ICRP Publication 128

Radiation Dose to Patients from

Radiopharmaceuticals: a Compendium of Current
Information Related to Frequently Used
Substances
ICRP PUBLICATION 128

Approved by the Commission in July 2014

Abstract–This report provides a compendium of current information relating to

radiation dose to patients, including biokinetic models, biokinetic data, dose coeffi-
cients for organ and tissue absorbed doses, and effective dose for major radiophar-
maceuticals based on the radiation protection guidance given in Publication 60
(ICRP, 1991). These data were mainly compiled from Publications 53, 80, and 106
(ICRP, 1987, 1998, 2008), and related amendments and corrections. This report also
includes new information for 82Rb-chloride, iodide (123I, 124I, 125I, and 131I) and 123I-
labelled 2ß-carbomethoxy 3ß-(4-iodophenyl)-N-(3-fluoropropyl) nortropane (FP-
CIT). The coefficients tabulated in this publication will be superseded in due
course by values calculated using new International Commission on Radiation
Units and Measurements/International Commission on Radiological Protection
adult and paediatric reference phantoms and Publication 103 methodology (ICRP,
2007). The data presented in this report are intended for diagnostic nuclear medicine
and not for therapeutic applications.
ß 2015 ICRP. Published by SAGE.

Keywords: Radiopharmaceuticals; Biokinetics; Dosimetry; Patients

AUTHORS ON BEHALF OF ICRP

S. MATTSSON, L. JOHANSSON, S. LEIDE SVEGBORN, J. LINIECKI, D. NOßKE,
K.Å. RIKLUND, M. STABIN, D. TAYLOR, W. BOLCH, S. CARLSSON, K. ECKERMAN,
A. GIUSSANI, L. SÖDERBERG, S. VALIND

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 PREFACE

In 1987, the International Commission on Radiological Protection (ICRP) published

a report entitled ‘Radiation dose to patients from radiopharmaceuticals’ (ICRP,
1987). This report contained results from calculations of organ absorbed dose and
effective dose equivalent per unit activity administered for some 120 radiopharma-
ceuticals in regular use at the time. Over the years, ICRP has provided the following
radiopharmaceutical reports, amendments, and corrections:

. ICRP, 1987. Radiation dose to patients from radiopharmaceuticals. ICRP

Publication 53. Ann. ICRP 18(1–4).
. ICRP, 1991. Radiation dose to patients from radiopharmaceuticals. Addendum 1
to ICRP Publication 53. ICRP Publication 62. Ann. ICRP 22(3).
. ICRP, 1997. General principles for the radiation protection of workers. Erratum
for ICRP Publication 62. ICRP Publication 75. Ann. ICRP 27(1). [Not used in
this report]
. ICRP, 1998. Radiation dose to patients from radiopharmaceuticals. Addendum 2
to ICRP Publication 53. ICRP Publication 80. Ann. ICRP 28(3).
. ICRP, 1998. Radiation dose to patients from radiopharmaceuticals. Addendum 2
to ICRP Publication 53. Errata: Printing errors in ICRP Publication 53. ICRP
Publication 80. Ann. ICRP 28(3). [Not used in this report]
. ICRP, 2008. Radiation dose to patients from radiopharmaceuticals. Addendum 3
to ICRP Publication 53. ICRP Publication 106. Ann. ICRP 38(1/2).
. ICRP, 2013. Radiation dose to patients from radiopharmaceuticals. A fourth
addendum to ICRP Publication 53. Available at: http://www.icrp.org/docs/
Radiation%20Dose%20to%20Patients%20from%20Radiopharmaceuticals%20-
%20A%20fourth%20addendum%20to%20ICRP%20Publication%2053.pdf

This report includes a compendium of current information relating to radiation dose

to patients for widely used radiopharmaceuticals, and also provides new information
for 82Rb-chloride and 123I-, 124I-, 125I-, and 131I-iodide.

The data on effective dose shown in this report are calculated as specified in
Publication 60 (ICRP, 1991a). However, work is in progress to develop a new set
of dose coefficients calculated in accordance with the Publication 103 methodology
(ICRP, 2007).

The data are not intended for therapeutic applications of radionuclides. More
detailed and patient-speciEc dosimetry and dose planning should be applied for
therapeutic application of radionuclides.

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 ICRP Publication 128

The membership of the Task Group on Radiopharmaceuticals at the time of com-

pletion of this report was:

S. Mattsson (Chair) L. Johansson (Secretary) J. Liniecki

D. Noßke K.Å. Riklund S. Leide-Svegborn
M. Stabin D. Taylor
The corresponding members were:

W.E. Bolch S. Carlsson K. Eckerman

A. Giussani L. Söderberg S. Valind

Main Commission critical reviewers were:

C-M. Larsson S. Romanov

The membership of Committee 2 during the period of preparation of this report was:

(2009–2013)

H.G. Menzel (Chair) M. Bailey M. Balonov

D. Bartlett V. Berkovski W. Bolch
R. Cox G. Dietze K. Eckerman
A. Endo J. Harrison J. Ma
N. Ishigure R. Leggett J. Lipsztein
F. Paquet N. Petoussi-Henss A. Pradhan

(2013–2017)

J. Harrison (Chair) F. Paquet (Vice-Chair) W. Bolch (Secretary)

M. Bailey V. Berkovski D. Chambers
M. Degteva A. Endo J.G. Hunt
C.H. Kim R. Leggett J. Ma
D. Nosske N. Petoussi-Henss F. Wissmann

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 Radiation dose to patients from radiopharmaceuticals

The membership of Committee 3 during the period of preparation of this report was:

(2009–2013)

E. Vañó (Chair) J-M. Cosset (Vice-Chair) M.M. Rehani (Secretary)

M.R. Baeza L.T. Dauer I. Gusev
J.W. Hopewell P-L. Khong P. Ortiz López
S. Mattsson D.L. Miller K.Å. Riklund
H. Ringertz M. Rosenstein Y. Yonekura
B. Yue

(2013–2017)

E. Vañó (Chair) D.L. Miller (Vice-Chair) M.M. Rehani (Secretary)

K. Applegate M. Bourguignon L.T. Dauer
S. Demeter K. Kang P-L. Khong
R. Loose P. Ortiz López C. Martin
K.Å. Riklund P. Scalliet Y. Yonekura
B. Yue

The authors wish to thank the former ICRP Assistant Scientific Secretary Michiya
Sasaki, former ICRP Interns Ian Steadman, Taylor Whitter, Tudor Dragea, and
Robert Martin who contributed to the checking and editing at the early stage of
this publication.

