Adrenal scanning and uptake with 311-o-beta-iodomethyl-nor-cholesterol. Radiology 128, 157-161.

Biokinetic Data
Organ (S) Total body Adrenals Liver Thyroid Fs 1.0 0.003 0.18 0.05 T 1.4d 13d 1d 13d 1.4d 13d 2d 12d a 0.2 0.8 -1.0 1.0 0.75 0.25 0.6 0.4 As/A, 6.1 d 27.5 min 13.3 hr 5.0 hr

317

53 NP 59

IODOMETHYL-19-NORCHOLESTEROL (NP 59)

131I 0.04 days

per Organ Adult * Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other Bffective tissue

unit

Absorbed dose activity administered 15 year 5.3BtOO 4.7B-01 4.4E-01 4.OE-01 4.0E-01 S.OB-01 5.0%01 4.6B-01 4.9E-01 1.5BtOO 4.7E-01 5.OE-01 5.5B-01 4. BE-01 4.7E-01 4,2B-01 4.7E+Ol 5.OE-01 4.4E-01 10 year 7.7EtOO 7.4E-01 7.1B-01 6.3E-01 7.7E-01 8.2E-01 7.9B-01 7.6B-01 7.9B-01 2.3E+OO 7.4E-01 0.OB-01 0.7E-01 7. SE-01 7.6B-01 6.7B-01 7.3EtOl 0.1B-01 7.1E-01

(mGy/MBq) 5 year 1 year 1.6BtOl 2.2E+OO 2.2BtOO 2. OBtOO 2.3BtOO 2.5EtOO 2.4EtOO 2.3EtOO 2.4B+OO 6.5E+OO 2.3E+OO 2.4BtOO 2.6E+OO 2.2BtOO 2.3E+OO 2.1BtOO 3.2Bt02 2.4BtOO 2.2EtOO

4 *OE+OO 3.9E-01 3.7E-01 4.OE-01 4.OE-01 4.1E-01 4.1%01 3.9E-01 4.1E-01 1.2EtOO 3.0E-01 3.0E-01 4.3E-01 3.9E-01 3.9E-01 3.6&01 3.OE+Ol 4.OE-01 3.6B-01

1.lE+Ol
1.2B+OO

1. lE+OO
1.

OEtOO

* *

1.2EtOO 1.3EtOO 1.3EtOO 1.2BtOO 1.3E+OO 3.4E+OO 1.2BtOO 1.3EtOO 1.4EtOO l.ZE+OO 1.2EtOO

1. lB+OO
1.7E+02 1.3BtOO

1.1EtOO
6.BRtOO

dose equivalent (=Sv/lIBq)

1. SE+00

2.2BtOO

3.4E+00

1.3B+Ol

318

RADIATION DOSE TO PATIENTS FROM RADIOPHARMACEUTICALS

I 53 PVP

IODINATED POLYVINYLPYRROLIDONE (PVP)

1251 1311

Biokinetic Model Iodinated polyvinylpyrrolidone (PVP), with an average molecular weight of 30 000 to 40000, is used as a nonmetabolizable substitute for human serum albumin in studies of gastrointestinal protein loss. In humans, after intravenous administration, approximately half of the administered activity is excreted via the urine during the first 24 hr (Ravin et al., 1952; Seltzer et al., 1964), with half-times of 1 hr (0.3) and 6 hr (0.2), according to data obtained by Tothill (1965). The remainder is retained in the body for a very long time, most of it being located in the liver (Tothill, 1965). It is assumed that, after intravenous administration, half the administered activity is lost from the body via the urine, according to a double-exponential function with component half-times of 1 hr (0.3) and 6 hr (0.2). The remainder of the administered activity (0.5) is assumed to be retained indefinitely, mainly in the liver (0.4) and kidneys (0.03). The residual indefinitely retained fraction (0.07) is assumed to be uniformly distributed throughout ail other organs and tissues. The thyroid is assumed to be blocked. References
Miller, J. P., Dalziel, A. and Crawford, L. E. M. (1965). Internal dosimetry studies of radiopharmaceuticals. I. Tolpovidone I-131 J. Nucl. Med. 6, 59-68. Ravin, H. A., Seligman, A. M. and Fine, J. (1952). Polyvinyl-Pyrrolidone as a plasma expander; Studies on its excretion, distribution and metabolism. New Engf. J. Med. 247,921-929. Seltzer, R. A., Kereiakes, J. G., Saenger, E. L. and Myers, D. H. (1964). Radiation exposure from radioiodine compounds in pediatrics. Radiology 82, 486494. Tothill, P. (1965). The retention by the body of I-131-Polyvinylpyrrolidone and its effect on radiation dose. J. Nucl. Med. 6. 582-587.

Biokinetic Data

Organ (S) Total body (excluding bladder contents)

Fs 1.0 1 hr 6 hr
W

Liver Kidneys Bladder contents

0.4 0.03 0.5

03 w

0.3 0.2 0.5 I.0 1.0

43.5 d

5.89 d

34.7 d 2.61 d 1.09 hr

4.64 d 8.35 hr 1.07 hr

319

I 53 PVP

BIOKINETIC MODELS AND DATA

125I

IODINATED POLYVINYLPYRROLIDONE (PVP)

60.14 days per unit Absorbed dose activity administered 15 year 8.8B-01 1.3B-01 2.8E-01 9.7B-02 2.2E-01 1.7E-01 2.8E-01 8.6E-02 5.3E+OO 1.5E+Ol 5.7B-01 9.4B-02 6.2E-01 3.78-01 2.2B-01 7.2B-02 0.3E-02 9.2E-02 2.1E-01 10 year 1.5B+OO 2.OB-01 5.OB-01 1.9B-01 5.6B-01 3.9B-01 6.8B-01 1.4B-01 7.7B+OO 2.2B+Ol 9.OE-01 1.7B-01 1.3B+OO 6,3E-01 4.2&01 1.2E-01 1.4&01 1.7B-01 3.5E-01 (mGy/MBq) 5 year 2.2B+OO 3*4B-01 9.OB-01 3.6B-01 1.3B+OO 8.4B-01 1.5E+OO 2.7B-01 1 year 4.1B+OO 7.6B-01 2.2E+OO 8.3E-01 3.OB+OO 1.9B+OO 3.OB+OO 6.1B-01 2.OB+Ol 6.1BtOl 3 *OBtoo

Organ Adult * Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue 6.7B-01 l.OE-01 2.1E-01 9.0B-02 1.5&01 1.3E-01 2.3&01 7.3&02 4.4B+OO 1.2B+Ol 3 *7B-01 7.5B-02 3.8&01 2.3E-01 1.7B-01 5.8B-02 6.1B-02 7.4B-02 l.EE-01

* * *

1. lE+Ol
3.3B+Ol 1*5B+OO 3.4B-01 2.6B+OO

E. lB-01
5.1B+OO 2.1EtOO 1.5BtOO 4.1B-01 5.1B-01 7.8B-01 1.2EtOO

1. OB+OO
7.4B-01 2.OB-01 2.5B-01 3.2B-01 5 *8B-01

Effective dose equivalent Wv/llBq)

1.2BtoO

1.5B+OO

2.3B+OU

3.5B+OO

6.6B+00

131I

0.04

days

Organ * * Adrenals Bladder

Adult 5.6B-01 4.2B-01 1.3B-01 1. BE-01 2.5B-01 2 * 2B-01 3.OE-01 9.93-02 3.8EtOO 9 .OBtOO 2.7E-01 1 .OB-01 4. BE-01 l.EE-01 2.OB-01 7.3B-02 7.3B-02 1.2B-01 1.6B-01

15 year 7.3E-01 5.3B-01 1.7B-01 1.8B-01 3.2B-01 2.7B-01 3.5B-01 1.2B-01 4.7BtOO l.lB+Ol 3.7B-01 1.6B-01 6.4B-01 2.3B-01 2.7&01 0.2B-02 9.3B-02 1.6E-01 1.9B-01

LO year

5 year 1.5BtOO 1.3B+OO 3.9B-01 4 * 9B-01 9.5B-01 0*OB-01 1. OBtOO 3.7B-01 9. SE+00 2.6B+Ol 7.9B-01 4.8E-01 1.6BtOO 4.6B-01 6.9B-01 2.4B-01 2.7B-01 4.9B-01 4.5B-01

1 year 2.3BtOO 2.5BtOO 7.0B-01 9.2B-01 1.9BtOO 1.4BtOO 2.OB+OO 6.9B-01 1.7EtOl 5. OBtOl 1.4BtOO 9.2E-01 2.7BtOO 7,6B-01 1.2BtOO 4.0B-01 5.3B-01 9*2B-01 8.5B-01

Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue

wall

1. 1BtOO 8.2B-01 2.5B-01 3,OB-01

5.7B-01 4. BE-01 6.4B-01 2.1E-01 6.7BtOO l.EB+Ol 5*3B-01 2.8B-01 1. OBtOO 3.38-01 4.4B-01 1.4B-01 1.6B-01 2. BE-01 2.9B-01

* * *

Bffective dose equivalent WV/W)

9.7B-01

1.2BtOO

l.EB+OO

2.7BtOU

5.1BtOo

320

RADIATION DOSE TO PATIENTS FROM RADIOPHARMACEUTICALS

53 T4

THYROXINE
1251 1311

(T4)

Biokinetic Model Intravenously administered thyroxine (tetra-iodo-thyronine, T4) is bound to specific transport proteins in the blood and rapidly distributed throughout the extracellular fluids. The primary metabolic disposal route is deiodination, whereby free iodide is formed. In the case of complete blocking of the thyroid, the iodide is excreted via the kidneys and bladder, with a half-time of 8 hr. A fraction of the thyroxine (0.17) is excreted via the biliary tract and intestines. The half-life of thyroxine has been measured in several studies and found to be 5 to 9 d, with most values around 6 d. Other thyronines of medical interest, such as triiodothyronine (T3), reverse triiodothyronine (rT3) and diiodothyronines (T2), follow the same pathways in the body, the only difference being the rate of turnover. The model used here is similar to that of Hays (1985), with the addition of the blocked thyroid model (see the biokinetic model for iodide). References
Bernstein, G., Hasen, J. and Oppenheimer, J. H. (1967). Turnover of i3iI-Thyroxine in patients subject to surgical trauma. J. Clin. Endocrinol. Metab. 7, 741-744. Faber, J., Lumholtz, I. B., Kirkegaard, C., Siersbaek-Nielsen, K. and Friis, T. (1982). Isolation of radioactive iodothyronines for kinetic studies: A comparison of two methods. Acta Endocrinol. 99, 6471. Hays, M. T. (1985). Radiation dosimetry of radioiodinated thyroid hormones. J. iVuc2. Med. 25, 1068-1074. Hays, M. T. and McGuire, R. A. (1980). Distribution of subcutaneous thyroxine, triiodothyronine, and albumin in man: Comparison with intravenous administration using a kinetic model. J. C/in. Endocrinol. Metab. 51.1112-l 117. Inada, M. and Sterling, K. (1967). Thyroxine turnover and transport in active acromegaly. J. Clin. Endocrinol. Metab. 27, 1019-1027. McConnon, J., Row, V. V. and Volpe, R. (1971). Simultaneous comparative studies of thyroxine and tri-iodothyronine distribution and disposal rates. J. Endocr. 51, 17-30. Oddie, T. H., Meade, J. H. and Fisher, D. A. (1966). An analysis of published data on thyroxine turnover in human subjects. J. Clin. Endocrinol. Metab. 26, 425-436. Thomson, J. A. and Wallace, T. J. (1966). Anomalous values for the half-life of radiothyroxine in dyshormonogenetic goiter. J. Clin. Endocrinol. Metab. 26, 875-877.

Biokinetic Data

Organ (S) TCbound iodine Total body (excluding contents of GI tract) GI-tract contents SI ULI LLI Released iodine (iodide) Total body (excluding bladder contents) Kidneys Bladder contents
JUCRP Le.: l-4-L

Fs 1.0 0.17 0.17 0.17 0.83 0.83 0.83

125I

,311

6.0 d

1.0

7.87 d 37 min 2.00 hr 3.58 hr

4.96 d 23 min 1.22 hr 1.96 hr 5.27 hr 3.3 min 46 min

6.0 d 8.0 hr

-1.0 1.o

8.68 hr 6.0min 1.38 hr

321

BIOKINETICMODELSANDDATA 53 T4

125I

THYROXINE
60.14 days

(T4)

Absorbeddose Per unit activityadministered (mGy/MBq)

Organ

Adult Adrenals * Bladderwall

Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue

15 year
l.lB-01

10 year

5 year

1 year
6.28-01 8.6E-01 9.8E-01 4.2E-01 6.1B-01 3.4B-01 9. JE-01 1.9B+OO 4.9B-01 6.OE-01 6.4B-01

E.OE-02 1.4E-01 1.3B-01 8.9E-02 9.1B-02 5.2E-02 1.4B-01 Z.EB-01 8.9B-02 9.43-02 9.53-02 l.lE-01 9.?B-02 1.4E-01 9.5E-02 7.73-02 E.lE-02 9.53-02 8.43-02 1.2%01

1.J&01
1.6B-01

8.81-02
l. lE-01 5.5E-02 l.JE-01 3.5E-01 l.lE-01 l. lE-01 l. ZB-01 1.3E-01 l. ZE-01 1. EE-01 l. lE-01 9. JE-02 l. lE-01

1.9%01 3.1B-01 2.6E-01 4.2E-01 4.JB-01 2. EE-01 Z.lE-01 1.3E-01 1. EE-01 l.OE-01 3.OE-01 5.8B-01 l.JE-01 1.9E-01 Z.OE-01 Z.ZB-01 1.9E-01 3.OE-01 1.9E-01 1.6E-01 1.9E-01 Z.OE-01 l.JB-01

* *

3.1E-01 l.JE-01 4.9E-01

9. JE-01 2.6B-01 3.OE-01 3.2&01 3. JE-01 3.2B-01 5.OB-01 3.OE-01

* *

?.2B-01

6.4B-01
1.OE+OO 6,OE-01
5.3E-01 6.2E-01 6.6E-01 5.48-01

1. ZB-01
l.OB-01

2.6E-01 3.1E-01 3.3E-01 2.JB-01

3. EB-01

Bffective dose equivalent (=Sv/nas)

1.4B-01 2.3B-01

7.6B-01

131I

8.04

days

Organ Adult * * Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow 4.1E-01 5.1B-01 3.6&01 3. JB-01 3.8E-01 1. JE-01 6.OE-01 15 year 4,6E-01 6.3E-01 4.2E-01 3. JB-01 4.5E-01 Z. lB-01 7.4E-01 1.4B+OO 4.6E-01 4.5B-01 4.3E-01 5.1E-01 4.8E-01 4.5E-01 4.5E-01 4.1E-01 4.3E-01 4.9B-01 4.18-01

10 year
7,4E-01
9. JB-01 6.8E-01 5,9B-01 J.ZE-01 3.2B-01 1. ZB+OO 2.4E+OO 6.JE-01 J.ZE-01 6. JB-01 E.OE-01 J.JE-01 J. lE-01 6.6E-01

5 year
l.ZE+OO 1. SE+00

1 year
2. PE+OO 2.8EtOO

1. lE+OO
9.6B-01 1. lE+OO 4. EE-01 2. lB+OO 3.9B+OO 9. EE-01 1. 1EtOO

2. lE+OO
1.9E+OO

2. lE+OO
E.OE-01 3.9B+OO 7. JE+OO 1. JEtOO 2.2BtOO 2.1EtOO 2.4BtOO 2.3E+OO Z.lE+OO Z.ZE+OO 2.1BtOO 2.2EtOO 2.3B+OO 2.1BtOO

* *

1. lE+OO
3.8E-01 3.7&01 3.5E-01 3.9&01 3.9B-01 3.JB-01 3.8E-01 3.5B-01 3.3E-01 3.9E-01 3 *4E-01

1. lE+OO
1.3E+OO 1. ZE+OO 1 . lE+OO 1. lE+OO 1 . lE+OO 1.2BtOO 1 . ZB+OO 1 . lE+OO

Spleen
Testes Thyroid Uterus Other tissue

J. ZB-01 J. lE-01 ?.9B-01

6.6B-01

Bffective dose equivalent WV/W)

4.4B-01

5.2J.b01

8.5B-01

1.4B+OO

2.6BtOO

322

RADIATION

DOSE TO PATIENTS FROM RADIOPHARMACEUTICALS

I 53 T3

TRIIODOT+;YftiNINE
I I Biokinetic Model

(T3)

The model is the same as that described for thyroxine (T4) (see p. 321), except that the degradation half-life of T3 is assumed to be 24 hr. References (1) Adopted model Bianchi, R., Zucchelli, G. C., Giannessi, D., Pilo, A., Mariani, G., Carpi, A. and Toni, M. G. (1977). Evaluation of triiodothyronine (Ts) kinetics in normal subjects, in hypothyroid and hyperthyroid patients using specific antiserum for the determination of labeled T, in plasma. J. Ch. Endocrinol. Metnb. 46,203-214. Cavalieri, R. R., Steinberg, M. and Searle, G. L. (1971). Metabolic clearance rate of L-triiodothyronine in man: A comparison of results by single-injection and constant infusion methods. J. C/in. Endocrinol. Metab. 33, 624-629. Faber, J., Lumholtz, I. B., Kirkegaard, C., Siersbaek-Nielsen, K. and Friis, T. (1982). Isolation of radioactive iodothyronines for kinetic studies: A comparison of two methods. Acta Endocrinol. 99, 64-71. Hays, M. T. and McGuire, R. A. (1980). Distribution of subcutaneous thyroxine, triiodothyronine, and albumin in man: Comparison with intravenous administration using a kinetic model. J. Clin. Endocrinol. Metab. 51,1112-l 117. McConnon, J., Row, V. V. and Volp&, R. (1971). Simultaneous comparative studies of thyroxine and tri-iodothyronine distribution and disposal rates. J. Endocr. 51, 17-30. Oddie, T. H., Fisher, D. A., Dussault, J. H. and Thompson, C. S. (1971). Triiodothyronine turnover in euthyroid subjects. J. Clin. Endocrinol. Metab. 33, 653-660. (2) Diaplacental transfer Laakso, L., Rekonen, A. and Holopainen, T. (1965). Suitability of isotope renography for study of the kidney in pregnancy. Stand. J. Clin. Lab. Invest. 17, 395-397. Evans, T. C., Kretzschmar, R. M., Hodges, R. E. and Song, Ch. W. (1967). Radioiodine uptake studies of the human fetal thyroid. J. Nucl. Med. 8, 157-165. Biokinetic Data

