Radon is a naturally occurring radioactive material formed by the slow decay of uranium and thorium found in the earth’s crust or construction materials. Internal exposure to radon accounts for about half of the natural background radiation dose to which humans are exposed annually. Radon is a carcinogen and is the second leading cause of lung cancer following smoking. An association between radon and lung cancer has been consistently reported in epidemiological studies on mine workers and the general population with indoor radon exposure. However, associations have not been clearly established between radon and other diseases, such as leukemia and thyroid cancer. Radiation doses are assessed by applying specific dose conversion coefficients according to the source (e.g., radon or thoron) and form of exposure (e.g., internal or external). However, regardless of the source or form of exposure, the effects of a given estimated dose on human health are identical, assuming that individuals have the same sensitivity to radiation. Recently, radiation exceeding the annual dose limit of the general population (1 mSv/yr) was detected in bed mattresses produced by D company due to the use of a monazite-based anion powder containing uranium and thorium. This has sparked concerns about the health hazards for mattress users caused by radiation exposure. In light of this event, this study presents scientific information about the assessment of radon and thoron exposure and its human implications for human health, which have emerged as a recent topic of interest and debate in society.
Use of radioactive iodine (RAI) for thyroid cancer patients is accompanied by elevated risks of radiation-induced adverse effects due to significant radiation exposure of normal tissues or organs other than the thyroid. The health risk estimation for thyroid cancer patients should thus be preceded by estimating normal tissue doses. Although organ dose estimation for a large cohort often relies on absorbed dose coefficients (i.e., absorbed dose per unit activity administered, mGy/MBq) based on population models, no data are available for thyroid cancer patients. In the current study, we calculated absorbed dose coefficients specific for adult thyroid cancer patients undergoing RAI treatment after recombinant human TSH (rhTSH) administration or thyroid hormone withdrawal (THW). We first adjusted the transfer rates in the biokinetic model previously developed for THW patients for use in rhTSH patients. We then implemented the biokinetic models for thyroid cancer patients coupled with S values from the International Commission on Radiological Protection (ICRP) reference voxel phantoms to calculate absorbed dose coefficients. The biokinetic model for rhTSH patients predicted the extrathyroidal iodine decreasing noticeably faster than in the model for THW patients (calculated half-times of 12 and 15 h for rhTSH administration and THW, respectively). All dose coefficients for rhTSH patients were lower than those for THW patients with the ratio (rhTSH administration/THW) ranging from 0.60 to 0.95 (mean = 0.67). The ratio of the absorbed dose coefficients in the current study to the ICRP dose coefficients, which were derived from models for normal subjects, varied widely from 0.21 to 7.19, stressing the importance of using the dose coefficients for thyroid cancer patients. The results of this study will provide medical physicists and dosimetrists with scientific evidence to protect patients from excess exposure or to assess radiation-induced health risks caused by RAI treatment.
The International Commission on Radiological Protection (ICRP) recently adopted a detailed biokinetic model for systemic iodine with reference transfer coefficients based on typical worldwide dietary intakes of stable iodine. The regional data provided demonstrate that the ICRP reference thyroidal biokinetics may differ substantially across regions with atypically low or high dietary intakes of stable iodine. Importantly, the design of the ICRP model facilitates modifications of reference thyroidal kinetics based on regional dietary iodine intake. The present study extended the ICRP model to the South Korean population, whose dietary iodine intake is much higher than the global mean. The following three transfer coefficients were selected as targets for Korean-specific values: thyroidal uptake rate (λ 1), hormonal secretion rate (λ 4) and leakage rate of thyroidal organic iodine as inorganic iodide (λ 5). The Korean-specific values for λ 1, λ 4 and λ 5 were determined to be 4.48, 0.0086 and 0.0171 d−1, respectively, to yield the measurements of thyroidal iodine and physiological status of Korean adults. The determined λ 1 and λ 5 values differed noticeably from the ICRP values, whereas the λ 4 value was comparable to that of the ICRP. Compared with the ICRP reference model, the Korean model, in which the Korean-specific transfer coefficients were adopted, predicted noticeably lower thyroidal uptake and faster decrease of thyroidal iodine. In addition, the predicted cumulative activities of radioiodine in the thyroid were substantially lower (40–80%) than those predicted by the ICRP model. The Korean model developed in this study demonstrates that the iodine biokinetics for Koreans (i.e. a population with a high iodine consumption) obviously differ from the prediction of the ICRP model. Hence, the Korean model may serve to improve the accuracy of thyroid dose estimation for Koreans and will lead to practical changes in matters concerned with radiological protection.
The exponential growth in the use of nuclear medicine procedures represents a general radiation safety concern and stresses the need to monitor exposure levels and radiation-related long term health effects in NM patients. In the current study, following our previous work on NCINM version 1 based on the UF/NCI hybrid phantom series, we calculated a comprehensive library of S values using the ICRP reference pediatric and adult voxel phantoms and established a library of biokinetic data from multiple ICRP Publications, which were then implemented into NCINM version 2. We calculated S values in two steps: calculation of specific absorbed fraction (SAF) using a Monte Carlo radiation transport code combined with the twelve ICRP pediatric and adult voxel phantoms for a number of combinations of source and target region pairs; derivation of S values from the SAFs using the ICRP nuclear decay data. We also adjusted the biokinetic data of 105 radiopharmaceuticals from multiple ICRP publications to match the anatomical description of the ICRP voxel phantoms. Finally, we integrated the ICRP phantom-based S values and adjusted biokinetic data into NCINM version 2. The ratios of cross-fire SAFs from NCINM 2 to NCINM 1 for the adult phantoms varied widely from 0.26 to 5.94 (mean=1.24, IQR=0.77–1.55) whereas the ratios for the pediatric phantoms ranged from 0.64 to 1.47 (mean=1.01, IQR=0.98–1.03). The ratios of absorbed dose coefficients from NCINM 2 over those from ICRP publications widely varied from 0.43 (colon for 99mTc-ECD) to 2.57 (active marrow for 99mTc-MAG3). NCINM 2.0 should be useful for dosimetrists and medical physicists to more accurately estimate organ doses for various nuclear medicine procedures.
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