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 1. INTRODUCTION

(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, recognised under the name of ‘nuclear medicine and
molecular imaging’. New methods and new radiopharmaceuticals are being intro-
duced continually. Reasonably accurate dosimetry for representative groups of
patients for each specific investigation is needed to optimise use of the various
alternative radiodiagnostic techniques, and to estimate the collective radiation expo-
sure and risk from nuclear medicine investigations. The limited, but increasing, use
of radiopharmaceuticals for therapy requires even more detailed and patient-specific
dosimetry and dose planning for both tumour and normal tissue. The data presented
in this report are intended for diagnostic nuclear medicine and not for therapeutic
applications.
(2) With regard to dose calculations for diagnostic radiopharmaceuticals, a number
of reports have been published by the Commission. In 1987, Publication 53 (ICRP,
1987) was published containing dose coefficients for approximately 120 substances
and superseding Publication 17 (ICRP, 1971). In 1991, dose data for six additional
substances were published in Publication 62 (ICRP, 1991b), and data for another
10 substances were published in Publication 80 (ICRP, 1998). In 2008, biokinetic
information and dose coefficients covering 25 different substances were published in
Publication 106 (ICRP, 2008) – a third addendum to Publication 53. This publication
also includes recommendations relating to breast feeding for mothers who have
undergone nuclear medicine procedures. A fourth addendum including 6 substances
has been available on the ICRP’s website (www.icrp.org). Further work of the Task
Group on Radiation Dose to Patients from Radiopharmceuticals has included 82Rb-
chloride, 123I-, 124I-, 125I-, and 131I-iodide as well as 123I-labelled 2ß-carbomethoxy 3ß-
(4-iodophenyl)-N-(3-fluoropropyl) nortropane (FP-CIT).
(3) Information regarding dose calculations from radiopharmaceuticals has also
been published in reports from the International Commission on Radiation Units
and Measurements (ICRU), notably ICRU Reports 32 and 67 (ICRU, 1979, 2002).
At the national level, several absorbed dose catalogues for radiopharmaceuticals and
collections of published values have also been issued (Roedler et al., 1978; NCRP,
1982; Johansson et al., 1992; ARSAC, 2014). Of particular importance is the work of
the Medical Internal Radiation Dose (MIRD) Committee of the US Society of
Nuclear Medicine, and the dosimetry work performed at Oak Ridge National
Laboratory (http://crpk.ornl.gov/), at the Radiation Internal Dose Information
Center at Oak Ridge Associated Universities in Oak Ridge, TN, USA (now dis-
banded), and the Radiation Dose Assessment Resource (RADAR) (www.doseinfo-
radar.com).
(4) A computer software code named ‘MIRDOSE’ was developed (Stabin, 1996)
to facilitate automated and standardised internal dose calculations for nuclear med-
icine applications. This code was completely rewritten and renamed ‘OLINDA’
(Organ Level INternal Dose Assessment) (Stabin et al., 2005). The OLINDA/

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 ICRP Publication 128

EXM code (where EXM stands for ‘EXponential Modelling’) allows users to fit data
to one, two, or three exponential functions. The OLINDA/EXM code uses the same
technical basis (phantoms, organ masses, equations, relationships assumed, and
other details) as the MIRDOSE code and the RADAR system.
(5) Reference biokinetic and dosimetric models and reference data for workers and
members of the public exposed to radionuclides have been published by the
Commission, giving dose coefficients for intake of radionuclides by inhalation and
ingestion (ICRP, 1973, 1979, 1980, 1981, 1993, 1994, 1996, 2012).
(6) The Task Group has made extensive use of the information and material
available from these sources.

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 2. SELECTION OF RADIOPHARMACEUTICALS

(7) Certain general principles were followed in establishing the list of radiophar-
maceuticals for inclusion in this report. A radiopharmaceutical that has been
described in the literature and proposed for use in humans was included if 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.
(8) 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. The list is based on the judgement of the Task Group regarding their
past, present, or potential future application in nuclear medicine procedures. Data
relating to these substances were obtained from an extensive search of the literature.
Some information had been published in scientific journals covering subjects other
than nuclear medicine.
(9) Complete radionuclide and radiochemical purity is assumed in all absorbed
dose calculations.

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 3. SELECTION OF ORGANS AND TISSUES FOR DOSE CALCULATIONS

(10) Absorbed doses are calculated for most organs and tissues (‘target organs and
tissues’). These absorbed doses may arise as a result of radioactive decay occurring in
other regions (‘source regions’). Thus, absorbed doses in a particular organ or tissue
are typically the sum of contributions from various sources, 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); and
. other organs and tissues that receive significantly higher absorbed doses than
the average to the rest of the body, or which are of special interest in the
investigation (Group 2).

Table 3.1. Organs and tissues for which absorbed dose is calculated.

Group 1 Group 2

Adrenals Lachrymal glands

Bone surfaces Salivary glands
Breast Spinal cord
Brain
Gallbladder wall
Gastrointestinal tract
Stomach wall
Small intestine wall
Large intestine wall
Heart wall
Kidneys
Liver
Lungs
Oesophagus*
Other tissuesy
Ovaries
Pancreas
Red marrow
Skin
Spleen
Testes
Thymus
Thyroid
Urinary bladder wall
Uterus
*The absorbed dose to thymus is used as a substitute.
y
Mainly muscle tissues.

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 ICRP Publication 128

(11) The absorbed dose to organs and tissues not included in Table 3.1 can usually
be approximated by using the absorbed dose provided for ‘Other tissues’ (e.g.
muscle). The absorbed doses given in the annexes are the mean absorbed doses to
an organ or region. In general, these mean absorbed doses are calculated assuming
uniform distribution of the radionuclide in the source regions.
(12) An exception to the assumption of a uniform dose distribution is made for the
kidneys, where a non-uniform distribution of radionuclides may be taken into
account. However, even in this case, absorbed doses to other organs and tissues
are calculated under the assumption that the radionuclide is distributed uniformly
throughout both kidneys; this is justified because, in practice, use of a non-uniform
distribution when calculating the absorbed doses to other organs and tissues results
in very small changes (<10%) in the results obtained.
(13) Discussions were held regarding whether or not to calculate doses to regions
of the brain that will receive doses considerably higher than the average dose, such as
the putamen and nucleus caudatus from 123I-labelled FP-CIT. As S values for the
calculation of regional doses in this case have been published (Bouchet et al., 1999),
the decision was made to include the absorbed dose to the region of the brain that
receives the highest absorbed dose as a footnote to the dose table. However, this dose
is not used in calculation of the effective dose for these radiopharmaceuticals. It is
important to stress that the doses are small; even if the central regions of the brain
receive doses 10 times higher than average, this is still below levels at which known
deterministic effects (‘tissue reactions’) can be observed.
(14) The lens of the eye is considered as a tissue at risk in Publication 60 (ICRP,
1991a) because of the possibility of inducing opacities that may interfere with vision.
The radionuclides 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 which is used in the synthesis of melanin (Winchell et al., 1980).
For this reason, the lens of the eye is not included in the list of target organs and
tissues.