Organ (S) T3-bound iodine Total body (excluding contents of GI tract) GI-tract contents SI ULI LLI Released iodine (iodide) Total body (excluding bladder contents) Kidneys Bladder contents

Fs 1.0 0.17 0.17 0.17 0.83 0.83 0.83

125I

,311

l.Od

1.0

1.42 d 40 min 2.16 hr 3.93 hr

1.28 d 36 min 1.85 hr 3.15 hr 8.09 hr 5.6 min 1.28 hr

l.Od 8.0 hr

-1.0 1.0

9.39 hr 6.5 min 1.49 hr

323

BIOKINETICMODELSANDDATA 53 T3

TRIIODOTHYRONINE (T3)
125I 60.14 days Absorbeddose per unit activityadministered (mGy/BBq) Organ Adult Adrenals * Bladderwall Bone surfaces Breast GI-tract Stomachwall * Small intest * ULI wall * LLI wall * Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue Bffective dose equivalent (mSv/tW) 1.8B-02 9.53-02 3.OE-02 1.9E-02 2.1E-02 3.5B-02 l.lE-01 2.58-01 2.38-02 2.1&02 2.18-02 4.1B-02 2.2E-02 3.63-02 2.1E-02 1.8E-02 1.8E-02 2.63-02 2.OE-02 4.9E-02 15 year 10 year 5 year 7.OE-02 2.8E-01 l.lE-01 4.73-02 7.43-02 1.3E-01 3.7E-01 8.98-01 6.81-02 7.OE-02 7.1E-02 1.5E-01 7.33-02 1.2E-01 6.81-02 6.4%02 6.98-02 l.OE-01 6.43-02 1 year 1.4E-01 5.5E-01 2.3E-01 9.3E-02 1.5E-01 2.4E-01 7.2E-01 1.7EtOO 1.3E-01 1.4B-01 1.4R-01 2.8E-01 1.5E-01 2.4E-01 1.4E-01 1.3B-01 1.4E-01 2.1E-01 1.3B-01 3.3R-01 2.53-02 4.2E-02 1.2E-01 1.8%01 3.73-02 6.4E-02 1.9E-02 2.8E-02 2.73-02 4.3B-02 4.33-02 7.63-02 1.3E-01 2.3E-01 3.2E-01 5.4E-01 2.9B-02 2.5E-02 2.6B-02 5.3B-02 2.63-02 4.53-02 2.53-02 2.23-02 2.43-02 3.33-02 2.43-02 6.1B-02 4.43-02 4.23-02 4.33-02 8.93-02 4.43-02 7.53-02 4.213-02 3.7E-02 4.1E-02 5.93-02 3.9E-02

l.OB-01 1.7B-01

131I

8.04 days

Organ Adult Adrenals * Bladderwall Bone surfaces Breast GI-tract Stomachwall * Small intest * ULI wall * LLI wall * Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue Bffective dose equivalent (=Sv/nes) 1.3E-01 5.2E-01 l.lE-01 1.2E-01 1.3E-01 1.7E-01 6.2E-01 1.5EtOO 1.4E-01 1.2E-01 l.lE-01 1.8B-01 1.3E-01 1.3E-01 1.2E-01 1.2E-01 l.OE-01 1.6E-01 l.lE-01 2.7B-01 15 year 10 year 5 year 1 year 1.5E-01 2.4E-01 6.5B-01 9.9E-01 2.2E-01 1.4&01 1.2B-01 1.8E-01 l.SE-01 2.1E-01 7.7E-01 1.9EtOO 1.8E-01 1.4B-01 1.3&01 2.3E-01 1.6E-01 l.SE-01 1.4E-01 1.4E-01 1.4E-01 2.08-01 1.4E-01 3.3R-01 3.88-01 7.2E-01 1.5EtOO 2.9EtOO 3.5E-01 6.7E-01 3.OB-01 5.9E-01 7.2E-01 9.81-01 4.3E+OO l.lE+Ol 6.7E-01 7.2B-01 6.6E-01 l.OBtOO 7.5B-01 6.8E-01 7.1E-01 7.1E-01 7.OE-01 9.OB-01 6.8&-01 1.7B+GO

2.4E-01 3.9E-01 3.4E-01 5.4E-01 1.3E+OO 2.2E+OO 3.2EtOO 5.4EtOO 2.5E-01 2.3&01 2.1E-01 3.5E-01 2.5E-01 2.4E-01 2.3%01 2.3E-01 2.2%01 3.1E-01 3.8E-01 3.8%01 3.4E-01 5.5E-01 4.OE-01

3.7E-01 3.7%01 3.7E-01 3.6E-01 4.9E-01 2*2E-01 3.5E-01 5.41-01 8.7R-01

324

RADIATION

DOSE TO PATIENTS

FROM RADIOPHARMACEUTICALS

1 53 Reverse T3

REVERSE TRIIODOTHYRONINE
1251 1311

(rT3)

Biokinetic Model The model is the same as that described for thyroxine (T4) (see p. 321), except that the degradation half-life of rT3 is assumed to be 2 hr. References
Faber, J., Lumholtz, I. B., Kirkegaard, C., Siersbaek-Nielsen, K. and Friis, T. (1982). Isolation of radioactive iodothyronines for kinetic studies: A comparison of two methods. Acta Endocrinol. 99,64-71. Geola, F., Chopra, I. .I., Solomon, D. H. and Maciel, R. M. B. (1979). Metabolic clearance and production rates of 3,5-diiodothyronine and 3,3-diiodothyronine in man. J. Clin. Endocrinol. Metab. 48,297-301. Smallridge, R. C., Wartofsky, L., Desjardins, R. E. and Burman, K. D. (1978). Metabolic clearance and production rates of 3,3,5-triiodothyronine in hyperthyroid, euthyroid, and hypothyroid subjects. J. Clin. Endocrinol. Metab. 47, 345-349.

Biokinetic Data

Organ (S) rT3-bound iodine Total body (excluding contents of GI tract) GI-tract contents SI ULI LLI Released iodine (iodide) Total body (excluding bladder contents) Kidneys Bladder contents

Fx 1.0 0.17 0.17 0.17 0.83 0.83 0.83 2.0 hr 8.0 hr -1.0 1.0 2.0 hr 1.0 2.88 hr 41 min 2.19 hr 4.00 hr 9.55 hr 6.6 min 1.52 hr 2.86 hr 40 min 2.06 hr 3.50 hr 9.12 hr 6.3 min 1.45 hr

325

I 53 Reverse T3

BIOKINETIC MODELS AND DATA

125I

REVERSE TRIIODOTHYRONINE
60.14 days per Adult unit Absorbed dose activity administered 15 year 7.2E-03 l*lE-01 1.2E-02 5 *5E-03 8.93-03 4.1E-02 1.2E-01 3.1E-01 1.3E-02 7.5E-03 7.5E-03 3.7E-02 7.5E-03 1.8E-02 7.3E-03 7.43-03 6.93-03 1.6E-02 8.OE-03 10 year 1.2E-02 1.7E-01 2.1E-02 8.1E-03 1.5E-02 7.2E-02 2.1E-01 5.3E-01 1.9E-02 1.3E-02 1.2E-02 6.3E-02 1.3E-02 3.OE-02 1.2E-02 1.3E-02 1.2E-02 3.2E-02 1.4E-02

(rT3)
(mGy/MBq) 5 year 2.1E-02 2.6E-01 3.5E-02 1.3E-02 2.73-02 1.2E-01 3.5E-01 8.7E-01 2.9E-02 2.3E-02 2.OE-02 l .OE-01 2.2E-02 4.7E-02 2.1E-02 2.5E-02 2.OE-02 5.7E-02 2.2E-02 1 year 4.2E-02 4.8E-01 7.7E-02 2.7E-02 5.6E-02 2.2E-01 6.7E-01 1.7E+OO 5.4E-02 4.6E-02 4.1E-02 2.OE-01 4.7E-02 8.7E-02 4.3E-02 5.3&02 3.9E-02 1.2E-01 4.5E-02

Organ

* * * *

Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Soleen Testes Thyroid Uterus Other tissue

5.2&03 8.7E-02 9.5E-03 5.5E-03 7.3E-03 3.2E-02 9.9E-02 2.5E-01 l . OE-02 6.3E-03 6.OE-03 2.73-02 6.3&03 1.4E-02 6.2E-03 5.63-03 5.1E-03 1.2E-02 6.6E-03

Effective dose equivalent WV/W)

3.6B-02

4.61-02

?.7B-02

l . ZB-01

2.4B-01

131*

8.04

days

Organ Adult Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue 4.3E-02 5.3E-01 3.98-02 3.63-02 4.93-02 1.7E-01 6.3B-01 1.6EtOO 7.OE-02 4.1E-02 3.4%02 1.1%01 4.3B-02 5.1B-02 4.1&-02 4.5B-02 3.2E-02 8.1E-02 4.2E-02 15 year 5.OE-02 6.5E-01 4.7E-02 3.63-02 5.93-02 2.1E-01 7.9E-01 2. OEtOO 8.63-02 5.OE-02 4.2B-02 1.4%01 5.5E-02 6.1E-02 5.OE-02 5.43-02 4.2E-02 1 .OE-01 5.OB-02 10 year 8.OE-02 1. OE+OO 7.4E-02 5.8E-02 9.38-02 3.5%01 1.4E+OO 3.5EtOO 1.3E-01 8.3E-02 6.?E-02 2.1E-01 8.8E-02 9.1B-02 8.1E-02 9.1E-02 6.9E-02 1.7E-01 8.0&02 5 year 1.3E-01 1 year 2.4E-01 2.9B+OO 2.3B-01 1.9E-01 2.7E-01 1. OEtOO 4.5EtOO 1. l&t01 3.3%01 2.6E-01 Z . lE-01 5.6%01 2.6E-01 2.3B-01 2,5E-01 2.8%01 2.2B-01 4.5%01 2.4E-01

1*!%too
l . ZE-01 9.5E-02 1.51-01 5,6E-01 2.3EtOO 5.8E+OO 1.98-01 1.3B-01 l . lE-01 3.2E-01 1.48-01 1.3E-01 1.3E-01 1.5E-01 l. lE-01 2.6B-01 1.3E-01

* * * *

Bffective dose equivalent Wv/lces)

Z . ZB-01

2.7B-01

4.5%01

7.3%01

1.4B+O0

326

RADIATION

DOSE TO PATIENTS

FROM RADIOPHARMACEUTICALS

I 53 T2

DIIODOTHYRONINE 12511311
Biokinetic Model The model is the same as that described for thyroxine (T4) (see p. 321), except that the degradation half-life of T2 is assumed to be 1 hr. References
Faber, J., Lumholtz, I. B., Kirkegaard, C., Siersbaek-Nielsen, K. and Friis, T. (1982). Isolation of radioactive iodothyronines for kinetic studies: A comparison of two methods. Acta EndocrinoL 99, 64-71. Galeazzi, R. L. and Burger, A. G. (1980). The metabolism of 3,3-diiodothyronine in man. J. Clin. Endocrinol. Metab. 50, 148-151. Geola, F., Chopra, I. J., Solomon, D. H. and Maciel, R. M. B. (1979). Metabolic clearance and production rates of 3,5-diiodothyronine and 3,3-diiodothyronine in man. J. Clin. Endocrinol. Metab. 48, 297-301.

Biokinetic Data

Organ (S) T2-bound iodine Total body (excluding contents of GI tract) G&tract contents SI ULI LLI Released iodine (iodide) Total body (excluding bladder contents) Kidneys Bladder contents

F.S 1.0 0.17 0.17 0.17 0.83 0.83 0.83 1.0 hr 8.0 hr - -1.0 1.0 1.Ohr 1.o 1.44 hr 41 min 2.19 hr 4.00 hr 9.55 hr 6.6 min 1.52 hr 1.44 hr 40 min 2.07 hr 3.52 hr 9.17 hr 6.4 min 1.45 hr

327

I 53 T2

BIOKINETIC MODELS AND DATA

125I

DIIODOTHYRONINE
60.14 days per unit Absorbed dose activity administered 15 year 6.4E-03 l.lE-01 l. lE-02 4.93-03 E. lE-03 4.1E-02 1.2E-01 3.1E-01 1.2E-02 6.73-03 6.7E-03 3.6E-02 6.7E-03 1.7E-02 6.5E-03 6.7E-03 6.1E-03 1.5E-02 7.3E-03 10 year l. lE-02 1.7E-01 1.9&02 7.1E-03 1.4E-02 7.1E-02 2.1E-01 5.3E-01 1. EE-02 1.2E-02 l.lE-02 6.1E-02 1.2E-02 2. EE-02 l.lE-02 1.2E-02 l.OE-02 3. DE-02 1.2E-02 (mGy/MBq) 5 year 1. EE-02 2. SE-01 3.2E-02 1.2E-02 2.4E-02 1.2E-01 3.5E-01 8.7E-01 2.7E-02 2.1E-02 1. EB-02 l .OE-01 2.OE-02 4.43-02 1.9E-02 2.3E-02 1.7E-02 5.5E-02 2.1B-02 1 year 3.78-02 4.8E-01 7.OE-02 2.4E-02 5.2E-02 2.2E-01 6.7E-01 1.7E+OO 5.08-02 4.2E-02 3.6E-02 1.9E-01 4.2E-02 E.OE-02 3.83-02 4.9E-02 3.4E-02 1.2E-01 4.1E-02

Organ Adult Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Soleen T& tes Thyroid Uterus Other tissue 4.6E-03 8.7E-02 8.53-03 4.93-03 6.7&03 3.2E-02 9.83-02 2.5l.k01 9.6E-03 5.6E-03 5.3E-03 2.7&02 5.6E-03 1.3E-02 5. SE-03 5.OE-03 4.5E-03 1.2E-02 6.OE-03

* * * *

Effective dose equivalent

3.6B-02

4.5E-02

7.6B-02

1.2E-01

2.4E-01

(=Sv/lIBq)

131I

8.04

days

Organ Adult Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Soleen Testes Thyroid Uterus Other tissue 3.9E-02 5.2E-01 3.53-02 3.2E-02 4.4E-02 1.7E-01 6.3E-01 1.6EtOO 6.7E-02 3.7E-02 3.OE-02 l. lE-01 3.9&02 4.7E-02 3.78-02 4,1E-02 2. EE-02 7.7B-02 3. EE-02 15 year 4.58-02 6,5E-01 4.2E-02 3.28-02 5.43-02 2.1E-01 7.9R-01 2. OEtOO 8.23-02 4.5E-02 3.83-02 1.4E-01 4.9E-02 5.63-02 4.5E-02 5.OE-02 3.7E-02 9.98-02 4.68-02 10 year 7.2E-02 9.9E-01 6.7E-02 5.2E-02 8.5E-02 3.5E-01 1.4E+OO 3.5E+OO 1.2E-01 7.5E-02 6.OE-02 2.1B-01 E.OE-02 8.3E-02 7.3E-02 8.43-02 6.1E-02 1.6E-01 7.3B-02 5 year 1.2E-01 1.5E+OO l. lE-01 8. SE-02 1.4E-01 5.5E-01 2.3E+OO 5. EE+OO 1. EE-01 1.2E-01 9.7E-02 3.1E-01 1.3B-01 1.2E-01 1.2B-01 1.3%01 l.OE-01 2.4E-01 1.28-01

1 year
2.2&01 2.9EtOO 2.OE-01 1.7E-01 2.5E-01

* * * *

1. OE+OO
4.5B+OO

1. lE+Ol
3.1E-01 2.3E-01 1.9E-01 5.4E-01 2.4E-01 2.1E-01 2.2E-01 2.6%01 1.9E-01 4.3B-01 2.2E-01

Effective dome equivalent @k/W)

2.2R-01

2.7%01

4.48-01

7.2B-01

1.4E+W

328

RADIATIONDOSE TO PATIENTS FROM RADIOPHARMACEUTICALS 53 MIBG

METAIODOBENZYLGUANIDINE 1231 1311

Biokinetic Model

(MIBG)

MIBG is an analogue of the adrenergic blocking agent guanethidine, having uptake and storage mechanisms similar to those of norepinephrine. It has an affinity for chromaffin storage granules in adrenal medulla, myocardium and other tissues richly supplied with sympathetic nerves. From the publications cited below the following model can be constructed. After intravenous injection there is a rapid uptake mainly in the liver (0.33), and smaller uptakes in lungs (0.03), heart (O.OOS), spleen (0.006) and salivary glands (0.004). The uptake in normal adrenals is very low (0.0003). Hypexplastic adrenals and tumours like pheochromocytoma, neuroblastoma and other tumours with neurosecretory granules show a high uptake. According to the report by Jacobsson et al. (1986) total body retention can be described by half-times of 3 hr (0.36) and 1.4 d (0.63), with a small fraction (0.01) retained in the liver with a half-time which is long in comparison with the physical half-life of the radionuclides used. The retention data for the specified organs have been derived from the same study. Blocking of the thyroid is assumed. References
Jacobsson, L., Mattsson, S., Johansson, L., Lindberg, S. and Fjglling, M. (1986). Biokinetics and dosimetry of 3I-metaiodobenzylguanidine (MIBG). In: Proc. Fourth ht. Rndiophnrmuceutical Dosimetry Symposium. Oak Ridge 1985, Oak Ridge Assoc. Universities CONF-851113, pp. 389-398. Oak Ridge National Laboratories, Oak Ridge, Tennessee. Kline, R. C., Swanson, D. P., Wieland, D. M., Thrall, J. H., Gross, M. D., Pitt, B. and Beierwaltes, W. H. (1981). Myocardial imaging in man with I-123 meta-iodobenzylguanidine. J. Nucl. Med. 22, 129-132. Swanson, D. P., Carey, J. E., Brown, L. E., Kline, R. C., Wieland, D. M., Thrall, J. H. and Beienvaltes, W. H. (1981). Human absorbed dose calculations for iodine-131 and iodine-123 labeled meta-iodobenzylguanidine (MIBG): A potential myocardial and adrenal medulla imaging agent. In: Proc. Third ht. Radiopharmaceutical Dosimetry Symposium, Oak Ridge 1980, HHS Publication FDA 81-8166, pp. 213-224. Oak Ridge National Laboratories, Oak Ridge, Tennessee. Wieland, D. M., Brown, L. E., T&es, M. C., Rogers, W. L., Marsh, D. D., Mangner, T. J., Swanson, D. P. and Beierwaltes, W. H. (1981). Imaging the primate adrenal medulla with lz31 and 1311metaiodobenzylguanidine. J. Nucl. Med. 22, 358-364.

