The need for in vivo bone strontium assessment arises because strontium may exert a number of effects on bone, which may be either beneficial or toxic. Measurements discussed here are noninvasive, no sample is taken, nor is there discomfort to patients. The developed source excited x-ray fluorescence system employs a 109Cd source to excite the strontium K x rays, with the source and detector in approximately 90 degree geometry relative to the sample position. The factors affecting the accuracy and minimal detectable limit for bone strontium in vivo measurements are discussed. A system calibration revealed a minimum detectible limit of approximately 0.25 mg Sr/g Ca, which is sufficient for the monitoring of strontium levels in healthy subjects and patients with elevated bone strontium concentrations. Preliminary in vivo measurements in ten healthy subjects at two bone sites (phalanx and tibia) indicated that this system can be applied for cumulative bone strontium estimation while delivering a low effective dose of 80 nSv during the measurement time. Future work will involve attempts to enhance system precision with alternative fluorescing sources and further optimization of the detection system.
An x-ray fluorescence (XRF) system using 125I as the source was developed to measure strontium in bone in vivo. As part of an in vivo pilot study, 22 people were measured at two bone sites, namely the index finger and the tibial ankle joint. Ultrasound measurements were used to obtain the soft tissue thickness at each site, which was necessary to correct the signal for tissue attenuation. For all 22 people, the strontium peak was clearly distinguishable from the background, proving that the system is able to measure Sr in vivo in people having normal bone Sr levels. Monte Carlo simulations were carried out to test the feasibility and the limitations of using the coherently scattered peak at 35.5 keV as a means to normalize the signal to correct for the bone size and shape. These showed that the accuracy of the normalized Sr signal when comparing different people is about 12%. An interesting result arising from the study is that, in the measured population, significantly higher measurements of bone Sr concentration were observed in continental Asian people, suggesting the possibility of a dietary or race dependence of the bone Sr concentration or a different bone biology between races.
A non-invasive in vivo x-ray fluorescence (XRF) method of measuring bone strontium concentrations has previously been reported as a potential diagnostic tool able to detect strontium concentration in the finger and ankle bones. The feasibility of coherent normalization for (125)I-source-based finger bone strontium x-ray fluorescence (XRF) measurements is assessed here by theoretical considerations and Monte Carlo simulations. Normalization would have several advantages, among which are the correction for the signal attenuation by the overlying soft tissue, and intersubject variability in the bone size and shape. The coherent normalization of bone strontium XRF measurements presents several challenges dictated by the behaviour of the coherent cross section and mass attenuation coefficient at the energies involved. It was found that the coherent normalization alone with either 22.1 keV or 35.5 keV photons was not successful in correcting for the overlying soft tissue attenuation. However, it was found that the coherent peak at 35.5 keV was able to correct effectively for variability in the finger bone size between people. Thus, it is suggested that, if the overlying soft tissue thickness can be obtained by means of an independent measurement, the 35.5 keV peak can be used to correct for the bone size, with an overall accuracy of the normalization process of better than 10%.
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