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 4. BIOKINETIC MODELS AND DATA

(15) The Task Group 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.
(16) The Task Group wishes to repeat the requests most recently made in
Publication 106 (ICRP, 2008) for securing the maximum information possible
from any investigation that involves radiopharmaceuticals. The information
needed for dose calculations includes fractional long-term retention of radionuclides
and labelled compounds, turnover of the radiopharmaceutical and its metabolites,
fractional gastrointestinal absorption values for orally administered compounds,
distribution of radionuclides within different organs, and their excretion pathways.
Collection of such data should be encouraged by professional and scientific societies
and by regulatory authorities, and data should be made available by publication and
storage in accessible databases. The editors and referees of scientific journals are
encouraged to request such information in papers on new, as well as commonly
administered, radiopharmaceuticals.
(17) For each radioactive compound, the Task Group has agreed upon a bioki-
netic model giving quantitative estimates for the distribution and metabolism of the
radiopharmaceutical in the body. The literature on which each model is based is
referenced. In appropriate cases, the range of pathological variation expected in the
metabolic data is also indicated.
(18) Some biokinetic models have been developed within a generic framework for
application to a class of radiopharmaceutical (e.g. monoclonal antibodies and brain
receptor substances). Each of the generic model frameworks is a compromise
between biological realism and practical considerations regarding the amount and
quality of information that is available to determine parameter values for specific
compounds.
(19) A realistic maximum model (assuming no biological elimination) have been
developed for substances labelled with 11C.
(20) For absorbed dose calculations, knowledge of the time–activity curve in
different organs and tissues of the body after administration of a radiopharmaceu-
tical is needed. The best way to get this information is by pharmacokinetic analysis,
which includes knowledge about mechanisms affecting radionuclide localisation and
physiological assumptions regarding its behaviour in body tissues. On the basis of
this knowledge, a biokinetic model is defined, delineating the detailed distribution
and flow, or transfer, of the radionuclide.
(21) This biokinetic model, in 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

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 ICRP Publication 128

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.
(22) The method outlined above could, in principle, be applied to derive absorbed
doses in those disease states leading to quantitative changes in normal physiological
processes. However, this is not generally possible because, with some exceptions,
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;
these can be established in alternative ways, as discussed in detail in ICRU Reports
32 and 67 (ICRU, 1979, 2002), the MIRD primer (Loevinger et al., 1991) and the
MIRD Pamphlet 21 (Bolch et al., 2009).
(23) For example, a simple approach involves modification of the bone dose in
younger individuals in whom bone growth is assumed to result in higher uptakes and
thus doses. In these tissues, the absorbed dose may be approximately two to five
times higher for 99mTc-phosphonates (Gelfand et al., 1983; Kaul et al., 1985) com-
pared with 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 both children and adults would underestimate radiation doses to a parti-
cular part of the skeleton, although the mean absorbed dose to bone surfaces is not
likely to be underestimated substantially. In calculations of absorbed doses to chil-
dren, age-dependent data are used for organ mass, blood distribution, and S values.
(24) 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.
(25) The models and absorbed dose values presented are intended for use in
diagnostic nuclear medicine and clinical research with radionuclides, and should
not be used in radionuclide therapy.
(26) Some radiopharmaceuticals administered to breast-feeding women may be
excreted in the breast milk and thus transferred to the breast-fed child. This problem
is covered in Annex D of this report. Excretion in breast milk in connection with
occupational exposure is covered in Publication 95 (ICRP, 2004).
(27) In the case of radionuclides such as 67Ga, 111In, 125I, and 201Tl, administered
in forms that result in their uptake in cell nuclei, the minor fraction of the energy
carried by Auger electrons may have a disproportionately large effect due to their
very short range in tissue (Stepanek et al., 1996; Bingham et al., 2000; Taylor, 2000;
Kassis, 2004). The assumption made here, that the absorbed dose is distributed
uniformly within the cell, may result in underestimation of the risk.
(28) This problem has been discussed in earlier publications (ICRP, 1979, 1991a,
2003), and by many other authors (e.g. Hofer, 1996; Gardin et al., 1999; Bingham
et al., 2000; Feinendegen and Neumann, 2004). MIRD has given detailed advice and

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 Radiation dose to patients from radiopharmaceuticals

presented S values for the cellular level (Goddu et al., 1994, 1997). Nonetheless, it is
still difficult to establish the intracellular distribution of the radionuclides of interest
so that such detailed S values can be used effectively.
(29) It is usually assumed that daughter radionuclides produced within the body
stay with, and behave metabolically like, their parent nuclide. This may be an over-
simplification in some cases, and if specific information to the contrary is available,
the dose estimates presented here should be modified appropriately.
(30) For some substances, such as iodine-labelled compounds, pertechnetate, and
some radiopharmaceuticals used for renal studies, blocking agents may be adminis-
tered before or simultaneously with the radiopharmaceutical (e.g. to induce compe-
titive inhibition of uptake in specific organs). In such circumstances, including
blocking of the thyroid, total inhibition of radionuclide uptake has been assumed,
although this may be difficult to achieve in practice.
(31) It is often possible to reduce the absorbed dose to a patient by increasing the
rate of elimination of the radionuclide from the body, for example by more frequent
emptying of the urinary bladder (with hydration, diuretics, and catheterisation), the
bowel (with laxatives and enemas), and the gallbladder (with a meal of high fat
content and cholecystokinin).

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 5. METHODS FOR CALCULATING ABSORBED DOSE
5.1. Calculation of absorbed dose
(32) The mean absorbed dose DT to a target organ or tissue T is the sum of the
contributions, D(T S), arising from nuclear transformations of the radionuclide in
various source organs S:
X
DT ¼ DðT SÞ ð5:1Þ
S

(33) Several methods of calculating the absorbed dose to an organ from radio-
active 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 ICRU Reports 32 and 67
(ICRU, 1979, 2002), Publication 30 (ICRP, 1979), and NCRP Report 84 (NCRP,
1985). The most common method currently in use in nuclear medicine was originally
developed from an approach by Loevinger and Berman (1968), using tabulated data
on absorbed fractions of energy in a target tissue from a specific source region
(Snyder et al., 1969; Loevinger et al., 1991). This method was later improved by
Snyder et al. (1975) who introduced the ‘S value’, which also contains all necessary
physical information for a specific radionuclide.
(34) With this more straightforward method, the absorbed dose in T from a radio-
nuclide in a single source organ S is given by:

DðT SÞ ¼ A~ S  SðT SÞ ð5:2Þ

where à is the time-integrated or cumulated activity, equal to the total number of

nuclear transformations in S, and S(T S) is the absorbed dose in T per unit cumu-
lated activity in S.
(35) The value of S(T 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 excluding the 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
(Cloutier et al., 1973; Roedler and Kaul, 1976; Coffey and Watson, 1979); this latter
method is used in this report.
(36) If S values are not available, the absorbed dose per nuclear transformation is
calculated using the absorbed fraction ’, derived from Snyder et al. (1978):
c X
SðT SÞ ¼ Ei Yi ’i ð5:3Þ
MT i

where MT is the mass of the target organ or tissue (see Table A.1), Ei is the mean
energy of radiation type i, Yi is the yield of radiation type i per transformation, ’i is

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 ICRP Publication 128

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, MT in kg, and
c ¼ 1, the absorbed dose per transformation, S, will be in gray).