Biokinetic Data

Organ (S) Total body (excluding bladder contents)

Fs 1.0

T 3 hr 1.4d co 1.4d 5d 3 hr 1.4d :4d 1.4d 5d

a 0.36 0.63 0.01 1.0 1.0 0.40 0.57 0.03 1.0 1.0 1.0

1231 9.91 hr

1311 1.26d

Adrenals Heart wall Liver

o.ooo3 0.008 0.33

15s 8.1 min 3.23 hr 24.3 min 3.2 min 6.1 min 4.0 min 51.5 min

45 s 51.2 min 11.1 hr

Lungs Salivary glands Spleen Kidneys Bladder contents

0.03 0.004 0.006 0.99 0.99

1.24 hr 9.9 min 38.4 min 9.0 min 1.65 hr

329

I 53 MIBG

BIOKINETIC MODELS AND DATA

123I

METAIODOBENZYLGUANIDINE (MIBG)
13.2 hours

Organ

per Adult l. lE-02 ?.OE-02 7.6E-03 6.2E-03 7.0E-03 8.3E-03 a. 9E-03 7.7B-03 l. lE-02 1.4E-02 7.1E-02 1.6E-02 E.OE-03 l. lE-02 1.7802 9.2E-03 2.OE-02 5.43-03 4.2%03 l. lE-02 6.5E-03

unit

Absorbed dose activity administered (mGy/MBq) 15 year 10 year 5 year 1 year 1.5E-02 8.7E-02 9.3E-03 6.23-03 l .OE-02 l .OE-02 l. lE-02 9. EE-03 1.4E-02 1.7E-02 8.9E-02 2.3E-02 l .OE-02 1.5E-02 2.2E-02 1.2E-02 2. EE-02 7.3E-03 6.2E-03 1.4E-02 7. EE-03 2.2E-02 1.3E-01 1.5E-02 9 :8E-03 1.7E-02 1.7E-02 1. EE-02 1.6E-02 2.1B-02 2.5E-02 1.3%01 3.2E-02 1.6E-02 2.5E-02 3.1E-02 1.7E-02 4.3E-02 1.2E-02 l.OE-01 2.3E-02 1.2E-02 3.1E-02 1.9E-01 2.3%02 1.6E-02 2. EE-02 2.7E-02 3.1E-02 2.48-02 3.1B-02 3.6E-02 1.9E-01 4. EB-02 2.6E-02 3.9E-02 4.5E-02 2.5E-02 6.6E-02 2.OE-02 1.7%01 3.6E-02 1.9%02 5.1E-02 3.5E-01 4.5E-02 3.0%02 5.1E-02 5.OE-02 5.6E-02 4.5E-02 5.6B-02 6.OE-02 3.4E-01 9.1E-02 4,7E-02 6.9E-02 7.2E-02 4.5%02 1.2E-01 3.83-02 3.1E-01 6.5E-02 3.5E-02

Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Heart Kidneys Liver Lungs Ovaries Pancreas Salivary

* *

* *

glands

Red marrow Spleen Testes Thyroid Uterus Other tissue

Effective dose equivalent (=Sv/KW

l.EB-02

2.3%-02

3.4E-02

5.0%02

9.OE-02

ose 1241 1251 (4.18 (60.14 d) d)

equivalent 2.4E-01 4.9E-02

(mSv/MBq of 3.OE-01 6.3E-02

the

impurity) 4.4E-01 9. EE-02 6.7E-01 1.5E-01 1.2E+OO 2.9E-01

330

RADIATION

DOSE TO PATIENTS FROM RADIOPHARMACEUTICALS 53 MIBG

1311

METAIODOBENZYLGUANIDINE (MIBG)
0.04 days

Organ Adult * * Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Heart Kidneys Liver Lungs Ovaries Pancreas Salivary

per

unit

Absorbed dose activity administered 15 year 10 year 3 * 3E-01

(uIGY/I~B~)
I year 6.9E-01 3.3E+UO 3.6E-01 3.5E-01 4.7E-01 4.5B-01 4.8E-01 3.9E-01 3.5E-01 5.1E-01 4.6E+OO 1.2E+OO 4.2E-01 5.7E-01 7.5E-01 3.5E-01 3.2E+OO 3.6E-01 3.5E-01 4.8E-01 3.7E-01

5 year 4.5E-01 1.7E+OO 1.8&01 1.8E-01 2.5%01 2.4&01 2.6&01 2.1E-01 2.OE-01 3.OE-01 2.4B+OU b.OB-01 2.3B-01 3.2B-01 5 * lE-01 1.9E-01 1.78+00 1.9E-01 1.83-01 2.6%01 1 t 9E-01

1.7E-01 5.9E-01 6.1E-02 6.9E-02 7.7E-02 7.4E-02 8.OE-02 6. BE-02 7.2E-02 1.2E-01 8.3E-01 1.9E-01 6.6E-02 l .OE-01 2.3E-01 6.7E-02 4.9E-01 5.9E-02 5.OE-02 8.0%02 6.2E-02

2.3E-01 7.3E-01 7.2%02 6.9E-02 9.3E-02 9.1E-02 9.6%02 8.1E-02 9.1E-02 1.4E-01 1. lE+OO 2.8E-01 8.8E-02 1.3E-01 2.8E-01 8.3E-02 6.9E-01 7.OE-02 6.5E-02 l . OE-01 7.5E-02

lE+OO

l. lE-01 l.lE-01 1.5E-01 1.5E-01 1,6E-01 1.3E-01 1.4E-01 2.1E-01 1.6E+OO 3.9&01 1.4E-01 2.OE-01 3.8E-01 1.3E-01

* *

glands

Red marrow Spleen Testes Thyroid Uterus Other

1 . lE+OO
l. lE-01 l. lE-01 1.6E-01 l . ZE-01

tissue

Effective dose equivalent (mSv/llBq)

Z . OE-01

2.6%01

4.OB-01

6-l&01

1 .lE+OO

331

RADIATION

DOSE TO PATIENTS FROM RADIOPHARMACEUTICALS

I 53 Rose bengal

SODIUM ROSE BENGAL

1231 1311

Biokinetic Model Rose bengal is a halogenated fluorescent dye, sodium-tetrachloro-tetraiodo-fluorescein, used for testing hepato-biliary function. Its biokinetics are similar to the Tc-labelled iminodiacetic acid (IDA) derivatives (see p. 201). The biokinetic model and the clinical conditions considered are defined in Appendix Section A.9. Reference
MIRD Dose Estimate Report No. 7 (1975). Summary of current radiation dose estimates to humans from iz31, iY, 1261,1301and i3iI as sodium rose bengal. J. Nucl. Med. 16, 12141217.

Biokinetic Data

Organ (S)

Fs

1231

,311

(1) Normal hepato-biliary conditions 1.0 Blood 0.95 Liver Gallbladder GI-tract content SI ULI LLI Kidneys Bladder contents (2) Parenchymal liver disease Blood Liver Gallbladder GI-tract content SI ULI LLI Kidneys Bladder contents (3) Occlusion of the cystic duct Blood Liver Gallbladder GI-tract content SI ULI LLI Kidneys Bladder content 0.10 0.95 0.95 0.95 0.05 0.05 1.0 0.35 0.03 0.35 0.35 0.35 0.65 0.65 1.0 0.70 0 0.70 0.70 0.70 0.30 9.30

7.5 min 7.5 min 90 min

1.0 -1.0 1.0

10.7 min 1.75 hr 19.9 min 2.75 hr 5.31 hr 4.33 hr 15 s 9.1 min

10.8 min 2.04 hr 29.0 min 3.71 hr 11.5 hr 19.6 hr 15s 9.9 min 28.8 min 1.98hr 13.4 min 1.35 hr 4.18 hr 6.99 hr 3.25 min 1.96 hr 14.4 min 1.50 hr

20 min 20 min 4 hr

1.0 -1.0 1.0

28.1 min 1.51 hr 6.48 min 50.8 min 1.64 hr 1.34 hr 3.16 min 1.77 hr

10 min 10 min 1.5 hr

1.0 -1.0 1.0

14.2 min 1.34 hr 2.05 hr 3.96 hr 3.18 hr 1.48 min 53.3 min

2.74 hr 8.50 hr 14.2 hr 1.50 min 58.3 min

continued

333

I 53 Rose bengal

BIOKINETIC MODELS AND DATA

Biokinetic Data (continued)

Organ (S)

Fs

T 7.5 min 7.5 min 8d

12q

131I

(4) Occlusion of the common bile duct Blood 1.0 Liver 0.95 Gallbladder GI-tract contents SI ULI LLI Kidneys Bladder contents 0 0 0 0 1.0 1.0

1.0 -1.0 1.0

10.7 min 16.9 hr -

10.8 min 5.49 d 2.63 min 1.00 hr

33 s 15.3 min

SODIUM ROSE BENGAL

1231 13.2
hours

per Organ Adult

unit

Absorbed dose activity administered 15 year l .OE-02 3.6E-02 8.83-03 1.4E-03 1,4E-01 2.OE-02 1.9E-01 4.3E-01 4.8E-01 1.5E-02 5.6E-02 4.OE-03 9.OE-02 1.5E-02 2.5E-02 7.5E-03 5.7E-03 3.9E-04 4.3E-02 l .OE-02 10 year 1.6E-02 5.7E-02 1.3E-02 3 .OE-03 1.9E-01 3.2E-02 3.2E-01 7.2E-01 8.2E-01 2.4B-02 8.83-02 6.2E-03 1.4E-01 2.6E-02 3.43-02 1.3E-02 l.lE-02 8.4E-04 7.1E-02 1,5E-02

(mGy/MBq) 5 year 2.5E-02 8.7E-02 2.1E-02 5. SE-03 3.2E-01 5.3E-02 5.OE-01 1.2EtOO 1.3E+OO 3.6&02 1.3E-01 l .OE-02 2.1E-01 4.3B-02 4.3E-02 2.2E-02 1.8E-02 1.7E-03 l. lE-01 2.4E-02 1 year 4.2E-02 1.6E-01 4.4E-02 l. lE-02 9.2E-01 9.93-02 9,OE-01 2.2E+OO 2. SE+00 5.9E-02 2.4E-01 2.OE-02 3.6E-01 7.9E-02 5.7E-02 4.1E-02 3.7E-02 3,9E-03 2.OE-01 4.3E-02

Adrenals Bladder wall

Bone surfaces Breast Gall bl wall GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue

7.OE-03 2.9E-02 6.9E-03 1.4E-03 1.2E-01 1.6E-02 1.5E-01 3.5E-01 3.9E-01 1.3E-02 4.53-02 2.8E-03 7.1E-02 l. lE-02 2.1E-02 5.93-03 4.OE-03 3 .OE-04 3.1E-02 8.3E-03 7.6B-02

Effective dose equivalent (&J/BBq)

9.4B-02

1.5E-01

2.4E-01

4.7E-01

ii!!%%ose
lz41 1251 (4.18 (60.14 d) d)

equivalent

(mSv/MBq of 1.3E+OO 1.9E-01

the

impurity) 2.2E+OO 3.2E-01 3. bE+OO 5.3E-01 6.9E+OO 1 .OE+OO

1.lE+OO
1.5E-01

334

RADIATION

DOSE TO PATIENTS FROM RADIOPHARMACEUTICALS 53 Rose kngal

SODIUM ROSE BENGAL

Parenchysal liver disease 13.2 hours

par

unit

Absorbed dose activity administered 15 year 6.5E-03 1.7E-01 4.4E-03 1.2E-03 5.4E-02 7.8E-03 6.3E-02 1.3E-01 1.6E-01 1.3E-02 10 year l.OE-02 2.673-01 6.6%03 2.2&03 7.6E-02 1.3E-02 l .OE-01 2.3E-01 2.6E-01 1.9E-02 6.6E-02 4.6E-03 5.2E-02 1.3E-02 1. SE-02 6.3E-03 1.2E-02 l. lE-03 4.6E-02 8.2E-03

(mGy/MFSq)
5 year 1.5E-02 3.9E-01 l. lE-02 3. BE-03 1.2E-01 2.2E-02 1.6E-01 3.7&01 4.3E-01 2.8E-02 9.78-02 7 *3E-03 E.OE-02 2.2E-02 1.9E-02 l .OE-02 2.1E-02 2.OE-03 7.1&02 1.3E-02 1 year 2.5E-02 7.1E-01 2.2E-02 7.5E-03 3.4E-01 4.18-02 2.9B-01 6.9E-01 E. lE-01 4.7%02 1. EE-01 1.43-02 1.4E-01 3.9E-02 2.6E-02 1.9E-02 4.1E-02 4.1E-03 1.3B-01 2.3E-02

Organ
Adult Adrenals Bladder wall Bone surfaces Breast Gall bl wall GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other Bffective tissue 4.6E-03 1.4E-01 3.5E-03 1.2E-03 4.X-02 6.1E-03 5.OE-02 l. lE-01 1.3%01 l . OE-02 3.5E-02 2.2E-03 2.7%02 5.5E-03 8.78-03 2.8E-03 4.4E-03 4.5E-04 2.1E-02 4.5E-03

* * * *

4.33-02
3.1E-03 3.4E-02 7.6E-03 1 .OE-02 3.6B-03 6.5E-03 6.5E-04 2.7E-02 5.4E-03

dose equivalent (mSv/nBq)

3.4B-02

4.2E-02

6.78-02

l . OB-01

2.0%01

335

I 53 Rose bengal

BIOKINETIC MODELS AND DATA

SODIUM ROSE BENGAL

Occlusion 123I 13.2 hours per Organ Adult Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue 5.2&03 8.1&02 5.4E-03 l . lE-03 1.2E-02 1.2E-01 2.6E-01 2.9E-01 l.lE-02 3.43-02 2.1E-03 5.5E-02 7.5E-03 1.6E-02 4.5E-03 4.3E-03 3.OE-04 2. EE-02 6.6E-03 15 year 7.5E-03 l .OE-01 6.83-03 l. lE-03 1.4E-02 1.5E-01 3.2E-01 3.6E-01 1.3E-02 4.2E-02 3.OE-03 6.9E-02 l .OE-02 1.9E-02 5.7E-03 6.3E-03 4.1E-04 3.83-02 E.OE-03 10 year 1*2E-02 1. SE-01 l .OE-02 2 .3E-03 2.3E-02 2. 4E-01 5.4E-01 6.OE-01 2.1E-02 6.53-02 4.7E-03 l. lE-01 1.7E-02 2.6E-02 9.9e-03 1.2E-02 E . OE-04 6.3E-02 1.2E-02 5 year l .EE-02 2.3E-01 1.6E-02 4.2E-03 3. EE-02 3.7e-01 8.6E-01 9.8E-01 3.2E-02 9.83-02 7.7E-03 1.6E-01 2.8E-02 3.4E-02 1.6E-02 2 .OE-02 1.5E-03 l . OE-01 1.9E-02 1 year 3.2E-02 4.1E-01 3.4B-02 8.5E-03 7.1E-02 6.7E-01 1.6&+00 1.9E+OO 5.2&-02 1. EE-01 1.5E-02 2. EE-01 5.4E-02 4.4E-02 3.1E-02 4.OE-02 3.5E-03 l.EE-01 3.4B-02 unit Absorbed dose activity administered (mGy/MBq) of the cystic duct

*
* *

Effective dose equivalent (=Sv/llBq)

5 . ?B-02

7.OE-02

l . lE-01

l.EB-01

3.4E-01

Occlusion Organ * * Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue Adult 3.1E-02 2.1E-02 6.823-03 6.8E-03 l. lE-02 9.7E-03 1.5E-02 2,1E-03 2.5E-02 3.6E-01 1.7E-02 3.2E-03 2.5E-02 9.4E-03 5.3E-03 9*4E-04 l. lE-03 3.9E-03 7.1E-03

of

the

common bile 10 year 6.5E-02 3.9E-02 1.3E-02 1.2E-02 3.2E-02 2.3E-02 3.7E-02 5.7E-03 4.7E-02 6.6E-01 3.4E-02 9. EE-03 6.5E-02 1.9E-02 1.5E-02 2.2E-03 2.5E-03 l. lE-02 1.3E-02

duct 5 year 8.6E-02 6.4E-02 2.1E-02 2.OE-02 5. EE-02 4.2E-02 6.88-02 l. lE-02 6.7E-02 9.5E-01 5.OE-02 1. EE-02 l.lE-01 2.7E-02 2.5E-02 4. SE-03 4.9%03 2 .OE-02 2,OE-02 1 year 1.3E-01 1.2E-01 4.53-02 3.9&02 l.lE-01 7.7E-02 1.2E-01 2.2E-02 l.OE-01 1,7E+OO 8,9E-02 3.6E-02 l.EE-01 4.3E-02 4.4E-02 l .OE-02 l . OE-02 4.OE-02 3.7E-02

15 year 4.4E-02 2.6E-02 8.9E-03 6. EE-03 1.7E-02 1.2E-02 1.9E-02 2. EE-03 2.9E-02 4.5E-01 2.4E-02 4.9E-03 4.OE-02 1.4E-02 8.3E-03 l.lE-03 1.2E-03 5.6E-03 8.6E-03

* *

Effective dose equivalent (mSv/nas)

3.3E-02

4.2E-02

6.3B-02

9.2B-02

1.7B-01

336

RADIATION DOSE TO PATIENTS FROM RADIOPHARMACEUTICALS

I 53 Rose bengal

Newborns. Congenital 123I 13.2 hours

SODIUM ROSE BENGAL

biliary

atresia

Organ

Absorbed dose per unit activity administered (mGy/MBq) l.OE-01 3.1E-01 8.3E-02 1.4E-01 3.9E-01 2,4E+Ol 6.1E-02 7.9E-01 3.9E+OO 2.OE-01 2.7E-01 2 .OE-01 1.3E-01 6.2E-02 8.1E-02 3.43-02 l.lE-01 7.OE-02 1.8I?+OO

* * * *

Adrenals Bladder wall Bone surfaces CI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue Effective dose equivalent (mSv/IIBq)

331

I 53 Rose bcngal

BIOKINETIC

MODELS

AND DATA

SODIUM
131I 8.04 days per Adult Adrenals Bladder wall Bone surfaces Breast Gall bl wall GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue 2.9E-02 1.7E-01 2,9E-02 6.5E-03 7.1E-01 7.4E-02 8.9E-01 3.4E+OO 8.8E+OO 5.6E-02 2.OE-01 9.6E-03 4.OE-01 4.5E-02 8.4E-02 3.2E-02 3.6E-02 1.3E-03 1.6E-01 4.6E-02 unit

ROSE BENGAL
Absorbed dose activity administered 15 year 4.OE-02 2. IE-01 3.5E-02 6.6E-03 8.4E-01 9.4E-02 1. lE+OO 4.2E+OO 1. lE+Ol 6.9E-02 2.5E-01 1.3E-02 5.OE-01 6.OE-02 9.6E-02 3.9E-02 4.4E-02 1.6E-03 2.2E-01 5.43-02 10 year 6.3E-02 3.5E-01 5.OE-02 1.5E-02 1. lE+OO 1.5E-01 1.9E+OO 7.4E+OO 1.9B+Ol l. lE-01 4.OE-01 2.3E-02 7.4E-01 l .OE-01 1.2E-01 7.OE-02 8.7E-02 3.7E-03 3.6E-01 8.2E-02

Organ

(mGy/MBq) 5 year l .OE-01 5.1E-01 7.5E-02 2.7E-02 2.OE+OO 2.4E-01 3.OE+OO 1.2E+Ol 3.2EtOl 1.6E-01 6.1E-01 3.7E-02 1. lE+OO 1.7E-01 1.5E-01 l. lE-01 1.3E-01 7.9E-03 5. SE-01 1.2E-01 1 year 1.8B-01 9.OE-01 1.5E-01 5.3E-02 6.8E+OO 4.2E-01 5.6E+OO 2.4E+Ol 6.3E+Ol 2,5E-01 1.2E+OO 7.7E-02 1.8E+OO 2.9E-01 1.8E-01 2.OE-01 2.7E-01 1.9E-02 9.2E-01 2.2E-01

* *

*
* *

Effective dose equivalent (mSv/lIBq)

9.1B-01

1.lB+OO

1.9E+OO

3.2E+oo

6.3E+OO

Parenchymal Organ Adrenals Bladder wall Bone surfaces Breast Gall bl wall GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue Adult 1. BE-02 6.9E-01 1.3E-02 5.1E-03 3.5E-01 3.lE-02 3.3E-01 1.2E+OO 3,2E+OO 4.7E-02 1.7E-01 7.2E-03 1,6E-01 2.3E-02 3.5E-02 1.4E-02 2,1E-02 1.9E-03 8.2E-02 2.1E-02

liver

disease 10 year 3.63-02 1.3E+OO 2.4E-02 l.OE-02 5.7E-01 6.2E-02 6.9E-01 2.7E+OO 6.8E+OO 0.7E-02 3.4E-01 1.6E-02 2.9E-01 5.1E-02 5.3E-02 3.2E-02 5.3E-02 4.4B-03 1. EE-01 3. EE-02 5 year 5.6E-02 2.OE+OO 3.6E-02 1.7E-02 9.9E-01 l .OE-01 1. lE+OO 4.5E+OO 1 year 9.6E-02 3.9E+OO 7.OE-02 3.4E-02 3.3E+OO 1. BE-01 2.1E+OO 8.9E+OO 2.2E+Ol 2.2E-01 9.9E-01 4.83-02 7.1E-01 1.4E-01 0.3E-02 9.2E-02 1.6E-01 1.7E-02 4.5E-01 l.OE-01

15 year 2.4E-02 8.6E-01 1.6E-02 5.1E-03 4.2E-01 3.9E-02 4.1E-01 1.5E+OO 3.9E+OO 5,9E-02 2.2E-01 9.9E-03 1.9E-01 3.OE-02 4.OE-02 1.8E-02 2,7E-02 2.4E-03 l. lE-01 2.6E-02

*
* *

1. lE+Ol
1.3E-01 5.2E-01 2.5E-02 4.2E-01 8.3E-02 6,5E-02 5.1E-02 8.1E-02 0.2E-03 2.7E-01 5.9E-02

Effective dose equivalent WV/W)

3.8B-01

4.6%01

7.8%01

1.3B+oo

2_6B+OO

338

RADIATION

DOSE TO PATIENTS

FROM RADIOPHARMACEUTICALS

I 53 Rose bengal

SODIUM ROSE BENGAL

Occlusion of the cystic duct 131I 8.04 days per Organ Adult Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Suleen Testes Thyroid Uterus Other Effective tissue Z. lE-02 4.1E-01 Z.ZE-02 5.2E-03 5.43-02 6.5E-01 2.5E+OO 6.4E+OO 4.9E-02 1.5E-01 7.3E-03 3.OE-01 3.2E-02 6.3E-02 2.3E-02 3.OE-02 1.4E-03 1.3E-01 3.5E-02 15 year 2.9E-02 5.OE-01 2.6E-02 5.2E-03 6. EE-02 E.lE-01 3.1E+OO 7.9E+OO 6,2E-02 1. EE-01 l ,OE-02 3.7E-01 4,2E-02 7.1E-02 2.9E-02 3.7E-02 1.7E-03 l.EE-01 4.1E-02 10 year 4,6E-02 7.9E-01 3. EE-02 l.ZE-02 l. lE-01 1.4E+OO 5.5E+OO 1.4E+Ol 9.4E-02 2.9E-01 1.7E-02 5.5E-01 7 .OE-02 9.3E-02 5.1E-02 7.3E-02 3.7E-03 2.8801 6.2E-02 5 year 7.5E-02 l.ZE+OO 5 e7E-02 Z. lE-02 1.7E-01 2. ZE+OO 9.1E+OO 2.3E+Ol 1.4E-01 4.5E-01 2.83-02 E.OE-01 l. lE-01 l. lE-01 E. ZE-02 l. lE-01 7.4E-03 4.3E-01 9.5E-02 1 year 1.3E-01 Z.ZE+OO l. lE-01 4.1E-02 3.OE-01 4.1E+OO 1. EE+Ol 4.6E+Ol 2.3E-01 8.5E-01 5.83-02 1.3E+OO Z .OE-01 1.4E-01 1.5E-01 Z.ZE-01 1.7E-02 7.2E-01 1.7E-01 unit Absorbed dose activity administered

(mGy/MBq)

* * * *

dose equivalent Wv/IIB9)

6.6E-01

8.1E-01

1.4E+OO

2.3E+OO

4.5B+OO

Occlusion Organ * * Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue Adult 5.OE-01 3.6E-01 8.2E-02 1.3E-01 1.9E-01 1.7&01 2.6E-01 3.5E-02 4.OE-01 1. lE+Ol 2.5E-01 4.OE-02 4.4E-01 l.ZE-01 l.OE-01 1.5E-02 Z. lE-02 5.4E-02 l. lE-01

of

the

common bile 10 year 9.8E-01 7.OE-01 1.5E-01 2.4E-01 4.9E-01 3.8&01 5. BE-01 8.7E-02 7.3E-01 2.1E+Ol 4.8E-01 1.7E-01 9.8E-01 2.2E-01 2.6E-01 3.1E-02 4.3E-02 1.7E-01 Z .OE-01

duct 5 year 1.3E+OO 1.28+00 2.3E-01 3. EE-01 8.5E-01 6.5E-01 9.5E-01 1. EE-01 1 year 1.9E+OO 2,2E+OO 4.6E-01 6.9E-01 1. EE+OO

15 year 6.9E-01 4,5E-01 l .OE-01 1.3E-01 2.7E-01 Z .OE-01 3.OE-01 4.5E-02 4.8E-01 1.3E+Ol 3.4E-01 8.3E-02 6.1E-01 1.7E-01 1.5E-01 1.4E-02 2.4E-02 8. EE-02 1.4E-01

1. lE+OO
1. EE+OO 3.4E-01 1.5E+OO 5.9E+Ol 1.2E+OO 5.7E-01 2. SE+00 4.3E-01 7.4E-01 1.4E-01 1.8%01 5. EE-01 5.5E-01

* *

1.lE+OO
3.1E+Ol 7.OE-01 2.9E-01 1.5E+OO 2.9E-01 4.2E-01 6.4E-02 8.7E-02 3.1E-01 3.OE-01

Bffective dose equivalent (=Sv/ltBg)

8.2B-01

l.oB+oo

1.6B+oo

2.4B+oo

4.5B+OO

339

I 53 Rose bengal

BIOKINETIC MODELS AND DATA

SODIUM ROSE BENGAL

Newborns.

Congenital

biliary

atresia

1311

0.04

days Absorbed dose per unit activity administered (mGy/MBq) 9.3E-01 5.9E+OO 7.3E-01 1.9B+OO 2.6E+OO 7. lE+OO ?.2E-01 3.1E+OO 1.3EtO2 l.BE+OO B.6E-01 3.OE+OO 1.3E+OO 9.2E-01 0.2E-01 5.1E-01 1 . OE+OO 9.OE-01 9.9B+oU

Organ *

* * *

Adrenals Bladder wall Bone surfaces GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue Effective dose equivalent WIv/llBq)

340

RADIATION

DOSE TO PATIENTS

FROM

RADIOPHARMACEUTICALS

Xe 54

Gas/Solution

XENON
12Xe 33Xe

Biokinetic Model Radioactive xenon can be administered as a gas by inhalation or as xenon dissolved in saline through intravenous injection. Xenon gas is inhaled as a single breath or it can be contained in a closed spirometer system from which the patient is rebreathing for 2-60 min, usually 5 or 10 min. There are also other techniques which can be regarded as combinations of the methods described. The MIRD-model (Atkins et al., 1980) which is partly based on the references given below, is adopted here. The total body retention of xenon has been described as a sum of four exponential functions associated with xenon retention in the lungs, (air and tissue), lean body mass and fat (two fat components). For the purpose of absorbed dose calculations it is assumed that xenon not present in the lungs is uniformly distributed in the rest of the body. The rate of uptake in the rest of the body during breath-hold and rebreathing is assumed to be the same as the elimination rate observed after discontinuing the xenon administration. References
Ackery, D. M. and Goddard, B. A. (1975). Radiation doses from lJJXe and *Xe used for lung function investigations. In: Radioaktive Isotope in Klinik und Forschung 1 I. Band. pp. 3143. (HGfer, R. ed.) Urban und Schwarzenberg, Miinchen. Atkins, H. L., Robertson, J. S., Croft, B. Y., Tsui, B., Susskind, H., Ellis, K. J., Loken, M. K. and Treves, S. (1980). Estimates of radiation absorbed doses from radioxenons in lung imaging. Mird Dose Estimate Report No. 9. J. Nucl. Med. 21,459-465. Goddard, B. A. and Ackery, D. J. (1975). Xenon-133, 12Xe and *Xe used for lung function investigations: A dosimetric comparison. J. Nucl. Med. 16, 780-786. Susskind, H., Atkins, H. L., Cohn, S. H., Ellis, K. J. and Richards, P. (1977). Whole body retention of radioxenon. J. Nucl. Med. l&462471

Biokinetic Data

Organ (S)

F,

Xe

la3Xe

(1) Single inhalation with 30 s breathhold, or i.v. injection 0.98 22 s Lungs 3.1 min 0.02 24 min Remaining tissues 2.7 hr 11 hr (2) Rebreathina for 5 min 0.86 22 s Lungs 3.1 min 0.14 24 min Remaining tissues 2.7 hr 11 hr (3) Rebreathing for 10 min 0.77 22 s Lungs 3.1 min Remaining tissues 0.23 24 min 2.7 hr 11 hr

with 30 s breathhold 0.98 36 s 0.02 0.50 4.8 min 0.35 0.15 0.91 0.09 0.50 0.35 0.15 0.88 0.12 0.50 0.35 0.15 46 s 34 min

36 s 4.6 min

46 s 32 min

46 s 55 min

46 s 53 min

341

XC

BIOKINETIC MODELS AND DATA

54 Gas/Solution

Single 12Xe

inhalation days

or i.v.

XENON GAS
injection,

with 30 s breathhold

36.41

Organ * Adrenal8 Bladder wall Bone surfaces Breast G1-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue Effective dose equivalent Wv/nas)

per unit Adult 1.3B-04 l . lB-04 1.2B-04 l.lE-04 1.2E-04 1.2E-04 1.2E-04 1.18-04 l. lE-04 1.28-04 3.48-04 l . lE-04 1.4B-04 1.4B-04 1.28-04 8.3E-05 8.98-05 1.2B-04 9.9E-05 1.4B-04

Absorbed done activity adminirtcrcd 15 year 1.68-04 1.4E-04 1.48-04 1.18-04 1.4B-04 1.5E-04 1.48-04 1.4B-04 1.38-04 1.5E-04 5 *OB-04 1.5B-04 1.6B-04 1.78-04 1.4B-04 l. lB-04 1.38-04 1.58-04 1.2B-04 1.8B-04 10 year 2.48-04 2.1E-04 2.3B-04 1.6E-04 2.2B-04 2.38-04 2 *lE-04 2,2B-04 2.18-04 2.2B-04 6.9B-04 2.3E-04 2.5&04 2.5B-04 2.2E-04 1.6E-04 2.18-04 2.3B-04 1.88-04 2. B-04

(mGy/mq)

5 year 3. B-04 3.1E-04 3.5Ba04 2.5B-04 3.38-04 3.5&04 3.48-04 3.2E-04 3.2E-04 3.4E-04 1.08-03 3.5B-04 3.88-04 3. B-04 3.48-04 2.6B-04 3.4E-04 3.W-04 2-88-04

1 year 6. B-04 5. B-04 6. B-04 4.6E-04 5.83-04 6.38-04 5.98-04 6.08-04 5.88-04 6.2B-04 1.9E-03 6.3E-04 6.98-04 6. E-04 6.3B-04 4.E-04 6.28-04 6.3B-04 5.28-04 7.5B-04

* *

4.1B-05

342

RADIATION

DOSE TO PATIENTS FROM RADIOPHARMACEUTICALS

Xe 54

Gas/Solution

XENON GAS
Rebreathing 127X8 36.41 days per Organ Adult
l

for

5 minutes

unit

Absorbed dose activity administered 15 year 9. E-04 l .OB-03 9.6E-04 6.4E-04 9.4E-04 l .OE-03 9.9B-04 9.6E-04 9.OB-04 9.2B-04 l . lE-03 l . OE-03 l.OE-03 l.lE-03 9.2E-04 7.242-04 a,B-04 l .OE-03 7 .B-04 10 year 1.5B-03 1.5%03 1.5E-03 9.3B-04 1.5E-03 1.6E-03 1.5B-03 1.5E-03 1.4B-03 1.4B-03 1.6E-03 1.6E-03 1.6E-03 1.6B-03 1.4E-03 l.lE-03 1.4E-03 1.6E-03 l . ZB-03

(mGy/MBq) 5 year 2.3B-03 Z . ZB-03 2.3B-03 1.5E-03 Z . ZB-03 2.4B-03 2.4B-03 Z . ZE-03 2.1%03 Z . ZB-03 2.4B-03 2.4E-03 2. hB-03 2.4B-03 Z . ZE-03 1*8B-03 Z.ZB-03 2.4B-03 1.9B-03 1 year 4.2%03 3.9B-03 4.4B-03 2.0E-03 3.8E-03 4.3B-03 h. lB-03 4.2g-03 3.9E-03 4.OB-03 4.4B-03 4.48-03 4.4E-03 4.4B-03 4 .OB-03 3.3B-03 4.1B-03 4.43-03 3.4E-03

*
l

Adrenals Bladder vall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI vall Kidneys Liver Lungs Ovaries

8 .OE-04
7. B-04 0.1B-04 6.5E-04 8.lE-04 0.5E-04 B . OE-04 7. B-04 7.5E-04 7. XL04

0.2B-04
8.OE-04 8. m-04

Pancreas
Red marrow Spleen Testes Thyroid Uterus Other tissue

9.OE-04
.0E-04 5.03-04 6.OE-Oh a. R-04 6.5E-04

Bffcctive dose equivalent (=Sv/)W

7.7B-04

9.4B-04

1.4B-03

2.2B-Q3

4.OB-03

Rebreathing

for 15 year 1.6B-03 1.6E-03 1.6B-03 l .OB-03 1.5B-03 1. B-03 1.6B-03 1.6g-03 1.5E-03 1.5E-03 1.5E-03 1. E-03 1. E-03 1.0E-03 1.5E-03 l . ZE-03 1.4E-03 1. E-03 1.3E-03

10 minutes 10 year 2.4B-03 2.43-03 2.4B-03 1.5B-03 2.4B-03 2.6E-03 2.4E-03 2.5E-03 2.3E-03 2.3B-03 Z. lE-03 2.6E-03 2.6E-03 2. E-03 2.3g-03 1.9E-03 2.3E-03 2.61-03 1.9E-03 5 year 3.7B-03 3.6B-03 3.8B-03 2.41-03 3.68-03 3.91-03 3.93-03 3. B-03 3.5B-03 3.5B-03 3.2B-03 4.08-03 4.OB-03 4.OB-03 3*5B-03 2 *98-03 3. B-03 4.OE-03 3.OE-03 1 year 6. BB-03 6.5B-03 ? . ZB-03 4.5B-03 6.28-03 . lB-03 6. E-03 6.86-03 6.48-03 6.5E-03 5.8E-03 .2E-03 . lB-03 .ZB-03 6.5B-03 5.4E-03 6. E-03 7.2&-03 5.6B-03

Organ
* Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI vall LLI vall Kidneys Liver Lungs Ovaries Pancreas Red marrov Soleen Testes Thyroid Uterus Other tissue

Adult 1.3E-03 1.3E-03 1.3B-03 l . OE-03 1.3E-03 1.4E-03 1.31-03 1.3E-03 l .ZE-03 1.2E-03 1.13-03 1.3E-03 1.4E-03 1.5E-03 1.3E-03 9.6E-04 9. m-04 1.4E-03 l. lE-03