5.2. Calculation of cumulated activity

(37) 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 serves as a short account of the
calculation of cumulated activity in selected cases.
(38) The cumulated activity ÃS in a source organ or tissue S depends on
the administered activity, A0, the physical half-life, T, and the biokinetics of
the radiopharmaceutical. ÃS, which represents the number of disintegrations
occurring in source region S, is obtained by integrating the time-dependent
activity:
Z t
A~ S ðtÞ ¼ AS ðuÞdu ð5:4Þ
0

where AS(u) is the activity at time u in the source organ or tissue considered. Due to
the relatively short physical half-life of radionuclides used in nuclear medicine, the
upper integration limit, t, can be taken as infinity.
(39) 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. As this is all that
is required for dosimetric calculations, these models are used extensively in this
report.
(40) A general first-order kinetic model can be represented as a system of n com-
partments, interlinked with constant rate coefficients. In such a system, the rate of
change of the amount of material (qi) in compartment i is given by:

dqi Xn
¼ ii qi ðtÞ  p qi ðtÞ þ ij qj ðtÞ ð5:5Þ
dt j¼1
j6¼i

where ii is the fraction of the amount of material in compartment i leaving per unit
time, ij is the fraction of the amount of material in compartment j flowing to
compartment i per unit time, and p is the radioactive decay constant, as
appropriate.
(41) A direct correspondence between compartments and anatomical regions of
the body does not usually exist. However, for absorbed dose calculations, it is
necessary to know the amount of substance in different regions of the body.
Therefore, for practical reasons, specific organs and tissues are considered instead

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 Radiation dose to patients from radiopharmaceuticals

of compartments. The activity in an organ or tissue can usually be described suffi-

ciently accurately by a sum of exponentials:

X
n
AS ðtÞ ¼ ki eði þp Þt ð5:6Þ
i¼1

where ki is a constant, and i is the biological elimination constant of the exponential

component i.
(42) The constants in this equation are often derived directly from measurements.
Expressed in terms of fractional distributions to the organ or tissue, and fractions of
organ or tissue contents where half-times are given in the biokinetic data tables of
this report, AS is given by:

nX Xn      
A~ S þm
Ti  lnð2Þ  lnð2Þ
¼ FS aj ai exp t  exp t ð5:7Þ
A0 j¼nþ1 i¼1
Ti  Tj Ti,eff Tj,eff

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 if
there were no radioactive decay), ai is the fraction of FS eliminated with a biological
half-time Ti ( ai ¼ 1), aj is the fraction of FS taken up with a biological half-time Tj
(marked by a minus sign in the biokinetic data tables) ( aj ¼ 1), n is the number of
elimination components, m is the number of uptake components, and Tj,eff and Ti,eff
are the elimination and uptake effective half-times, respectively. Eq. (5.7) is, under
certain constraints, a solution to Eq. (5.5).
(43) The effective half-time can be calculated from the corresponding biological
half-time Ti and the functional physical half-life Tp:

1 1 1
¼ þ ð5:8Þ
Ti,eff Ti Tp

(44) Eq. (5.7) describes the build-up and subsequent decline of activity. If Ti ¼ Tj
for some combination of i and j, the corresponding term in the sum in Eq. (5.7)
becomes:
 
lnð2Þ  lnð2Þ
ai t exp t ð5:9Þ
Ti Ti,eff

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

Xn  
AS ðtÞ  lnð2Þ
¼ FS ai exp t ð5:10Þ
A0 i¼1
Ti,eff

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 ICRP Publication 128

Integrating Eq. (5.7) over time up to infinity gives the normalised cumulated
activity:

nX Xn   
A~ S þm
Ti Ti,eff Tj,eff
¼ FS aj ai  ð5:11Þ
A0 j¼nþ1 i¼1
Ti  Tj lnð2Þ lnð2Þ

or, if Eq. (5.10) is integrated:

A~ S Xn
Ti,eff
¼ FS ai ð5:12Þ
A0 i¼1
lnð2Þ

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.
(46) For absorbed dose calculations in nuclear medicine, it has often been assumed
that the effective half-time in an organ equals the physical half-life. The reason for
this approximation is that the substance, in these cases, is labelled with a radio-
nuclide with a physical half-life that is short in comparison with the biological
half-time. For short-lived radionuclides, a slow biological excretion may not be
apparent and, for absorbed dose calculations, the approximation is sufficiently accu-
rate. However, this assumption has the consequence that infinite biological half-
times are given in the tables and this is not strictly correct. This should be kept in
mind when biokinetic data are used.

5.3. Uncertainties in absorbed dose estimates

(47) The uncertainty in the estimate of the mean absorbed dose for an organ or
tissue in a reference person reflects uncertainties in the cumulated activity and the S
value. Differences between planned and actual administered activity are considered
to be minor contributors to the total uncertainty if regular quality control is per-
formed (IAEA, 2006). Variation in mass of the target organ and, for photon radia-
tion, 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. 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 indi-
cated agreement within 20–60%; the latter for patients who differed considerably
from the body size and shape assumed in the calculations (i.e. the uncertainty for the
dose to the reference person would be considerably lower). The reader is referred to
Roedler (1980) for a review.
(48) Variations in the estimated cumulated activity largely arise from uncertainties
in the quantitative description of uptake, distribution, and retention of the radio-
pharmaceutical in tissues (Norrgren et al., 2003; Jönsson et al., 2005). Functional
impairment of an organ can introduce considerable variation in these factors.

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 Radiation dose to patients from radiopharmaceuticals

Variation in the body’s retention of radionuclides administered as radiopharmaceu-

ticals is limited by the short radioactive half-life of these radionuclides: thus, varia-
tion in the uptake and distribution of the radiopharmaceutical among the organs and
tissues is often the major contributor to uncertainties in cumulated activity.
(49) Calculations have shown (Roedler, 1980; Zanzonico, 2000) 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 99mTc. The effective dose
is less sensitive to variations in the distribution pattern than organ doses, and may
vary within a factor of two.

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 6. EFFECTIVE DOSE
6.1. Use of effective dose in nuclear medicine
(50) Radiation exposure of the different organs and tissues in the body results in
different probabilities of harm and different severities. The Commission uses the term
‘detriment’, meaning health detriment, for the combination of probability and sever-
ity of harm.
(51) The detriment depends on the type of radiation or, more specifically, the
ionisation density. This is accounted for by introducing the concept of equivalent
dose. The mean equivalent dose HT in a target organ or tissue T is given by ICRP
(1991a):
X
HT ¼ wR DT,R ð6:1Þ
R

where DT,R is the mean absorbed dose from radiation R in tissue or organ T, and wR
is the radiation weighting factor. For all types of radiation used in diagnostic nuclear
medicine, wR equals 1 (even if this value may not be appropriate for Auger emitters
incorporated into DNA).
(52) To reflect the combined detriment from stochastic effects due to the equiva-
lent doses in all the organs and tissues of the body, the equivalent dose in each organ
and tissue is multiplied by a tissue weighting factor, and the results are summed over
the whole body to give the effective dose. The special name for the SI unit for
effective dose is the sievert (Sv).
(53) The effective dose was developed primarily for radiation protection of
occupationally exposed persons (ICRP, 1977, 1991a). It attributes weighting fac-
tors 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 whole body is irradiated uniformly. The effective
dose is calculated by adding the weighted organ or tissue mean dose equivalents,
HT, i.e.:
X
E¼ w T HT ð6:2Þ
T

where E is the effective dose, wT is the relative radiation sensitivity of organ or tissue
T (see Table 6.1), and HT is the mean equivalent dose in target organ or tissue T. For
radionuclides used in diagnostic nuclear medicine, the effective dose is numerically
equal to that of the mean absorbed dose as the radiation weighting factor wR is taken
as unity for these radionuclides.
(54) If the body is irradiated uniformly, all the HT values are the same and the
equivalent dose at any point in the body is numerically equal to the effective dose.
(55) The weighting factors used in computing this quantity are applied both to
workers and the general population.