*
*

Effective dose equivalent WV/W)

l-23-03

1.51-03

2.233-03

3.5B-03

6.3B-03

343

XC 54 Gas/Solution

BIOKINETIC MODELS AND DATA

Single inhalation
133Xe 5.245 days

or

XENON GAS
i.v. injection,

with

30 s breathhold

Organ

per Adult

unit

Absorbed dose activity edminirtered 15 year 1.3E-04 1.3B-04 1.4B-04 1.2E-04 1.3B-04 1.3B-04 1.3B-04 1.3B-04 1.3B-04 1.3B-04 1.2B-03 1.3B-04 1.3B-04 1.5B-04 1.3B-04 1.2B-04 1.3E-04 1.3B-04 1.2E-04 10 year 2.2B-04 2.2B-04 2.4B-04 2.1B-04 2.2B-04 2.2B-04 2.2B-04 2.2B-04 2.1E-04 2.23-04 1.7B-03 2.2B-04 2.2B-04 2.5B-04 2.2B-04 2 .OB-04 2.2B-04 2.2B-04 2.lB-04

(mGy/MBq) 5 year 3.7B-04 3.6B-04 4.OB-04 3.4B-04 3.6E-04 3.6B-04 3.6B-04 3.6B-04 3.6B-04 3.6E-04 2.6B-03 3.6B-04 3.7B-04 4.1E-04 3.6B-04 3.43-04 3.6B-04 3.6E-04 3.5E-04 1 year 7.4B-04 7.3B-04 8.2B-04 6.9B-04 7.3B-04 7.3B-04 7.3B-04 7.3B-04 7.2B-04 7.3B-04 5.3B-03 7.3B-04 7.4E-04 8.2B-04 7.3B-04 6.9B-04 7.3E-04 7.33-04 7 .OB-04

Adrenals Bladder wall Bone surfaces

Breast
* * GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue

l . OE-04 l . OB-04 1.2B-04 1.2E-04 l . OB-04 l. lE-04 l . lB-04 1.1%04 l . OB-04 l. lB-04 7.7B-04 l . OB-04 l. lB-04 1.2B-04 l . lB-04 9.93-05 9.9E-05 l. lB-04 l . OB-04

* *

Effective dose equivalent (=Sv/rres)

1.9E-04

2.6B-04

4.OB-04

6.4B-04

1.3B-03

344

RADIATION

DOSE TO PATIENTS FROM RADIOPHARMACEUTICALS

Xe 54

Gas/Solution

XENON GAS
Rebreathing 133Xe 5.245 days per Organ Adult Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other 8ffective tissue J. lE-04 8.0%04 8.3E-04 15 year 9.OR-04 9.1E-04 9.9E-04 8.3E-04 9.OE-04 9.OE-04 9. HI-04 9.OE-04 8.8E-04 8.98-04 1. JE-03 9.1E-04 9. IE-04 l .OE-03 8.9E-04 8.5&04 8.8E-04 9.1E-04 8.6%04 10 year 1.58-03 1.5E-03 1.78-03 1.4E-03 1.5E-03 1.5E-03 1.5E-03 1.5E-03 1.5E-03 1.5E-03 2.4E-03 1.5E-03 1.5E-03 1. JE-03 1.5E-03 1.4E-03 1.5E-03 1.5E-03 1.4E-03 5 year 2.5E-03 2.5E-03 2.8E-03 2.38-03 2.5E-03 2. !.iE-03 2.58-03 2.5E-03 2.5E-03 2.5E-03 3. JE-03 2.5E-03 2.5E-03 2.8E-03 2.5E-03 2.48-03 2.58-03 2.5E-03 2.4E-03 1 year 5.OE-03 5.1%03 5.6E-03 4. JE-03 5.0X&03 5.1E-03 5.OE-03 5.1E-03 5.OE-03 5.OE-03 unit Absorbed dose activity administered (mGy/HBq) for 5 minutes

7.3B-04

* * * *

7.2&04 7.4E-04 7.4E-04 7.4E-04 7.2E-04 7.3E-04

l . lE-03

7.3E-04 7.4E-04
a. 4E-04

7.5E-03
5.1E-03 5.1E-03 5,6E-03 5.0&03 4.8E-03 5.OE-03 5.1E-03 4. BE-03

7.3E-04
6.9E-04 6.9E-04

7.4E-04 J . OE-04
8.0%04

dose equivalent Wv/lIBq)

1.0%03

1.6E-03

2.73-03

5.4B-03

Rebreathing Organ Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue Adult 1.2E-03 1.2E-03 1.3E-03 1.4E-03 1.2&03 1.2E-03 1.2E-03 1.2E-03 1.2E-03 1.2E-03 1.2E-03 1.2E-03 1.2E-03 1.4E-03 1.2E-03 l. lE-03 l. lE-03 1.2.8-03 1.2E-03

for 15 year 1.5E-03 1.58-03 1.6E-03 1.4E-03 1.5E-03 1.5E-03 1.5E-03 1.5E-03 1.5E-03 1,5E-03 1.8E-03 1.5E-03 1.5E-03 1. JE-03 1.5B-03 1,4E-03 1.5E-03 1.5E-03 1.4E-03

10 minutes 10 year 2.5E-03 2.5E-03 2.0E-03 2.3E-03 2.5E-03 2. SE-03 2.5E-03 2.5E-03 2.5E-03 2.5E-03 2.5E-03 2.5E-03 2.5E-03 2.8E-03 2.5E-03 2.4E-03 2.5E-03 2.5E-03 2.48-03 5 year 4.28-03 4.1E-03 4.6E-03 3.83-03 4.lE-03 4.2E-03 4.2E-03 4.2E-03 4.1E-03 4.1E-03 3.9E-03 4.2E-03 4.2E-03 4. JE-03 4.1E-03 4.OB-03 4.2E-03 4.28-03 4.08-03 1 year 8.4B-03 8.5E-03 9.2E-03

7.8E-03
8.3E-03 8.4E-03 8.4E-03 8.4E-03 8.2E-03 0.3E-03

* * *

7.8E-03
8.4E-03 8.4%03 9,3E-03 0.3E-03 8.OE-03 0.3E-03 8.4E-03 0.OE-03

Bffective dose equivalent Wv/nBq)

1.31-03

1.5B-03

2.58-03

4.1B-03

8.38-03

*ICaP

18: 14-M

345

RADIATION

DOSE TO PATIENTS

FROM RADIOPHARMACEUTICALS

CS 55

i29cs

CAESIUM
13OcS 131cS

iOIl

134mcS

Biokinetic Model According to NCRP Report No. 52 (1977) caesium is distributed throughout body tissues, muscle being among the tissues of higher concentration, with bone and fat having lower than average concentrations. However, the concentrations in most organs and tissues are within a factor of about two of the average concentration in the total body. In a report on a study by Kaul et al. (1966), on the distribution of 137Cs in man, relative activity concentrations in several organs and tissues, normalized to that in muscle, are given. Using a mass of 28 kg for muscle, a fractional uptake of 0.7 for that tissue may be derived. For adults, total body retention half-times of 2 d (0.1) and 110 d (0.9) are adopted from ICRP Publication 30 (ICRP, 1979) and are used also for muscle. Age-dependent data for total body and muscle retention have been taken from Leggett (1983). has been taken into account, The production and dose from 134Cs, the daughter of 134mC~, but at the time of administration, 134mC~ is assumed to be free from contamination with 134Cs. If the administered 134mC~ is contaminated with known quantities of 134Cs, the additional dose equivalent can be calculated from the data given at the bottom of the dose tables for 134mC~. References
ICRP (1979). Limitsfor Intakes ofRadionuclides by Workers, ICRP Publication 30: Part 1. Pergamon, Oxford. Kaul, A., Nay, V., Rajewsky, B., Stahlhofen, W. and Unnewehr, F. (1966). Distribution of cesium 137 in the human organism and in the human fetus. Nature (London) 209, 1310-1312. Leggett, R. W. (1983). Metabolic Data and Retention Functions for the Intra-cellular Alkali Metals, Report ORNLFM-8630. Oak Ridge National Laboratories, Oak Ridge, Tennessee. NCRP Report No. 52 (1977). Cesium-137from the Environment to Man: Metabolism and Dose. National Council on Radiation Protection and Measurements, Washington, DC 20014.

Biokinetic Data
&/A,

Organ (S) Total body Muscle 15 yr old Total body Muscle 10 yr old Total body Muscle 5 yr old Total body Muscle 1 yr old Total body Muscle

Fs 1.0 0.7 1.0 0.7

1.0

T 2.0 d 110d 2.0d 110d 3.2d 96 d 3.2 d 96 d 7.0d 52 d 7.0d 52d 8.8 d 32 d 8.8 d 32 d 10d 16d 10d 16d

a 0.1 0.9 0.1 0.9 0.18 0.82 0.18 0.82 0.36 0.64 0.36 0.64 0.44 0.56 0.44 0.56 0.51 0.49 0.51 0.49

=Cs 1.84d 1.29d 1.80d 1.26.d 1.79 d 1.25 d 1.77 d 1.24 d 1.74d 1.22d

Ys

3Cs

134mC~ andiJ4Cs

43.1 min 30.2 min 43.1 min 30.2 min 43.1 min 30.2 min 43.1 min 30.2 min 43.1 min 30.2 min

11.8d 8.26 d ll.Od 7.73 d 9.65 d 6.76 d 8.94 d 6.26 d 7.89 d 5.52 d

4.15 hr 2.91 hr 4.15 hr 2.91 hr 4.15 hr 2.91 hr 4.15 hr 2.91 hr 4.15 hr 2.91 hr

29 min 20 min 23 min 16 min 17 min 12 min 12 min 8.6 min 7.8 min 5.4 min

0.7 1.0 0.7 1.0 0.7

347

CS

BIOKINETIC MODELS AND DATA

55 Ion

CAESIUM
lZ9Cs 32.06 hours per Organ Adult * * Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue 5.2E-02 5.1E-02 4.2E-02 3.63-02 4.7E-02 5.1E-02 4.98-02 5.1E-02 4.6E-02 4.1E-02 4.4E-02 5.4E-02 5.4E-02 5.43-02 4.03-02 4.OE-02 4.2B-02 5.03-02 5.2E-02 15 year 5.8E-02 5.9E-02 5.3E-02 3.2E-02 5.2E-02 5.7&-02 5.4E-02 5.7B-02 5.2E-02 4.6E-02 5.2E-02 6.5E-02 6.3E-02 6.3E-02 5.5E-02 S.OE-02 5.9E-02 6.5E-02 5.6E-02 10 year 8.6E-02 8.8B-02 8.1E-02 4.8E-02 7.5E-02 8.6E-02 0.OB-02 0.7E-02 7.6E-02 6.0B-02 7.58-02 l.OE-01 9.3E-02 9.4E-02 E.OE-02 7.5E-02 9.5B-02 l.lB-01 0.7E-02 5 year 1.3g-01 1.4E-01 l.ZE-01 7 .OE-02 l. lE-01 1.3E-01 l.ZE-01 1.3E-01 l. lE-01 1 .OE-01 1.1%01 1.5E-01 1.4E-01 1.4E-01 l .ZE-01 l.ZE-01 1.6E-01 1.6E-01 1.4E-01 1 year Z . ZE-01 2.3E-01 2.4E-01 1.3E-01 2.0%01 2.3E-01 2.2E-01 2.3E-01 Z .OB-01 1.8%01 Z .OE-01 2.7B-01 2.5E-01 2.4E-01 Z. lE-01 Z. lE-01 2. BE-01 2.8B-01 2.5E-01 unit Absorbed dose activity administered

(mGy/RRq)

* *

Effective dose equivalent Wv/=l)

4.7B-02

5.4B-02

8.1B-02

1.2B-01

Z . ZB-01

130cs
Organ

29.9

minutes

Adult * * Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue 2.6&03 2.5E-03 Z. lE-03 2.4E-03 2.3B-03 2.5E-03 2.4E-03 2.5E-03 2.3E-03 2,2E-03 Z.ZE-03 2.5E-03 2. SB-03 2.3E-03 2.4E-03 2.3E-03 Z. ZE-03 2. SE-03 5.2B-03

15 year 2.8E-03 2.7E-03 2.4E-03 Z .OE-63 2.6E-03 2.7E-03 2.7B-03 2.7E-03 2.6B-03 2.4E-03 2.5E-03 2.9E-03 2.9E-03 2.68-03 2.6E-03 2.5E-03 2.7E-03 2.9B-03 4.9B-03

10 year 4. H-03 4.2E-03 3.6B-03 3.1R-03 3.83-03 4.2E-03 4.OE-03 4.2E-03 3.9B-03 3.6E-03 3.7E-03 4.5B-03 4-33-03 3.0E-03 4.OB-03 3.9B-03 4.3%03 4.713-03 0 * 3B-03

5 year 6.1E-03 6.4E-03 5,4E-03 4.7E-03 5.7B-03 6.2E-03 6.1E-03 6.3E-03 5.8B-03 5.43-03 5.6E-03 6.8E-03 6.4E-03 5.6B-03 5a 9E-03 5*8B-03 6. BE-03 7.OE-03 1,4B-02

1 year l . ZE-02 l .ZB-02 l. lE-02 9.3%03 l. lE-02 l.ZE-02 l . ZB-02 l . ZB-02 l. lE-02 l . lE-02 l. lB-02 1.3E-02 l.ZE-02 l. lE-02 l. lB-02 l. lB-02 1.3B-02 1.3B-02 2.8B-02

* *

Bffectivc dose equivalent (=Sv/BW

2.4B-03

2.6B-03

3.9B-03

5.9B-03

l . lB-02

348

RADIATION

DOSE TO PATIENTS FROM RADIOPHARMACEUTICALS

CS

55 Ion

CAESIUM
131CS 9.69 days

Absorbed par Organ Adult * * Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other Bffective tissue 4.6E-02 4.63-02 5.OE-02 3.5E-02 4.3E-02 4.63-02 4.5E-02 4.63-02 4.43-02 4.OB-02 4.9E-02 5.3E-02 5.3E-02 ?.9E-02 4.8E-02 3.5%02 4.5E-02 5.7E-02 6.7E-02 15 year 5.4E-02 5.2E-02 7.4E-02 2.9E-02 4.7E-02 4.6B-02 4.6E-02 4.7E-02 4.7E-02 4.OE-02 5.8E-02 5.7E-02 5.7E-02 8.9E-02 5.OE-02 4.6E-02 6.1E-02 5.6E-02 6.7E-02 unit

dose

activity administered (mGy/MBq)

10 year 7.5E-02 7,3E-02 l.lE-01 4.OE-02 6,3B-02 6.83-02 6.6E-02 6.71-02 6.4E-02 5.7%02 7.8E-02 8.6B-02 E. lE-02 1.3B-01 7. HI-02 6.7E-02 9.2E-02 9.2E-02 9.0E-02 5 year l.lE-01 l.lE-01 1.7E-01 5.&z-02 9.6E-02 l.OE-01 9.7E-02 l .OE-01 9.4E-02 8a 2E-02 1 year 1.9E-01 2.1e-01 3.3%01 l .OE-01 1.7E-01 1.9E-01 1.8%01 1. se-01 1.6E-01 1.5E-01 2.OE-01 2.3E-01 2.1%01 3.4E-01 1.0&01 1. EE-01 2. SE-01 2.4%01 2.6E-01

l. lE-01
1.3E-01 1,2E-01 1.9E-01 l.lE-01 l.OE-01 1.5E-01 1.4E-01 1,5E-01

* *

dose equivalent Wvfrn )

4.9E-02

5.4B-02

7.0B-02

1.2L01

2.18-01

MCRP 18:1-4-N

349

cs
55 Ion

BIOKINETIC MODELS AND DATA

CAESIUM
134nlOs 2.90 hours

per Organ Adult * * Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow 5.41-03 5.4E-03 4.6E-03 S . OE-03 5.OB-03 5.3B-03 5.3B-03 5.4E-03 5.OE-03 4. BE-03 4.0E-03 5.4E-03 5.3B-03 5.2E-03 S. lE-03 4.03-03 4.7E-03 6.OE-03 l . OE-02

unit

Absorbed dose activity administered 15 year 5.2&-03 5.2E-03 4.7B-03 3.03-03 4.93-03 5. x-03 5.OE-03 5.1E-03 4.9E-03 4.6E-03 4.0B-03 5.6B-03 5.4E-03 5.2E-03 5.OE-03 4.0E-03 5.2B-03 5.6E-03 9.23-03 10 year 6.0E-03 6.9B-03 6.4E-03 5.2E-03 6.3%03 6.0E-03 6.63-03 6.9E-03 6.4E-03 6.OE-03 6.2E-03 7.4&03 7.1E-03 6.9E-03 6.5B-03 6.4E-03 7.1E-03 7.7B-03 1.4E-02

(mGy/MBq) 5 year 1 year 1.6E-02 1.6E-02 1.6B-02 1.3E-02 1.5E-02 1.6E-02 1.5B-02 1.6E-02 1.5E-02 1.4E-02 1.5E-02 1.7E-02 1.6B-02 1.6E-02 1.5E-02 1.5E-02 1.7E-02 1.7E-02 4,4E-02

0.9E-03
9.3B-03 0.03-03 7 .OE-03 0.4B-03

* *

9.OE-03 0.0B-03
9.1E-03 0.4E-03 0.OE-03 0.3E-03 9.0B-03 9.23-03 9.2E-03 0.6E-03 0.6E-03 9.0E-03 l . OB-02 2.3E-02

Spleen Testes Thyroid Uterus Other tissue

Effective dose equivalent (=Sv/ltas)

5.18-03

4.9B-03

6.63-03

0 -73-03

1.5B-02

mose 134Cs (2.062 a)

equivalent, 1.6E+Ol

(mSv/HBq

of

the

impurity)

1,5E+Ol

1. lE+Ol

1 .OE+Ol

9.6E+OO

350

RADIATION

DOSE TO PATIENTS

FROM RADIOPHARMACEUTICALS

Ba 56

BARIUM
Ba
133mga

Ion

135mBB

Biokinetic Model Radioisotopes of barium are assumed to be distributed and retained in the body in accordance with the model developed by the Task Group on Alkaiine Earth Metabolism in Adult Man (ICRP, 1972) and values of the time integrals of retention functions have been taken from that publication. The ingrowth and dosimetry of the radioactive daughters of 13iBa (13iCs) and 133mBa(133Ba) have also been taken into account, but at the time of administration the parent radionuclides are assumed to be free from daughter activity. If the parent radionuclide is contaminated with known quantities of the corresponding daughter, the additional dose equivalent can be calculated by reference to the appropriate dose tables (i.e. 131Ba and 133mBa). According to the ICRP (1972) model, intravenously administered barium is cleared rapidly from the blood, with less than 1% remaining after a few hours. A fraction of about 0.1 is taken up by the skeleton, where it is roughly equally divided between cortical and trabecular bone. Following an initial loss from bone surfaces during the first 10 d, about two thirds of the bone content is retained for a time which is long in comparison with the physical half-lives of the isotopes of barium considered here. A fraction of 0.7 of the administered barium is initially distributed in soft tissues and a fraction of 0.9 of this is excreted within 10 d, the remainder being eliminated much more slowly. In accordance with ICRP criteria concerning the distribution of bone-seeking radionuclides (ICRP, 1979), all three of the radioisotopes of barium considered here are assumed to be distributed over bone surfaces at all times following their deposition in the skeleton. For the estimation of radiation doses to the GI tract and bladder, resulting from excretion of intravenously administered radioisotopes of barium, a faecal to urinary excretion ratio of 9: 1 is assumed. References
Harrison, G. E., Carr, T. E. F. and Sutton, A. (1967). Distribution of radioactive calcium, strontium, barium and radium following intravenous injection into healthy man. Int. J. Radiat. Biol. 13, 235-247. ICRP (1972). Task Group Report on Alkaline Earth Metabolism in Adult Man, ICRP Publication 20. Pergamon, Oxford. ICRP (1979). Limitsfor Intakes of Rudionuclides by Workers, ICRP Publication 30: Part 1. Pergamon, Oxford. Rundo, J. (1967). The retention of barium-133 in man. Int. J. Radiat. Biol. 13, 301-302.

Biokinetic Data

Organ (S) Total body (excluding contents of bladder and GI tract) Cortical bone Trabecular bone Bladder contents GI tract contents SI ULI LLI

i3Ba and i3iCs 2.45 d 13.0 hr 10.7 hr 10 min 3.0 hr 9.6 hr 16.7 hr 1.61 d 11.7 hr 9.2 hr 1.7 min 2 min 28 min 1.9 hr

isamBa and ssBa 18.2 hr 2.3 hr 2.1 hr 7.7 min 2.2 hr 5.9 hr 7.6 hr 1.0 hr 38 min 17 min 0.1 s 1.7s 5.6 s 10.3 s

13smga 15.1 hr 1.7 hr 1.5 hr 7.1 min 2.0 hr 5.0 hr 5.9 hr

351

Ba 56 Ion

BIOKINETIC MODELS AND DATA

BARIUM
131Ba 11.8 days

organ

per Adult

unit

Absorbed dose activity administered 15 year 1.7E-01 2.6E-01 2 .OE+OO 8.3E-02 Z.OE-01 7.2E-01 1.5EtOO 3.4E+OO 1.7E-01 1.5E-01 l.ZE-01 6.9E-01 1.7E-01 5.OE-01 1.5E-01 1.4E-01 l.ZE-01 3.4E-01 1.6E-01 10 year 2.6E-01 4.4E-01 3.2E+OO 1.3E-01 3.1E-01 l.lE+OO 2.5E+OO 5.6E+OO 2.7E-01 2.5E-01 1.9E-01 1. OE+OO 2,7E-01 7.7E-01 2.4E-01 2.3E-01 1.8E-01 5.5E-01 2.5E-01

(mGy/BBq) 5 year 4.1E-01 6.6E-01 5.4E+OO 2 .OE-01 4.8E-01 1.7E+OO 4.OE+OO 9.1E+OO 4.2E-01 4.OE-01 3.OE-01 1.5E+OO 4.3E-01 1. ZE+OO 3.7E-01 3.5E-01 2.9E-01 8,7E-01 3,8E-01 1 year 7.8E-01 1 . lE+OO 1.3E+Ol 3.9E-01 8.6E-01 3.OE+OO 7.4E+OO 1.7E+Ol 7.6E-01 7.4E-01 5.7E-01 2.7E+OO 7.9E-01 2.3E+OO 7.OE-01 6.9E-01 5.1E-01 1. SE+00 7.OE-01

*
*

*
*

Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue

1.4E-01 Z.ZE-01 1.5E+OO 8.33-02 1.6E-01 5.8E-01 1.ZE+OO 2,7E+OO 1.4E-01 l.ZE-01 9.9802 5.3E-01 1.3E-01 4.OE-01 l.ZE-01 l .ZE-01 8.7E-02 2.5E-01 1.3E-01

Effective dose equivalent (mSv/BBq)

5.OE-01

7.OE-01

l.lE+OO

1.8B+OO

3.4E+OO

1;trritie.s: E ective 131Cs (9.69

dose d)

equivalent 4.9E-02

(mSv/MBq of 5,4E-02

the

impurity) 7.8E-02 l.ZE-01 Z. lE-01

352

RADIATION

DOSE TO PATIENTS FROM RADIOPHARMACEUTICALS

Ba 56 Ion

BARIUM
133mBa 38.9 hours

per Organ Adult Adrenals Bladder wall Bone surfaces Bteas t GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid uterus Other tissue 3.3E-02 6.9E-02 2,2E-01 3.6E-02 3.7E-02 3.9E-01 1.8E+OO 3.7EcOO 3.5E-02 3.4E-02 3.1E-02 7.3E-02 3.4E-02 1.4E-01 3.3E-02 3.21-02 3.OE-02 4.5E-02 3.4E-02

unit

Absorbed dose activity edminietered 15 year 4.2E-02 8.6E-02 3.4E-01 3.6E-02 4.63-02 4.9E-01 2.3E+OO 4.6E+OO 4.3E-02 4.1E-02 3.9E-02 9.1E-02 4.2E-02 1.9E-01 4.1E-02 4.OE-02 3.8E-02 5.8E-02 4.23-02 10 year 7.OE-02 1.4E-01 5.6E-01 6.OE-02 7.6E-02 8.7E-01 4.OE+OO 8.1E+OO 7.2E-02 7.1E-02 6.5E-02 1.5E-01 7.2E-02 3.2E-01 6.9E-02 6.8E-02 6. SE-02 9.9E-02 7.OE-02

(mGy/MBq) 5 year 1.2E-01 2.2E-01 9.4E-01 1 .OE-01 1.3E-01 1.5E+OO 6.8!3+00 1.4E+Ol 1.2E-01 l.ZE-01 1. lE-01 2.3E-01 1.2E-01 5.7E-01 l.lE-01 l.lE-01 l. lE-01 1.6E-01 1.2E-01 1 year 2.3E-01 4.3E-01 2.2EiOO 2.1E-01 2.5E-01 2.9E+OO 1.4E+Ol 2.7E+Ol 2.4E-01 2.4E-01 2.2E-01 4.3E-01 2.4E-01 1.2E+OO 2.3E-01 2.3E-01 2.1E-01 3.2E-01 2.3E-01

* * * *

Effective dose equivalent (mSv/nBq )

4.1E-01

6.4B-01

1. lB+oo

1. se+00

3.8E+oo

Ir;;uri ties; E ective 133Ba (10.74

ose a)

equivalent 3.5E+OO

(mSv/MBq of 8.2E+OO

the

impurity) 1.3E+Ol 2.2E+Ol 4.8E+Ol

353

BIOKINETIC

MODELS

AND DATA

BARIUM
135mBa 28.7 hours Absorbeddose per unit activityadministered (mGy/MBq) Organ Adult * Adrenals Bladderwall Bone surfaces Breast GI-tract Stomachwall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue Effective dose equivalent (mSv/lIBp) 2.6B-02 5.7B-02 l.lE-01 2.9B-02 2.93-02 3.3E-01 1.4E+OO 2.7B+OO 2.73-02 2.6B-02 2.5&02 5.633-02 2.73-02 9.6B-02 2.6B-02 2.5B-02 2.4B-02 3.53-02 2.73-02 3.1B-01 15 year 10 year 5 year 1 year 1.8B-01 3.6B-01 9.2B-01 1.6B-01 3.2B-02 5.4B-02 9.OE-02 7.1E-02 1.2E-01 1.8B-01 1.4E-01 2.4E-01 3.9B-01 2.93-02 4.8B-02 8.OE-02 3.6B-02 6.OB-02 4.1E-01 7.4E-01 1.8E+OO 3.2B+OO 3.3E+OO 5.9B+OO 3.33-02 3.3B-02 3.OB-02 7.OE-02 3.3B-02 1.3E-01 3.2B-02 3.1E-02 3.OB-02 4.5B-02 3.3B-02 3.8B-01 5.6B-02 5.6B-02 5.18-02 l.lB-01 5.6B-02 2.2B-01 5.4B-02 5.3B-02 5.1E-02 7.7B-02 5.5B-02 6.7B-01

* * * *

l.OB-01 2.OB-01 1.2B+OO 2.4B+OO 5.4B+OO l.lB+Ol 9.9E+OO 2.OE+Ol 9.3B-02 9.43-02 8.5B-02 1.8E-01 9.4B-02 3.9B-01 9.OB-02 8.913-02 8.5B-02 1.3E-01 9.1B-02 l.lB+fm 1.8E-01 1.9E-01 1.7B-01 3.3B-01 1.9B-01 8.0%01 1.8B-01 1.8B-01 1.7B-01 2.5B-01 1.8B-01 2.3B+OO

354

RADIATION

DOSE TO PATIENTS

FROM RADIOPHARMACEUTICALS

Ba 56
Markers

BARIUM-LABELLED

NON-ABSORBABLE
131Ba Biokinetic Model

MARKERS

Insoluble barium compounds can be used as non-absorbable markers in studies of the gastrointestinal tract. For absorbed dose calculations a modified ICRP model for the gastrointestinal tract is used, as described in Appendix Section A.3. References
Ditchburn, R. K., Smith, A. H. and Hayter, C. J. (1974). The assessment of fat absorption in Man utilizing single stools or incomplete faecal collections after oral administration of radioactive triolein with an unabsorbed radioactive marker. ht. J. Appl. Rad. Isotopes 25, 167-176. Shafer, R. B. and Onstad, G. R. (1975). Measurement of fat absorption utilizing *3iodine-triolein and nonabsorbable radioactive markers. Am. J. Med. Sci. 269. 327-33 1.

Biokinetic Data

Organ (S)

Fs

13Ba

scs

(1) Oral administration of fluids GI-tract contents Stomach 1.0 SI 1.0 ULI 1.0 LLI 1.0 (2) Oral administration of solids GI-tract contents Stomach 1.0 SI 1.0 ULI 1.0 LLI 1.0

33 min 3.96 hr 12.5 hr 21.7 hr

3.2 s 3.2 min 37.8 min 2.53 hr

2.09 hr 3.94 hr 12.4 hr 21.6 hr

47 s 4.3 min 41 min 2.63 hr

355

Ba 56 Markers

BIOKINETIC

MODELS AND DATA

Ba-LABELLED NON-ABSORBABLE MARKERS

Oral administration of fluids 13188 organ Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue 11.8 days per unit Adult 2.5E-02 1.6E-01 4.1E-02 5.63-03 1.5E-01 6.7E-01 1.5E+OO 3.4E+OO 6.OE-02 4.2E-02 7.43-03 5.7E-01 5.3E-02 1.3E-01 4.2E-02 4.5E-02 8.83-04 Z.lE-01 5.9E-02 4.5&01 Absorbed dose activity administered 15 year 3.51-02 1.9E-01 5.OE-0% 5.6E-03 1.9E-01 8.4E-01 1.9E+OO 4.3E+OO 7.6E-02 5.3E-02 l .OE-02 7.4E-01 6.9E-02 1.5E-01 5.1E-02 5.63-02 l.lE-03 2.9E-01 7.OE-02 6.6E-01 10 year 5.9E-02 3.4E-01 7.5E-02 1.4E-02 2.9E-01 1.3E+OO 3.1E+OO 7.lE+OO 1.2E-01 l.OE-01 1.9E-02

(mCy/HBq) 5 year 1 .OE-01 4.9E-01 l.ZE-01 2.61-02 4.6E-01 Z.OE+OO 4.9E+OO 1.2E+Ol 1.8E-01 1.8E-01 3.3E-02 1.6E+OO 1.9E-01 2.6E-01 1.4E-01 1.8E-01 7.1E-03 7.7E-01 1.7E-01 1.7B+oO 1 year 1.9E-01 8.6E-01 2.4E-01 5.3E-02 8.6E-01 3.5E+OO 9.2E+OO 2.2E+Ol 2.9E-01 3.4E-01 7.5E-02 2. PE+OO 3.4E-01 3.2E-01 2.6E-01 3.6E-01 1.8E-02 1.4E+OO 3.OE-01

* * *

1.lE+OO

l. lE-01
Z.OE-01 8.9E-02 l.lE-01 3.1E-03 4.8E-01 l.lE-01 l.lE+OO

Effective

dose equivalent ~mSv/nBq)

3.18+00

ose equivalent 131Cs (9.69 d) 6.OE-02

(mSv/HBq of 7.6E-02

the impurity) 1.3E-01 of solids 5 year l.lE-01 5.OE-01 1.2E-01 3.1E-02 9 *3B-01 Z.OE+OO 4.9E+OO l.lE+Ol 1.9E-01 1.9E-01 6.OE-02 1.6E+OO 2.6E-01 2,6E-01 1.7E-01 1. BE-01 1 year 2.1E-01 8.6E-01 2.5E-01 6.1E-02 1. EE+OO 3.5E+OO 9.1E+OO 2.2E+Ol 3.1E-01 3.6.E-01 8.6E-02 2. BE+00 4.3E-01 3.3E-01 3.OE-01 3.6E-01 2.OE-02 1.4E+OO 3.OE-01 3.2B+oU Z.lE-01 3.9E-01

Organ Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes

Oral administration Adult 2,8E-02 1*6E-01 4.1E-02 7.2E-03 3.2E-01 6.7E-01 1,5E+OO 3.4E+OO 6.5E-02 4.53-02 l . OE-02 5.7E-01 B.OE-02 1.3E-01 5.63-02 6.5E-02 15 year 4.1E-02 1.9E-01 5.1E-02 7.2E-03 6. DE-01 8.6E-01 1.9E+OO 4.3E+OO E.lE-02 5.6E-02 1.3E-02 7.4E-01 9.7E-02 1.5E-01 6.6E-02 5.6E-02

10 year 6.7E-02 3.4E-01 7! 6E-02 1.7E-02 5.8E-01 1.3E+OO 3.1E+OO 7.lE+OO 1.3E-01 l. lE-01 2.3E-02 1.lE+OO 1.6E-01 2.1E-01 l.lE-01 l.lE-01

* * * *

Thyroid Uterus
Other tissue

l.lE-03 2.1E-01 6.1E-02 4.6B-01

1.3E-03 2.9E-01 7.33-02 6.7E-01

3.53-03 6.8E-01 l.lE-01 l.lE+Oo

7.93-03 ?.8E-01 1.7E-01 1.71+00

Effective dose equivalent (=Sv/=I)

ect ve ose k.F?%
131Cs

equivalent 6.1E-02

(mSv/HBq of 7.8E-02

the impurity) 1.3E-01 2. n-01 4.OE-01

(9.69

d)

356

RADIATION

DOSE TO PATIENTS FROM RADIOPHARMACEUTICALS

LANTHANUM-DTPA
140La Biokinetic Model After intravenous administration and initial distribution in the extracellular fluid, the substance is excreted exclusively by the renal system according to the models for GFR-substances and the kidney-bladder (see Appendix Sections A.6 and A.5, respectively). In the normal case, total body retention is described by a double-exponential function, with component half-times of 100 min (0.99) and 7 d (0.01). The fraction excreted by the kidneys is 1.0 and the renal transit time is 5 min. For the abnormal case, it is assumed that the retention half-time of the major component is 1000 min and that the renal transit time is increased to 20 min. Reference
Bianchi, C. and Blaufox, M. D. (1968). r3tI-hypaque and r4La-DTPA for the measurement of glomerular filtration rate in dog. J. Nucl. Viol. Med. 12, 117-120.

Biokinetic Data
Organ (S) (1) Normal renal function Total body (excluding bladder contents) Kidneys Bladder contents (2) Abnormal renal function Total body (excluding bladder contents) Kidneys Bladder contents
1.0

a 0.99 0.01

&/A, 2.76 hr 5.5 min 2.03 hr

1.67 hr 7.0 d

1.0 1.0 1.0 1.0 1.0 16.7 hr 7.0 d 0.99 0.01

17.3 hr 18.6 min 1.24 hr

AICRP 18:1-4-N*

357

La 57 DTPA

BlOKINETIC

MODELS AND DATA

La-DTPA
140La 40.272 hours per Organ Adult Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Snleen Testes Thyroid Uterus Other tissue 4. aB-02 2.2EtOO 3.3E-02 3.1E-02 3.4E-02 5.7E-02 5.OE-02 9.3E-02 1.4E-01 3.5E-02 2.8E-02 9.1E-02 3.7E-02 4.OE-02 3.4E-02 6.9E-02 i. 8E-02 1.5E-01 4.3%02 15 year 4.6E-02 2.7EtOO 3.9E-02 3.1E-02 4.4B-02 7.OE-02 6.2E-02 l. lE-01 1.7E-01 4.2E-02 3.6E-02 l.lE-01 4.7E-02 4. BE-02 4.5E-02 9.4E-02 3. se-02 1.9E-01 5.2E-02 10 year 7.2&02 4.1E+OO 6.2E-02 4. ag-02 6.7E-02 l. lE-01 1 .OE-01 1.7E-01 2.4E-01 6. BE-02 5.6E-02 1.6E-01 7.3E-02 7.3E-02 6.9E-02 1.6&01 5.9E-02 3.1e-01 a. OE-02 5 year l. lE-01 6.3E+OO 9.7E-02 7.7E-02 l. lE-01 1.7E-01 1.6&01 2.5E-01 3.6E-01 l. lE-01 8.9E-02 2.4E-01 1.2E-01 l. lE-01 l. lE-01 2.5E-01 9.5E-02 4.4E-01 1.3E-01 1 year 2.1E-01 1.2E+Ol 1.8E-01 1.5E-01 2.OE-01 3.1E-01 2.9E-01 4.2E-01 6.3E-01 2.OE-01 1.7E-01 4.OE-01 2,2E-01 1.8E-01 2.0%01 4.7E-01 1.8E-01 7.5E-01 2.3E-01 unit Absorbed dose activity administered (mGy/MBq)

* * * *

Effective dose equivalent Wv/llBq) Bladder wall contributes

1.9B-01 to 69.5

2.3B-01

3.5B-01

5.3B-01 dose

9.9B-01

X of the effective renal function 10 year

4.1E-01 2.7E+OO 3.4E-01 2.9E-01 3.7E-01 4.4E-01 4.2E-01 4.4E-01 a.ag-01 3.9E-01 3.4E-01 4.6E-01 4.2E-01 3.6E-01 3.9&01 4.OE-01 3 .?B-01 5.6E-01 3.6E-01

equivalent.