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 ICRP Publication 128

Table 6.1. Weighting factors for calculation of effective dose

E according to the Commission’s 1990 Recommendations
(ICRP, 1991a).

Tissue wT

Gonads 0.20
Colon 0.12
Lung 0.12
Red marrow 0.12
Stomach 0.12
Bladder 0.05
Breast 0.05
Liver 0.05
Oesophagus 0.05
Thyroid 0.05
Skin 0.01
Bone surfaces 0.01
Remainder* 0.05
*Adrenals, brain, upper large intestine, small intestine, kidney, muscle,
pancreas, spleen, thymus, and uterus.

(56) The Commission has issued its 2007 Recommendations (ICRP, 2007), super-
seding the 1990 Recommendations (ICRP, 1991a) with updated and amended tissue
weighting factors (and radiation weighting factors). Currently, work is in progress
within ICRP to generate correspondingly updated dose coefficients for the calcula-
tion of doses to workers and members of the public due to intake of radioactive
substances. In due course, doses to patients from intake of radiopharmaceuticals will
also be calculated. However, pending the availability of such updated information,
the present data should be used.
(57) Effective dose can be of practical value for comparing doses related to sto-
chastic effects from: different diagnostic examinations and interventional procedures;
the use of similar technologies and procedures in different hospitals and countries;
and the use of different technologies for the same medical examination, provided that
the representative patients or patient populations for which the effective doses are
derived are similar with regard to age and gender. However, comparisons of effective
doses may be inappropriate when there are significant dissimilarities between the age
and gender distributions of the representative patients or patient populations being
compared (e.g. children, all females, elderly populations), and the Commission’s
reference distribution of both genders and all ages. This is a consequence of the
fact that the magnitudes of risk for stochastic effects are dependent on age and
gender.

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 Radiation dose to patients from radiopharmaceuticals

(58) Effective dose should not be used to assess risks of stochastic effects in retro-
spective situations for exposures in identified individuals, nor should it be used in
epidemiological evaluations of human exposure.
(59) Risk assessment for medical uses of ionising radiation is best evaluated using
appropriate risk values for the individual tissues at risk, and for the age and gender
distribution of the population groups undergoing the medical procedures.
(60) For the exposure of young children, the risk would be higher, perhaps by a
factor of two or three (ICRP, 1991a, Annex C). For many common types of diag-
nostic examination, the higher risk will be offset by the reduction in administered
activity relative to that to an adult. For an age at exposure of approximately 60
years, the risk would be lower, perhaps by a factor of three. At higher ages at
exposure, the risks are even less (ICRP, 1991a, Annex C). The specific demographics
of the medically exposed population present obstacles to applying the concept of
effective dose as a tool for comparing doses from medical irradiation with other
sources of exposure to humans.

6.2. Calculation of effective dose

(61) The organs and tissues considered for calculation of effective dose are listed in
Table 6.1. Those with specific weighting factors are always included in the calcula-
tion. For the gonads, the arithmetic mean of the absorbed doses to ovaries and testes
is used in conjunction with the weighting factor of 0.20. Absorbed doses to blood
and blood vessels are not included in the calculation.
(62) The definition of ‘colon’ or ‘large intestine’ follows that given in Publication
67 (ICRP, 1993, Para. 14). The weighting factor is to be applied to the mass average
of the equivalent dose in the walls of the upper and lower large intestine (ULI and
LLI) of the gastrointestinal tract. As the ratio between the masses of the walls of the
ULI and LLI is independent of age, the equivalent dose to the colon Hcolon is given
as:

Hcolon ¼ 0:57 HULI þ 0:43 HLLI ð6:3Þ

where HULI and HLLI are the equivalent doses in the walls of the ULI and LLI,
respectively.
(63) The biokinetic model presented here contains no information on uptake and
retention of radionuclides in the oesophagus. As the transit time of materials through
the oesophagus is normally quite rapid in comparison with the physical half-life, only
the absorbed dose from penetrating radiation emitted from other source regions is
considered. In the absence of absorbed fraction values for the oesophagus, the dose
to the thymus has been used previously as a surrogate (ICRP, 1991b), and this
method is used in the present report.
(64) The weighting factor for the remainder tissues, 0.05, is applied on the mass-
weighted average dose of those organs listed in the footnote of Table 6.1. In those
cases in which a single remainder tissue or organ receives an equivalent dose that

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 ICRP Publication 128

exceeds the dose to any other organ, a weighting factor of 0.025 should be applied to
that organ, and 0.025 to the average dose in the rest of the remainder tissues or
organs as defined above. This ‘rule’ may also apply for any other organ that is
recognised as radiation sensitive.
(65) As many radiopharmaceuticals are excreted rapidly in the urine, the absorbed
dose to the wall of the urinary bladder is often large compared with the absorbed
dose to other organs and tissues in the same study, and may contribute considerably
to the effective dose. In cases where the contribution is more than 50%, a note at the
foot of the dosimetry table states the actual contribution.
(66) 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.
(67) In this report, complete radiochemical purity has been assumed, unless other-
wise stated.

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 7. DOSE TO EMBRYO AND FETUS

(68) 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 if the subject is in
the first 2–3 months of pregnancy. Similarly, the absorbed dose to the fetus 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 organs and tissues of the mother may, as a first approximation,
be taken as representative of the absorbed dose to the corresponding organs and
tissues of the fetus.
(69) More detailed radiation dose estimates for the fetus from administration of a
number of radiopharmaceuticals to women at various stages of pregnancy are given
by Russell et al. (1997). Their data illustrate that the majority of studies will probably
involve fetal doses <10 mGy. Only studies using 131I-iodide, 201Tl-chloride, and
67
Ga-citrate appear to result in fetal doses >10 mGy, according to present knowl-
edge. Therapeutic administrations are routinely contra-indicated in the case of preg-
nancy or breast feeding as this may result in very high fetal doses. In addition,
beyond 10–13 weeks of gestation, the fetal thyroid may receive extremely high
doses in cases of therapy using 131I-iodide (Watson et al., 1989; Berg et al., 1998).
For substances in their ionic form, a comprehensive compilation of doses to the
embryo and fetus is found in Publication 88 (ICRP, 2001).

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ICRP, 1981. Limits for intakes of radionuclides by workers. ICRP Publication 30, Part 3.
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 ANNEX A. SPECIAL BIOKINETIC AND DOSIMETRIC MODELS
A.1. Organ and tissue masses for different ages
(A1) The masses of the organs and tissues are inherent in the S values used (Stabin
and Siegel, 2003; Stabin et al., 2005). The masses of the phantoms used for calcula-
tion of the S values are those presented by Stabin and Siegel (2003) (Table A.1). The
phantoms were produced by Cristy and Eckerman (1987), based predominantly on
data in Publication 23 (ICRP, 1975). As the masses refer to the phantoms used, they
may deviate somewhat from those in Publications 23 (ICRP, 1975) and 89 (ICRP,
2002).