Abnormal Organ
* * Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue

Adult 2.8E-01 1.5EtOO

1.8E-01 1.9E-01 1.9E-01 2.3E-01 2.2E-01 2.5E-01 5.OE-01 Z.OE-01 1 .aB-01 2.5E-01 Z. lE-01 Z.OE-01 Z .OE-01 Z.ZB-01 1.8E-01 2.8E-01

15 year 2.6E-01 1.8EtOO Z. ZB-01 1.9E-01 2.5E-01 2.8E-01 2.7E-01 2. BE-01 6.1E-01 2.4E-01 2.2E-01 3.OE-01 2.7E-01 2.4E-01 2.5E-01 2.5E-01 2.3E-01 3.5E-01 2.3E-01

5 year
6,4E-01 4 *2gtO0 5.3E-01 4.?E-01 6.1E-01 6.BE-01 6.5E-01 7 .OE-01 1.3E+00 6.OE-01 5.4E-01 7.2E-01 6.5E-01 5.5E-01 6.1E-01 6.3E-01 6 .OE-01 a. 4E-01 5.6B-01

1 year 1.2EtOO
7.8EtOO

1.OE+OO
8.9E-01

*
* *

1. lE+OO
l.ZE+OO 1.2EtOO 1. ZE+OO 2.3E+OO 1.lEtOO 1. OEtOO 1.3E+OO l.ZEtOO

1. OB+OO 1. l&00
l.ZE+O0

1 .lEtOO
1.5E+OO l.1Bt00

1.9E-01 3.18-01

Bffective dose equivalent Wv/rras)

3.61-01

5.5B-01

8.6B-01

1.6B+oo

358

RADIATION

DOSE TO PATIENTS

FROM RADIOPHARMACEUTICALS

Yb
70 DTPA

YTTERBIUM-DTPA
i6Yb Biokinetic Model After intravenous administration and initial distribution in the extracellular fluid, the substance is excreted exclusively by the renal system according to the models for GFR-substances and the kidney-bladder (see Appendix Sections A.6 and AS, respectively). In the normal case, total body retention is described by a double-exponential function, with component half-times of 100 min (0.99) and 7 d (0.01). The fraction excreted by the kidneys is 1.0 and the renal transit time is 5 min. For the abnormal case, it is assumed that the retention half-time of the major component is 1000 min and that the renal transit time is increased to 20 min. References
Hosain, F., Reba, R. C. and Wagner, H. N. (1968). Ytterbium-169 Diethylenetriaminepentaacetic acid complex. A new radio-pharmaceutical for brain scanning. Radiology 91, 1199-1203. Hosain, F., Reba, R. C. and Wagner, H. N. (1969). Measurement of glomerular filtration rate using chelated Ytterbium-169. ht. J. Appl. Radiat. Isotop. 20, 517-521.

Biokinetic Data
Organ (S) (1) Normal renal function Total body (excluding bladder contents) Kidneys Bladder contents (2) Abnormal renal function Total body (excluding bladder contents) Kidneys Bladder contents Fs 1.0 1.0 1.0 1.0 1.0 1.0 16.7 hr 7.0 d 0.99 0.01 T a As/A, 4.4 hr 6.2 min 2.15 hr 1.05 d 26.2 min 1.75 hr

1.67 hr 7.0d

0.99 0.01

359

Yb 70 DTPA

BIOKINETIC MODELS AND DATA

Yb-DTPA
16Yb 32.01 days per Organ Adult Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue l . OE-02 5.2E-01 1.4g-02 9.2E-03 l. lE-02 1.5&02 1.4E-02 2.2E-02 3.%-02 l . OE-02 9.4E-03 2.1E-02 1.2E-02 1.7E-02 l. lE-02 1.6E-02 8.63-03 3.9E-02 1.2E-02 15 year 10 year 2.1E-02 9.8B-01 2.6B-02 1.4%02 2.1E-02 3.OE-02 2.0E-02 4.4E-02 6.1E-02 2.OE-02 1. BE-02 4.3E-02 2.2E-02 3.2E-02 2.1E-02 3.8B-02 1.9E-02 7.4E-02 2.2E-02 5 year 3.4E-02 1.5E+OO 4.2E-02 2.48-02 3.3E-02 4.0B-02 4.6B-02 6.6602 9.OE-02 3.2E-02 2.9E-02 6.5E-02 3.5E-02 4.8E-02 3.3E-02 6.OE-02 3.1E-02 l.lE-01 3.5E-02 1 year 6.5E-02 2. BE+00 8.1B-02 4.6g-02 6.4B-02 8.9B-02 unit Absorbed dose activity administered (mGy/WBq)

1.4B-02
6.5E-01 1.7~~02 9.2E-03 1.3E-02 1.9E-02 1.7E-02 2. BB-02 4.3E-02 1.2E-02 1.2E-02 2.83-02 1.4E-02 2.1E-02 1.3E-02 2.2E-02 1.2E-02 4.7E-02 1.4E-02

* * * *

B .3E-02
1.6%01 6.2E-02 5.63-02 l.lB-01 6.7E-02

1, x8-01

8.3E-02 6.2E-02 l. lE-01 5.9E-02 1.9E-01 6.5E-02

Bffective dose equivalemt (mSv/llBq) Bladder wall contributes

4.6B-02

5.8B-02

8.9L02
effective

1.4B-01

2.56-01

to

67.8

X of

the

dose

equivalent.

Abnormalrenal function
Organ Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue Adult 5.6E-02 4.6E-01 7.2E-02 5.3E-02 5.9E-02 6.6E-02 6.4E-02 7.Og-02 1.5%01 5. BE-02 5.4E-02 6.7E-02 6.63-02 B. lE-02 6.OE-02 5.4&02 5.OE-02 0.6E-02 5.3E-02 15 year 7.6E-02 5. BE-01 8.7E-02 5.3E-02 7.4E-02 8.OE-02 8.OE-02 8.6E-02 1.9E-01 7.OE-02 6. BE-02 8. BE-02 7. BE-02 l .OE-01 7.2E-02 6.9E-02 6.7E-02 l .OE-01 6.4B-02 10 year 1.2B-01 8.7E-01 1.4E-01 8.3E-02 1,2E-01 1.3E-01 1.2E-01 1.4E-01 2.7E-01 1, lE-01 l.lE-01 1.4E-01 1.2E-01 1.5E-01 1.2E-01 l. lE-01 l.lE-01 1.6E-01 l .OE-01 5 year 1.9E-01 1.3E+OO 2.2E-01 1.3&01 1 *BE-01 2.OE-01 2.OE-01 2.1E-01 3.9E-01 1. BE-01 1.7E-01 2.2E-01 1,9E-01 2.4E-01 1. BE-01 1. BE-01 1. EE-01 2.%-01 1.6E-01 1 year 3.6E-01 2. SE+00 4.2E-01 2.6E-01 3.4E-01 3.8E-01 3,7E-01 4.OE-01 7.OE-01 3.4E-01 3.2E-01 4.OE-01 3.6E-01 4.2E-01 3.4E-01 3.5E-01 3.4E-01 4.6E-01 3.1E-01

it
* *

Effective dose equivalent (=Sv/llBq)

9.2B-02

l.lE-01 1.7E-01

2.7B-01

5.

M-01

360

RADIATION DOSE TO PATIENTS FROM RADIOPHARMACEUTICALS

Yb 70 DTPA

YTTERBIUM-DTPA

(INTRATHECAL
169Yb Biokinetic Model

ADMINISTRATION)

The model has been defined in Appendix Section A.lO. Two sites of intrathecal administration are considered, viz lumbar injection (region A) and cisternal injection (region C). It is assumed that activity reaching the blood follows the model for intravenously administered Yb-DTPA. Reference
Deland, F. H., James, A. E. Jr, Wagner, H. N. Jr and Hosain, F. (1971). Cistemography with 69Yb-DTPA. J. Nucl. Med. 12,683689.

Biokinetic Data
Organ (S) Fs AdA@

(1) Lumbar injection

Cerebrospinal fluid space (A) Cisterna terminalis (B) Spinal cord space (C) Brain cisterns Kidneys Bladder contents Total body (excluding bladder contents) (2) Cisternal injection Cerebrospinal fluid space (A & B) Cisterna terminalis and spinal cord space (C) Brain cisterns Kidneys Bladder contents Total body (excluding bladder contents) 1.0 0.5 0.25 1.0 1.0 1.0 17.9 hr 16.0 hr 10.2 hr 5.95 min 2.06 hr 48.3 hr

0.5 1.0 1.0 1.0 1.0

19.9 hr 33.0 hr 5.90 min 2.04 hr 57.1 hr

361

Yb 70 DTPA

BIOKINETIC

MODELS AND DATA

Yb-DTPA (Intrathecal administration)

Lumbar injection 16Yb 32.01 days * * * Organ Adrenals Bladder wall Bone surfaces Brain Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Spinal cord Red marrow Spleen Testes Thyroid Uterus Other tissue Absorbed dose per unit activity administered (mGy/MBq) 1.4E-01 5.OE-01 1.7E-01 2.7E-01 1.6E-02 7.9%02 8.6E-02 6.6%02 3.5E-02 2.OB-01 4.8E-02 4.63-02 5.6E-02 l. lE-01 1.2E+OO 5.8E-01 5.6E-02 1.7E-02 3.6E-02 6.1E-02 3.9E-02 2.3E-01

Effective dose equivalent (mSv/HBq)

Cisternal injection Organ

* * *

Adrenals Bladder wall Bone surfaces Brain Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Spinal cord Red marrow Spleen Testes Thyroid Uterus Other tissue

9.4E-02 5.OE-01 1.9E-01 8.4E-01 1.7E-02 1.2E-01 4,1E-02 3.3E-02 2.6E-02 l.OE-01 3.OE-02 3.9E-02 3.4E-02 6.2E-02 9.5E-01 3.8E-01 3.3E-02 1.6E-02 5.2E-02 4.6E-02 2.9E-02 2.2E-01

Effective dose equivalent (mSv/RBq)

362

RADIATION

DOSE TO PATIENTS

FROM RADIOPHARMACEUTICALS

AU 19 Colloid

GOLD COLLOID
198A~ Biokinetic Model This colloid belongs to the group of substances discussed in Appendix Section A.8, where uptake data and organ and tissue masses for different patient categories are defined. It is assumed that no redistribution or excretion of the administered activity occurs. Biokinetic Data
Organ (S) FS T a klA0

(1) Normal liver condition co 1.0 2.72 d Liver 0.70 CC 1.0 9.34 hr Spleen 0.10 co 1.0 14.0 hr Red marrow 0.15 1.0 14.0 hr Remaining tissues 0.15 (2) Early to intermediate diffuse parenchyzal liver disease cc 1.0 1.94d Liver 0.50 CC 1.0 18.7 hr Spleen 0.20 03 1.0 23.3 hr Red marrow 0.25 1.0 4.67 hr Remaining tissues 0.05 (3) Intermediate to advanced diffuse parezhymal liver disease CC 1.0 1.17 d Liver 0.30 CC 1.0 1.17d Spleen 0.30 CC 1.0 1.17d Red marrow 0.30 co 1.0 9.34 hr Remaining tissues 0.10

GOLD COLLOID
19Au 2.696 days par unit Organ Adult 15 year 4.9B-01 6.1B-02 1.4B+OO l. lB-01 2.6B-01 1.7B-01 Z.ZB-01 9.2B-02 3.8B-01 l*OB+Ol 2 *4B-01 l.lB-01 5.2B-01 2.7B+OO 1,6B+Ol 3.7B-02 5.2B-02 9.8B-02 l.ZB-01 2.1&00 10 year 7.1B-01 l. lB-01 2.4B+OO 1.9B-01 4.2B-01 3.OB-01 4.OB-01 1*5B-01 5.7B-01 1.6BtOl 3.5B-01 1.9B-01 8.1B-01 4.6B+OO 2.5B+Ol 6.38-02 8.3B-02 1.6B-01 1. SE-01 3.3B+oo 5 year 9.4B-01 Z.OB-01 4.4&+00 3.OB-01 6.8B-01 4.9B-01 6.3B-01 2.3B-01 8,2B-01 2.4B+Ol 5.1B-01 2,9B-01 1.2B+oa 8.5B+OO 3.9B+Ol l.lB-01 1.4B-01 2.7B-01 2. BB-01 5.3B+oo 1 year 1.4B+OO 3.6B-01 9.3B+OO 5.5B-01 1.3B+fxl 8.5B-01 1 . ZB+OO 4.1B-01 l.ZB+OO 4.7B+Ol 8.8B-01 S.ZB-01 2 . OB+OO 1.8B+Ol 7.3B+Ol 2.28-01 2.7B-01 4.9B-01 5*1B-01 l.OB+ol 3 *5B-01 4.58-02 9. BE-01 l. lB-01 Z.lB-01 1.5B-01 1*9B-01 ?.6B-02 3.1E-01 8.2&+00 1.8B-01 ?.9B-02 4.2B-01 1.9B+OO 1 .lB+Ol 3.1B-02 4 *OB-02 6.9B-02 1. OElOl 1.5B+oo Absorbad dose activity administered (mGy/MBq)

* Adrenals Bladder wall

Bone surfaces Brcas t GI-tract Stomach wall Small intest ULI wall LLI wall

* * * *

Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue

Bffective dome equivalent WV/_)

363

AU 79 Colloid

BIOKINETIC MODELS AND DATA

Early

to intermediate

GOLD COLLOID
diffuse

parenchymal

liver

disease

2.696

days

Organ

Absorbed dose per unit activity administered (mGy/MBq) 3.4E-01 4.73-02 1. bE+OO l.OE-01 2.6B-01 1.5E-01

Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue

1.8E-01 9.93-02 3.4E-01 4.4E+OO 1.7E-01 l.lE-01 5.1E-01 3.1E+OO l.SB+Ol 3.23-02 4.4%02 8.1E-02 l.lE-01
1.7B+oO

Effective dose equivalent (mSv/l(Bql Intermediate to advanced Organ * Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue diffuse

parenchymal

disease

3.46-01 6.7%02 1.9P+OO l.lE-01 3.3E-01 1.7E-01 l.EE-01 1.3E-01 3.7E-01 4.6E+OO 1.7E-01 1.4E-01 6.2E-01 3.8E+OO 2.OE+Ol 5.3E-02 6.4E-02 l.lE-01 1.3)s01
2.1B+oo

* * * *

Effective dose equivalent Wv/l(Bq)

364

RADIATION DOSE TO PATIENTS FROM RADIOPHARMACEUTICALS

Hg

80
Chloride

MERCURY (II) CHLORIDE

19Hg Biokinetic Model A variety of results from measurements are available for the deposition and retention of mercuric chloride in the human kidney. The data of Raynaud and Ricard (1976) indicate a fractional uptake of 0.4 in normal subjects and in patients with unilateral nephropathy or sound solitary kidneys. Lower values are reported for patients with a pathological solitary kidney and for children under the age of 4 yr (2 months, 0.05; 1 yr, 0.155; 3 yr, 0.19). As to retention, a biological half-time of 45 d is reported by Raynaud et al. (1963), confirmed by human data of Rahola et al. (1972). The intercept of this component of the retention function is taken as 0.8, from animal experiments (Berner, 1973). These experiments gave similar total body and kidney retention half-lives in rats and demonstrated a 2 d (0.2) component of the total body retention function. On this basis, the following components of the total body retention function are assumed: 2 d (0.2) and 45 d (0.8). Raynaud et al. (1963) suggested that liver deposition accounted for 80% of the extra-renal activity, i.e. 0.2. In a more recent publication, Raynaud and Ricard (1976) reported a much lower value of kidney deposition and did not mention liver deposition. In experiments on rats, Berner (1973) observed a liver uptake of 0.15, with retention half-times of 1 d (0.8) and 10 d (0.2). These half-time values are used herein. References
Bemer, W. (1973). Tierexperimentelle Untersuchungen zum Problem der Dekorporierung von radioaktiven Metallionen. M.D. Thesis, Freie Universitiit, Berlin. Raynaud, C., Desgrez, A. and Kellershohn, C. (1963). Exploration r&ale &laide de la nkohydrine et du bichlorure de mercure marquirs aux mercures radioactifs Hg-197 et Hg-203. In: Radioaktiue Isotope in Klinik und Forschung, Vol. 5, pp. 317-345. (Fellinger, K. and Hiifer, R. eds) Urban and Schwarzenberg, Miinchen. Raynaud, C. and Ricard, S. (1976). Results. In: The Renal Uptake ofRadioactive Mercury (9HgCZ2), American Lecture Series, Publication No. 975, pp. 84-108. (Raynaud, C. ed.) Charles P. Thomas, Springfield, Illinois. Rahola, T., Aaran, R. D. and Miettinen, J. K. (1972). Half-life studies of mercury and cadmium by whole-body counting. In: Assessment ofRadioactive Contamination in Mun, pp. 55F562. International Atomic Energy Agency, Vienna.

Biokinetic Data
Organ (S) Kidneys Kidneys (1 yr old) Liver Remaining tissues Remaining tissues (1 yr old) FS 0.4* 0.15 0.15
0.45

T 2d 45 d 2d 45 d Id 10d 2d 45 d 2d 45 d

a 0.2 0.8 0.2 0.8 0.8 0.2 0.2 0.8 0.2 0.8

&IA, 1.3 d 11.7 hr 5.21 hr 1.46 d 2.27 d

0.70

*Applicable for adults with normal kidney status, with unilateral nephropathy or with sound solitary kidney, and for children aged 4 yr or more.

365

His
80 Chloride

BIOKINETIC MODELS AND DATA

MERCURY CHLORIDE
19Hg 64.2 hours

per Organ Adult * Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue 9. E-02 3.3E-02 S.OE-02 3. SE-02 S.OE-02 4.83-02 4.8E-02 3.6&02 4. SE+00 1. E-01 3.6E-02 3. E-02 . lE-02 6.9E-02 8.4E-02 2.9E-02 2.9E-02 3.E-02 3. E-02

unit

Absorbed dose activity administered 15 year l. lE-01 4.3E-02 6.23-02 3. SE-02 6.2E-02 5.9E-02 6.OE-02 4.43-02 5.6E+OO 2.2E-01 4.73-02 4.6E-02 8.83-02 8.6E-02 l .OE-01 3. SE-02 3.88-02 4. SE-02 4. SE-02 10 year 1.8E-01 6.9E-02 l .OE-01 5. E-02 l .OE-01 9.8E-02 9.9E-02 .4E-02 8.OE+OO 3.3E-01 7.6&02 7 .E-02 1.4E-01 1.3E-01 1.6E-01 5.8E-02 6.4B-02 .6E-02 7.28-02

(mCy/MBq) 5 year 2.8E-01 l.lE-01 1. E-01 9.6E-02 1. SE-01 1.6E-01 1.6E-01 1.2E-01 1.2E+Ol 4.9E-01 1.2E-01 1.3E-01 2.1E-01 2.OE-01 2.4E-01 9. E-02 l. lE-01 1.3E-01 1.2E-01 i year 4. E-01 3.8E-01 4.6E-01 3.1E-01 3.9E-01 4.OE-01 3.9E-01 3.8E-01 8. X8+00 9.OE-01 3.6E-01 3.8E-01 4.3E-01 4.6E-01 4.3E-01 3.3&01 3. SE-01 3.8E-01 3. SE-01

* *

* *

Effective dose equivalent (mSv/llBq)

3.2E-01

4.0%01

5.8B-01

8.7B-01

8.8B-01

366

RADIATION

DOSE TO PATIENTS FROM RADIOPHARMACEUTICALS

Hi% 80 BMHP

BROMO-MERCURI-HYDROXYPROPANE Hg
Biokinetic Model

(BMHP)

Biokinetic data for BMHP-labelled red blood cells have been published by Wagner et al. (1964) and Croll et al. (1965). For absorbed dose calculations, it is assumed that the activity is completely localized in the spleen for the first 6 hr after administration. Thereafter, the metabolic behaviour of mercury in ionic form is taken to apply. References
Croll, M. N., Brady, L. W., Brodsky, J. and Stanton, L. (1965). A new agent for splenic imaging: BMHP. Radiology 84, 492495. Wagner, H. N., Weiner, J. M., McAfee, J. G. and Martinez, J. (1964). 1-Mercury-2-hydroxypropane (MHP). A new radiopharmaceutical for visualisation of the spleen by radioisotope scanning. Arch. Int. Med. 113, 696701.

Biokinetic Data
Organ (S) Fs T a &IA, 5.81 hr Id 10d 2d 45 d 2d 45 d 2d 45 d 2d 45 d 0.8 0.2 0.2 0.8 0.2 0.8 0.2 0.8 0.2 0.8 4.88 hr 1.21 d 10.9 hr 1.37 d 2.13 d

(1) First 6 hr after administration Spleen 1.0 (2) More than 6 hr after administration Liver 0.15 Kidneys Kidneys (1 yr old) Remaining tissues Remaining tissues (1 yr old) 0.40 0.15 0.45 0.70

367

Hg
80 BMHP

BIOKINETIC MODELS AND DATA

BROMO-MERCURIHYDROXYPROPANE (BMHP)

1971ig

64.2

hours

per Organ Adult * Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue 9.7B-02 3.2!&02 4.0B-02 3.3E-02 S.EE-02 4.6E-02 4.6&02 3.4B-02 4.2E+OO 1.6B-01 3.7B-02 3.5B-02 8.0B-02 6.7B-02 1.5E+OO 2.7B-02 2. BE-02 3.5E-02 3.6&02

unit

Absorbed dose activity administered 15 year 1.2E-01 4.1E-02 6.OE-02 3.3%02 7 * lE-02 5.6E-02 5.8E-02 4.2B-02 5.3E+OO 2.OE-01 4.7&02 4.4B-02 l. lE-01 8.33-02 2.2B+OO 3.3E-02 3.08-02 4.2B-02 4.4B-02 10 year l.EE-01 6.5E-02 9.8E-02 5.5E-02 l. lE-01 9.53-02 9.63-02 7.1E-02 7. SE+00 3.1&01 7.6B-02 7.3&02 1.7E-01 1.3E-01 3.4E+OO 5.5E-02 6.0&02 7.2B-02 7.OE-02

(mGy/MBq) 5 year 2 *8E-01 l. lE-01 1.6E-01 9.2E-02 1.7E-01 1.5%01 1,5E-01 l.lE-01 l.lE+Ol 4.7B-01 1.2E-01 1.2B-01 2.4E-01 1.9E-01 5.4E+OO 9.1E-02 l.OE-01 1.2E-01 l. lE-01 1 year 4.4E-01 3.2E-01 4.OE-01 2.7E-01 3.7E-01 3.5E-01 3.5E-01 3.3E-01 7.6E+OO 8.5E-01 3.2E-01 3.3E-01 4.4E-01 4.1E-01 9.9EtOO 2. WI-01 3.OE-01 3.3E-01 3.OE-01

* *

* *

Effective dose equivalent (=Sv/ltBg)

3.9B-01

5.OB-01

7.5B-01

1.lB+OO

1.4EtOo

368

RADIATION DOSE TO PATIENTS FROM RADIOPHARMACEUTICALS

Chlormerodrin

Hg 80

CHLORMERODRIN
r9Hg 03Hg Biokinetic Model The metabolic model from the MIRD Dose Estimate Report No. 6 (1975), which is based on human data, is adopted here without change. For details, the reader is referred to the MIRD publication. It may be possible to reduce absorbed doses to some extent by administration of blocking agents, as also mentioned in the above publication. References
(1) Adopted model MIRD Dose Estimate Report No. 6 (1975). Summary of current radiation dose estimates to humans from r9Hg- and 203Hg-labeled chlormerodrin. J. Nucl. Med. 16, 10951098. (2) Diaplacental transfer Sy, W. M., Rosen, H., Griffin, N. E., Fink, H., Vasicka, A., Lorber, St. A. and Solomon, N. A. (1972). Radiation dose to a human fetus following use of Hg-197. Radiology 103, 13&141.

Biokinetic Data

Organ (S) Total body (excluding bladder contents)

Fs 1.0

T 1.0 hr 6.0 hr 7.0 d 70.0 d 70.0 d 8.0 hr 30.0 d 40.0 d 40.0 d 70.0 d 70.0 d 70.0 d

a 0.10 0.53 0.10 0.27 1.0 0.76 0.24 1.0 1.0 1.0 1.0 1.0

197H g

*03Hg 12.0 d

1.46d

Bone Kidneys cortex medulla Liver Muscle Ovaries Testes Bladder contents

0.04 0.50 0.006 0.15 0.03 9 x lO-6 4 x lO-5 1.0

3.56 hr 14.1 hr 31 min 13.0 hr 2.67 hr 2.9 s 13 s 1.20 hr

1.62 d 3.35 d 4.48 hr 4.67 d 1.21 d 32 s 2.3 min 1.57 hr

369

Hg
80 Chlonnerodrin

BIOKINETW

MODELS AND DATA

CHLORMERODRIN 197ii11
Organ Adult * * Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid Uterus Other tissue 4. x-02 1.4%01 3.0%01 5.97%03 1. SE-02 1.4E-02 1. SE-02 6.7E-03 2.1E+OO 3.7E-01 l.lE-02 9.1E-03 2.9E-02 4. EE-02 2.9E-02 6.6E-03 3.2E-03 9.3E-03 l .lE-02 15 year 5.3&02 1.7E-01 3.9E-01 5.4E-03 1.9E-02 1.6E-02 1.9E-02 a. lE-03 2.6EtOO 4.7E-01 1. SE-02 1.2E-02 3.9E-02 6. SE-02 3. SE-02 1.3%02 4.1E-03 l.lE-02 1.3E-02 10 year 8.OE-02 2.7B-01 6.4E-01 9.4E-03 3.1E-02 2.9E-02 3.3B-02 1.4E-02 3.8EtOO 7.2E-01 2.2E-02 2.4g-02 6.2&02 l.OE-01 5.6E-02 8.3E-02 6.73-03 2.OE-02 2.OE-02 5 year 1.1%01 5.4E-01 1.lE+OO 1.48-02 4.8E-02 4.6E-02 5.3E-02 2.2E-02 5.6E+OO 1 year 1.9E-01 1 . OE+OO 2*6E+OO 2.8E-02 8.473-02 8.2E-02 9.3E-02 4. x-02 l.OEt01 2.1EtOO 5.9E-02 9.43-02 1. SE-01 3. BE-01 1.3E-01 1.4E-01 2.OE-02 6.3E-02 5.9E-02 64.2 hours per unit Absorbed dose activity administered (mGy/MBq)

* *

1. 1EtOO
3.3E-02 4.4B-02 0.9E-02 2 .OE-01 7.9E-02 l.OE-01 l . OE-02 3.4B-02 3.1E-02

Bffective dose equivalent (=Sv/lIBq)

l.EB-01

2.3B-01

3.4E-01

5.2B-01

9.8%01

20311g
Organ

46.60

days

Adult * Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Kidneys Liver Lungs Ovaries Pancreas Red marrow Snleen Tktes Thyroid Uterus Other tissue 0.1E-01 3.7E-01 6.1E-01 1.7E-01 3.3E-01 3.1E-01 3. SE-01 1. SE-01 1.9BtOl 5.1EtOO 2.6%01 1.9%01 5.9E-01 5.9E-01 S.OE-01 1.2E-01 l .OE-01 1.7E-01 2.3E-01

15 year l.OEtOO 4.7E-01 7.7E-01 1.6E-01 4.OE-01 3.7E-01 4.1E-01 1.8E-01 2.3EtOl 6.5BtOO 3. SE-01 2. SE-01 7.7E-01 7.8E-01 6.2E-01 2.2E-01 1.2E-01 2.1E-01 2.7E-01

10 year 1. SE+00 7.2E-01 1.2E+OO 2.7E-01 6.6E-01 6.OB-01 6.7E-01 2.9E-01 3.3E+Ol 9.9EtOO 4.9E-01 4.7E-01 1.2EtOO 1.2EtOO 9.6E-01 1.3E+OO 1.9E-01 3. SE-01 4,1g-01

5 year 2.1EtOO 1.2EtOO 2.OE+OO 4.1E-01 9.9E-01 9.3E-01

1 year 3.6EtOO 2.2EtOO 4.6EtOO 7.0E-01 1.7EtOO 1.6E+OO 1.9E+OO 8.3E-01 0.7E+Ol 2.8E+Ol 1.3g+oo 1.6E+OO 2.8EtOO 4.3EtOO 2.3EtOO 2.3E+OO 5.7E-01 1. OBtoo

1. 1EtOO
4.8E-01 4.8EtOl 1. SE+01 7.3E-01 0.OE-01 1.7E+OO 2.2EtOG 1.4E+OO 1.6EtOO 3.1E-01 5.6E-01 6.4E-01

* *

* *

1.ZE+OG
8.8&W

Effective dose equivalent (=Sv/nBp)

1.7B+GG

2.2B+oU

3.3B+oO

4.9B+oo

370

RADIATION

DOSE TO PATIENTS

FROM RADIOPHARMACEUTICALS

Tl 81 IOIl

THALLIUM
rT1
Biokinetic Model

Intravenously injected ionic monovalent thallium rapidly leaves the blood by uptake in the cells of all organs and tissues. The distribution is largely determined by the magnitude of the regional bloodflow, and is therefore dependent on the degree of physical activity. Compared with the situation at rest, which is considered in the present model, uptake in muscles increases 2-3 fold during exercise with a corresponding reduction in other tissues. The organ uptake data in the model are based on the reports by Samson et al. (1978), Atkins et uI. (1977) and Chen et al. (1983). Bartlett et al. (1984) have shown that 80% of thallium is excreted by way of the gastrointestinal tract and 20% by the renal tract. The whole-body retention curve can be represented by a two-exponential function with half-times equal to 7 d for 63% and 28 d for 37% of the injected activity (Chen et al., 1983). It is assumed here that all organs and tissues have a similar retention kinetics, with the exception of the heart, which shows a more rapid initial clearance (Freeman et al., 1986). The situation is unclear with regard to the uptake in testes. Direct organ measurements at autopsy in two cases by Samson et al. (1976) showed 0.1 l-0.12%, while Hosain and Hosain (1981) and Gupta et al. (1981) have derived values of 0.8-1.0% from gamma camera images of the testicular-scrotal region. A value of 0.8% has been chosen in this model. The lT1 preparation may be contaminated with Tl and 202T1. The effective dose equivalents per unit activity of these radionuclides are therefore also presented in the dosimetric table.
References
Atkins, H. L., Budinger, T. F., Lebowitz, E., Ansari, A. N., Greene, M. W., Fairchild, R. G. and Ellis, K. J. (1977). Thallium-201 for medical use. Part 3: Human distribution and physical imaging properties. J. Nucl. Med. 18, 1333140. Bartlett, R. D., Lathrop, K. A., Faulhaber, P. F. and Harper, P. V. (1984). Transfer of thallous ion to and from gastrointestinal sections. J. Nucl. Med. 25, P 92. Chen, C. T., Lathrop, K. A., Harper, P. V., Bartlett, R. D., Stark, V. J., Fultz, K. R. and Faulhaber, P. F. (1983). Quantitative measurement of long term in vivo thallium distribution in the human. J. Nucl. Med. 24, P 50. Freeman, M. R., Kanwar, N. and Armstrong, P. W. (1986). The variability of thallium half life at rest as compared to exercise. .I. Nucl. Med. 27, 997. Gupta, S. M., Herrera, N., Spencer, R. P., Hosain, F. and Crucitti, T. (1981). Testicular-scrotal content of 201T1and 67Ga after intravenous administration. Int. J. Nact. Med. Biol. 8, 211-213. Hosain, P. and Hosain, F. (1981). Revision of gonadal radiation dose to man from thallium-201. In: Proc. Third ht. Radiopharmaceutical Dositnetry Symposium, Oak Ridge 1980 (FDA 81-8166), pp. 333-345. Oak Ridge National Laboratories, Oak Ridge, Tennessee. Samson, G., Wackers, F. J. Th., Becker, A. E., Busemann Sokole, E. and van der Schoot, J. B. (1978). Distribution of thallium-201 in man. In: Nuklearmedizin und Biokybernetik, Vol. I, pp. 385-389. (Oeff, K. and Schmidt, H. A. E. eds) Medico-Informationsdienste, Berlin.

371

Tl
81 IOIl

Biokinetic Data
Organ (S) Total body F, 1.0 0.06 GI tract Stomach wall SI wall SI contents ULI contents LLI contents Heart wall
0.006

T 7d 28 d 7d 28 d 7d 28 d 7d 28 d

a 0.63 0.37 0.63 0.37 0.63 0.37

&I%
3.39 d

4.89 hr

29.3 min 2.44 hr 0.701 hr 2.03 hr 3.05 hr 1.98 hr

0.03 0.8 0.8 0.8 0.04

Kidneys Liver Lungs Muscles

0.06 0.09 0.04 0.41 0.003

Red marrow Spleen Testes Thyroid

0.06 0.007 0.008 0.002

10 hr 7d 28 d 7d 28 d 7d 28 d 7d 28 d 7d 28 d Id 28 d 7d 28 d 7d 28 d 7d 28 d 7d 28 d

0.50 0.32 0.18 0.63 0.37 0.63 0.37 0.63 0.37 0.63 0.37 0.63 0.37 0.63 0.37 0.63 0.37 0.63 0.37 0.63 0.37

4.89 hr 7.33 hr 3.26 hr 1.39 d 14.7 min 4.89 hr 34.2 min 39.1 min 9.77 min

372

RADIATION

DOSE TO PATIENTS

FROM RADIOPHARMACEUTICALS

Ti 81
IOll

THALLIUM
*lTl 3.044 days

Organ

per Adult

unit

Absorbed dose activity administered 15 year 6.6E-02 4.8E-02 4.5E-01 2.5E-02 1*6E--01 2.1E-01 2.3E-01 4.5E-01 2.5E-01 6.6E-01 2.2E-01 1.8E-01 1.3E-01 6.5E-02 2.4E-01 1.9E-01 l.ZE+OO 4.OE-01 5.6E-02 5.7E-02 10 year 9.9E-02 7.1E-02 7.3E-01 4.1E-02 2.4E-01 3.6E-01 4.OE-01 7.8E-01 3.9E-01 9.4E-01 3.4E-01 2.6E-01 3.2E-01 1 .OE-01 3.9E-01 2.9E-01 9.7EtOO 6.2E-01 9.1E-02 9.1E-02

(mGy/MBq) 5 year 1.4E-01 l.OE-01 1.3E+OO 6.4E-02 4.OE-01 5.7E-01 6.5E-01 1.3E+OO 1.2E+OO 1.4E+OO 5.1E-01 4.1E-01 5.4E-01 1.5E-01 6.9E-01 4.6E-01 1. lE+Ol 1.4E+OO 1.3E-01 1.5E-01 1 year 2.5E-01 2.OE-01 2.9E+OO 1.2E-01 7,. 8E-01

* * * * *

Adrenals Bladder wall Bone surfaces Breast GI-tract Stomach wall Small intest ULI wall LLI wall Heart Kidneys Liver Lungs Ovaries Pancreas Red marrow Spleen Testes Thyroid uterus Other tissue

5.1E-02 3.6E-02 3.4E-01 2.8E-02 1.2E-01 1.6E-01 1.9E-01 3.6E-01 2.3E-01 5.4E-01 1.8E-01 1.2x-01 1.2E-01 5.4E-02 1.8E-01 1.4E-01 5.6E-01 2.5E-01 5.OE-02 5.6E-02

1. lE+OO
1.2E+OO 2. SE+00 2.1E+OO 2.5E+OO 9.6E-01 7.9E-01 1.2E+OO 2.6E-01 1.4B+OO 8.3E-01 1.5E+Ol 2.7E+OO 2.4E-01 2.8E-01

Effective dose equivalent Wv/nas) IFpuriFies: E fectivaose *Tl **Tl (26.1 (12.23 h) d)

2.3E-01

3.61-01

1. SB+OO

2.OE+oo

3.OB+OO

equivalent 3.1E-01 8.OE-01

(mSv/MBq of 4.7E-01 1. lE+OO

the

impurity) 1.2E+OO 3.1E+OO 1.5E+OO 4.2E+OO 2.3E+OO 6.5E+OO

373