A.2. Blood volume and blood flow models

(A2) Substances that remain largely in the blood are assumed to be distributed
according to the relative blood volume of the different organs. Examples of such
substances are labelled blood cells and radionuclides attached to macro-molecules,
but this blood distribution model has also been used, where appropriate, for other
substances. This model requires information on blood volumes in different organs
and tissues. These data were taken from Leggett and Williams (1991) and Williams
and Leggett (1989), and were also proposed by the Commission in Publication 89
(ICRP, 2002). 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 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 Publication 89 (ICRP, 2002) and is presented in
Table A.1.
(A3) 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 blood. In this case, the activity in blood
in an organ or tissue has been added to the activity in that organ or tissue for
purposes of dose calculations.
Table A.2 presents the fractional cardiac output to different organs and tissues.
These fractions, which are also proposed in Publication 89 (ICRP, 2002), were taken
from Leggett and Willams (1995). These data have been applied as a model for the
activity distribution of radionuclides with very short physical half-lives (i.e. seconds
up to a few minutes).

A.3. Gastrointestinal tract model

(A4) The model presented in Publication 30 (ICRP, 1979) for the gastrointestinal
tract has been used for adults and children aged 1–15 years. The model, shown in
Fig. A.1, consists of four compartments: stomach, small intestine, ULI, and LLI.

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 ICRP Publication 128

Table A.1. Masses (g) of models of selected organs and tissues at different ages.*

Organ Adult 15 years 10 years 5 years 1 year Newborn

Adrenals 16.3 10.5 7.22 5.27 3.52 5.83

Brain 1420 1410 1360 1260 884 352
Breast 351 361 2.6 1.51 0.732 0.107
Gallbladder contents 55.7 49 38.5 19.7 4.81 2.12
Gallbladder wall 10.5 9.27 7.28 3.73 0.91 0.408
Gastrointestinal tract
LLI contents 143 109 61.7 36.6 18.3 6.98
LLI wall 167 127 70 41.4 20.6 7.96
SI contents 1100 838 465 275 138 52.9
Stomach contents 260 195 133 75.1 36.2 10.6
Stomach wall 158 118 85.1 49.1 21.8 6.41
ULI contents 232 176 97.5 57.9 28.7 11.2
ULI wall 220 168 93.4 55.2 27.8 10.5
Heart contents 454 347 219 134 72.7 36.5
Heart wall 316 241 151 92.8 50.6 25.4
Kidneys 299 248 173 116 62.9 22.9
Liver 1910 1400 887 584 292 121
Lungs 1000 651 453 290 143 50.6
Musclesy 28,000 15,500 7000 2000 1000 760
Ovaries 8.71 10.5 3.13 1.73 0.714 0.328
Pancreas 94.3 64.9 30 23.6 10.3 2.8
Remaining tissuey 51,800 40,000 23,100 13,300 6400 2360
Skeleton
Active marrow 1120 1050 610 320 150 47
Cortical bone 4000 3220 1580 875 299 0
Trabecular bone 1000 806 396 219 200 140
Skin 3010 2150 888 538 271 118
Spleen 183 123 77.4 48.3 25.5 9.11
Testes 39.1 15.5 1.89 1.63 1.21 0.843
Thymus 20.9 28.4 31.4 29.6 22.9 11.3
Thyroid 20.7 12.4 7.93 3.45 1.78 1.29
Urinary bladder contents 211 160 103 64.7 32.9 12.4
Urinary bladder wall 47.6 35.9 23.2 14.5 7.7 2.88
Uterus 79 79 4.16 2.7 1.45 3.85
Whole body 73,700 56,800 33,200 19,800 9720 3600
(continued on next page)

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 Radiation dose to patients from radiopharmaceuticals

Table A.1. (continued)

Organ Adult 15 years 10 years 5 years 1 year Newborn

z
Blood volume, males (ml) 5300 4500 2400 1400 500 270
Blood volume, females (ml)z 3900 3300 2400 1400 500 270
LLI, lower large intestine; SI, small intestine; ULI, upper large intestine.
*Stabin and Siegel (2003).
y
‘Remaining tissue’ is defined as the part of the phantom remaining when all defined organs except
muscles have been removed. The muscle mass is taken from Publication 23 (ICRP, 1975).
z
Data from Publication 89 (ICRP, 2002).

Table A.2. Adult values for blood content and blood flow in different organs.

Fractional blood Fractional

Organ volume (%) cardiac output (%)

Adrenals 0.06 0.3

Brain 1.2 12
Gastrointestinal tract
Stomach wall 1.0 1.0
Small intestine 3.8 10
Large intestine 2.2 4.0
Heart contents 9.0
Heart wall 1.0 4.0
Kidneys 2.0 19
Liver 10 25.5
Lungs 12.5 2.5
Ovaries 0.02 0.02
Pancreas 0.6 1.0
Skeleton
Red marrow 4.0 3.0
Cortical bone 0.8 0.6
Trabecular bone 1.2 0.9
Skin 3.0 5.0
Spleen 1.4 3.0
Testes 0.04 0.1
Thyroid 0.06 1.5

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 ICRP Publication 128

Ingestion

Stomach (ST)
λST
λB
Small intestine (SI) Body fluids
λSI
Upper large
intestine (ULI)

Colon λULI
Lower large
intestine (LLI)

λLLI
Excretion

Fig. A.1. Compartment model used to describe the kinetics of radionuclides in the gastroin-
testinal tract.

Table A.3. Parameters used for calculating absorbed dose to the gastrointestinal tract.

Section of Mass of Mass of Mean residence

gastrointestinal tract walls (g)* contents (g)* time (h)  (/h)

Stomach 150 250 1 1

Small intestine 640 400 4 0.25
Upper large intestine 210 220 13 0.077
Lower large intestine 160 135 24 0.042

Immediate mixing within each compartment is assumed. The recently introduced

model for the human alimentary tract (HAT model; ICRP, 2006) and Publication
89 (ICRP, 2002) present a more detailed model for the gastrointestinal tract, but this
has not been implemented for calculations in the present report.
(A5) For substances included in this report, the Task Group does not generally
consider the deviations in effective dose caused by using the Publication 30 model
instead of the HAT model to be significant. An example of a large deviation case
arises when the activity is distributed in the stomach. Using the HAT model, the
mean residence time in the stomach contents is considerably longer than that using
the Publication 30 model. This results in an absorbed dose to the stomach wall that is
30–40% larger with the HAT model compared with the Publication 30 model.
(A6) The same mean transit time in small and large intestine (41 h) is used for both
children and adults. In fact, the mean transit time is somewhat shorter in children
than that in adults (ICRP, 2002, 2006): 36 h compared with 41 h for adults. The
assumption of a transit time of 41 h in children will affect estimates of the absorbed

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 Radiation dose to patients from radiopharmaceuticals

dose to different parts of the gastrointestinal tract, depending upon the physical half-
life of the radionuclide. Absorbed doses for radionuclides with long half-lives will be
overestimated, and those for radionuclides with short half-lives will be underesti-
mated. For newborn babies, however, use of the same gastrointestinal transit time as
for adults is not recommended. For substances for which the dose is calculated for
newborn babies, further details about data for the transit time through the intestine
are given in the biokinetic model, where applicable.
(A7) A modified model is used for non-absorbable inert markers intended for
studying different aspects of the physiology of the gastrointestinal tract (e.g. gastric
emptying, intestinal transport and transit time, abnormal intestinal permeability,
etc.). These substances are usually labelled with 99mTc or 111In. Small 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. The modification to the standard ICRP
model is that the gastric residence time is changed to 0.5 h for fluids and 1.5 h for
solids (ICRP, 2002, 2006).

A.4. Kidney–bladder model

(A8) 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 of these cases, the bladder is a separate entry in the biokinetic
data tables.
(A9) 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 leave the body.
(A10) The rate at which a radionuclide is excreted is determined from knowledge
of the amount of activity in the total body, ATB, which is assumed to be described by
the sum of a series of exponential functions:

X
n  
ATB ¼ ai exp  i þ p t ðA:1Þ
i¼1

where i is the biological elimination constant for component i, p 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, A~ K , is given by:

1  expðp TK Þ X
n
i
A~ K ¼ fr ai ðA:2Þ
p i¼1
i þ p

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 ICRP Publication 128

where fr is the fraction of excreted activity that is eliminated through the kidneys,
and TK is the mean transit time through the kidneys appropriate for the given radio-
pharmaceutical and physiological status; unless otherwise stated, this is assumed to
be 5 min.
(A11) The expression is approximate as fr may differ for the individual compo-
nents of whole-body clearance. However, for practical application, this approxima-
tion is judged to be adequate. The cumulated activity in the kidneys given in the
biokinetic data tables for the individual substances is the sum of the cumulated
activity from the excretion process and a contribution from activity distributed uni-
formly in the remaining organs and tissues, which can include the kidneys.
(A12) The cumulated activity in bladder contents, A~ B , is given by:

X1  
1  expðp tv Þ 1  expðði þ p Þtv Þ
A~ B ¼ fr ai 
i¼1
p i þ p
  ðA:3Þ
1
  expðp TK Þ
1  expððp þ p Þtv Þ

where tv is the bladder filling and voiding interval, which for the purpose of the
present model is assumed to be constant and equal to 3.5 h for adults and
children aged 10 years; the average urinary cycle in humans (Syed, 1976). The
first voiding is assumed to occur at time tv after administration of the radio-
pharmaceutical to the patient. In the equations above, the effect of kidney resi-
dence time has been neglected as it is usually much shorter than the physical half-
life of the radionuclide; if this is not the case, this equation should be multiplied
by expðp TK Þ.
(A13) Calculating the radiation absorbed dose to the bladder wall involves
consideration of a complex relationship between urine flow rate, voiding period,
and urine volume initially present in the bladder when the radiopharmaceutical is
administered, and is critically dependent on the model used to describe the geome-
trical relationships between the wall of the bladder and its 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. The
MIRD Committee has published a dynamic bladder model (Thomas et al., 1999)
incorporating more physiologically realistic features providing for a varying blad-
der volume, varying initial content and voiding interval, and a night gap in the
voiding pattern.
(A14) Within the ranges of urine flow rate of 0.5–2 l/day, voiding period of 0.5–8 h,
and initial bladder contents of 0–300 ml, the predicted bladder wall dose varies over a
range of approximately 25 fold for radiopharmaceuticals that are cleared rapidly by
the renal system [e.g. 99mTc-labelled mercaptoacetyl triglycine (MAG3)], reducing to
a range of approximately five fold for substances that are cleared more slowly (e.g.
131
I-iodide). For voiding periods of 3.5 h, the bladder dose predicted by the

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 Radiation dose to patients from radiopharmaceuticals

Table A.4. Parameters used for calculating absorbed dose to the urinary bladder wall.

Age (years) Adult 15 years 10 years 5 years 1 year Newborn

Voiding period (h) 3.5 3.5 3.5 3.0 2.0 2.0

Mass of wall (g)* 40–50 35–40 25 16 9 4
Mass of wall used (g) 47.6 35.9 23.2 14.5 7.7 2.88
Volume (ml) 211 160 103 64.7 32.9 12.4
Excretion (ml/day)* 1200–1600 1200 700 500 400 300
*The lower limit of the interval applies for females and the upper limit applies for males. Data from
Publication 89 (ICRP, 2002).

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 five 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 h, may be of the order of
25 fold.
(A15) An age-related bladder voiding model is used. The voiding periods are based
on urinary production rates as described in Publication 89 (ICRP, 2002), and volume
of the content as described by Stabin and Siegel (2003). The voiding periods are
presented in Table A.4.
(A16) The S values used for calculation of the absorbed dose to the bladder wall
relate to the contents 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 fixed average
bladder contents (Table A.4). These S values have been used in the present report in
conjunction with cumulated activities in the bladder contents estimated for an age-
dependent bladder voiding interval presented in Table A.4. This method does not
allow for the variation in dose rate to the wall as the bladder fills with urine contain-
ing radionuclides.

A.5. Model for radiopharmaceuticals used to measure glomerular filtration rate

(A17) The following biokinetic model has been used for a variety of labelled inulin
and inulin-like radiopharmaceuticals used for the measurement of glomerular filtra-
tion rate (GFR). After intravenous administration and initial rapid distribution in
extracellular fluid, it is assumed that the radionuclide is excreted exclusively by the
kidneys according to the kidney–bladder model. In the normal case, total body
retention is described by a mono-exponential function with a half-time of 100 min,
fraction excreted by the kidneys of 1.0, and renal transit time of 5 min.
(A18) For chelated compounds (DTPA, EDTA), there is evidence of a small
degree of in-vivo dissociation of the radioactive label, leading to longer retention
of approximately 1% of the administered radionuclide. This fraction is assumed to

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 ICRP Publication 128

be distributed uniformly and to be eliminated with a half-time of 7 days. This is a

simplifying approximation as the dissociated label will exhibit specific biokinetics
depending upon its chemical form. Nevertheless, it is considered adequate for esti-
mating the contributions to absorbed dose from this dissociated label, provided that
the examinations are conducted with a blocked thyroid for those radiopharmaceu-
ticals for which the dissociated label would concentrate preferentially in the thyroid.
(A19) 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.6. Models for bone-seeking radionuclides administered as radiopharmaceuticals

(A20) For calculation of effective dose, the radiation-sensitive part of bone tissues
has been identified as a 10-mm-thick layer on bone surfaces, representing endosteal
and periosteal cells (ICRP, 1991a). The Task Group is aware that this figure is
subject to revision, and that future dose estimates should be based on an extended
bone surface volume (Gössner et al., 2000). However, for the present report, the dose
estimates were produced using the earlier established method.
(A21) The mean absorbed dose to bone surfaces and red marrow is presented in
this report. Calculation of the absorbed dose for these tissues is a complex task as
they comprise an intricate mixture of soft tissues and bone. For the present report,
the calculations are based on S values derived by Stabin and Siegel (2003), based on
methods for calculating the absorbed fraction for the non-penetrating radiation
developed by Eckerman and Stabin (2000) and Bouchet et al. (2000). The S values
from bone tissues to bone surfaces and red marrow are dependent on the distribution
of activity within the bone. Two different cases can be distinguished:
. surface-deposited activity in trabecular bone and cortical bone (‘bone surface
seekers’); and
. activity deposited uniformly throughout the entire volume of the mineral bone
in trabecular and cortical bone (‘bone volume seekers’).
(A22) In Publication 30 (ICRP, 1979), a general rule concerning short-lived radio-
nuclides was introduced and used for various elements: ‘radionuclides with a physical
half-life less than 15 days are assumed to be surface deposited’. The same general rule,
extended to apply to the effective half-life, is adopted in the present report. Thus, for
the absorbed dose calculations, substances with an effective half-time of <15 days
have been assumed to be surface deposited, and those with an effective half-time of
>15 days have been assumed to be volume distributed, unless otherwise stated. In
cases with two or more biological excretion half-times, the different components are
considered separately, thus a fraction excreted slowly from the skeleton may be con-
sidered to be volume deposited, while the remaining part is surface deposited.
(A23) If nothing is known about the distribution of cumulated activity between
cortical and trabecular bone, it is assumed to be distributed uniformly on surfaces or
throughout the volume, as appropriate.

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 Radiation dose to patients from radiopharmaceuticals

(A24) The distribution of activity thus follows the surface area or mass distribution
of mineral bone. For adults, the mass ratio cortical:trabecular bone, according to
Publication 89, is 80:20 and the surface area ratio is 40:60 (ICRP, 2002). As no
reference values for the distribution between cortical and trabecular bones for chil-
dren are available, and as the information on this matter in the open literature is very
scarce, the Task Group has also adopted these values for 15- and 10-year-old children.
For 5- and 1-year-old children, the mass ratio cortical:trabecular bone used for the
calculations is assumed to be 60:40 and the surface area ratio is assumed to be 30:70.
(A25) A few radiopharmaceuticals are concentrated to a significant extent in the
metaphyseal growth plates of children’s bones. This factor is not taken into account
in the dose calculations given herein. Thus, radiation doses to this part of the ske-
leton may be underestimated for children. However, the mean absorbed dose to bone
surfaces is not likely to be underestimated substantially.

A.7. Model for colloids taken up preferentially in the liver, spleen, and red marrow
(A26) Colloids of 99mTc-sulphur and 198Au were discussed in MIRD Reports
No. 3 and No. 4, respectively (Atkins et al., 1975; Cloutier et al., 1975). The
colloids were assumed to be taken up preferentially in the liver, spleen, and red
marrow, with a uniform distribution of any residue in the remainder 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 at 85, 7, and 5% for sulphur
colloid and 90, 3, and 7% for gold colloid, respectively. These values were esti-
mates based on clinical studies, but no details about the methods used for calculat-
ing the percentages were given. However, the values are in good agreement with
results obtained from animal studies.
(A27) Studies on man have shown decreased uptake of colloids with increasing
degree of liver disease, with corresponding increases in uptake for other organs
(Herzog et al., 1987; Groshar et al., 2002). The change in uptake depends on the
particle size of the administered colloid.
(A28) The Task Group has adopted the same view as the MIRD Committee
with regard to choice of patient categories, definition of organs with 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. (1987), which contains
results of quantitative measurements with conjugate view whole-body counting and
double-window regional counting over liver and spleen. For all types of colloid,
immediate uptake is assumed. The biological half-time of the radionuclide is
assumed to be long compared with the physical half-time, except for iodine-labelled
albumin micro-aggregates. For these substances, the metabolic breakdown of the
particles is assumed to be represented by biological half-times (fraction) of 3 h (0.8)
and 5 days (0.2).

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 ICRP Publication 128

Table A.5. Organ mass (kg): based on Atkins et al. (1975).

Condition

Organ 1* 2y 3z

Total body 70 70 70
Liver 1.8 2.4 1.4
Spleen 0.17 0.25 0.4
Red marrow 1.5 1.5 1.5
*Normal liver.
y
Early to intermediate diffuse parenchymal liver disease.
z
Intermediate to advanced diffuse parenchymal liver disease.

Table A.6. Uptake values (fractions) for large colloids (100–1000 nm

diameter).*

Condition

Organ 1y 2z 3§

Liver 0.70 0.50 0.30

Spleen 0.10 0.20 0.30
Red marrow 0.10 0.15 0.25
Remaining tissue 0.10 0.15 0.15
*Examples: 99mTc micro-aggregated albumin, 99mTc-phytate.
y
Normal liver.
z
Early to intermediate diffuse parenchymal liver disease.
§
Intermediate to advanced diffuse parenchymal liver disease.

(A29) The organ masses for different patient categories and uptake data for dif-
ferent sizes of colloid are presented in Tables A.5–A.7. For further details, the reader
is referred to the biokinetic data on the individual substances.

A.8. Model for liver and biliary excretion

(A30) This model is intended for substances that are actively taken up in hepato-
cytes and excreted, via the biliary tract, to the intestine. Typical examples are a large
group of technetium-labelled iminodiacetic acid (IDA) derivatives (e.g. BIDA,
HIDA, EIDA, PIPIDA, PBIDA, and DISIDA).
(A31) Several biokinetic models have been presented in the literature for techne-
tium-labelled IDA derivatives (Ryan et al., 1977; Wistow et al., 1977; Taavitsainen
et al., 1980; Brown et al., 1981, 1982; Wu et al., 1984). The substance is assumed to

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 Radiation dose to patients from radiopharmaceuticals

Table A.7. Uptake values (fractions) for small colloids (<100 nm

diameter).*

Condition

Organ 1y 2z 3§

Liver 0.70 0.50 0.30

Spleen 0.10 0.20 0.30
Red marrow 0.15 0.25 0.30
Remaining tissue 0.05 0.15 0.10
*Example: 99mTc mini-/micro-aggregated albumin.
y
Normal liver.
z
Early to intermediate diffuse parenchymal liver disease.
§
Intermediate to advanced diffuse parenchymal liver disease.

Extra-
cellular 1 3
fluid Liver Gallbladder
(blood)

2 4 5

Kidney Small
intestine

Excretion
Excretion

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

be taken up rapidly in the liver from the blood and then excreted, via the biliary
tract, partly to the gallbladder for temporary storage and partly to the intestine.
A minor portion of the radiopharmaceutical is excreted in the urine. In pathological
states (liver disease, occlusion of the biliary tract, congenital biliary atresia), the same
model is used but with different kinetic data (transfer factors). The compartmental
model is shown in Fig. A.2.
(A32) Similar models have been used for all substances that undergo biliary excre-
tion. For each substance, the fraction and half-time for movement between compart-
ments are specified in the biokinetic data table. Unless otherwise stated in the model,
it is assumed that 65% of the activity entering the liver is transferred directly from
the liver to the small intestine, and 35% goes to the gallbladder (Wu et al., 1984).
(A33) The gallbladder empties at intervals on stimulation by food. It is assumed to
empty in an identical manner for all substances. The first emptying is after 3 h, during
which time 75% of the radioactive material present in bile is assumed to be excreted

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 ICRP Publication 128

to the small intestine. The second emptying is after 9 h, again associated with the
excretion of 75% of the radioactive material in bile. For the dose estimation, the
third and final emptying is assumed to occur after 24 h when all the radioactive
material is excreted. Earlier emptying can be induced by a meal of high fat content
or by cholecystokinin.
(A34) The final excretion from the body follows the models for the gastrointestinal
tract and the kidney–bladder system (see above).

A.9. Model for salivary glands

(A35) Some substances are actively taken up in the salivary glands. In those cases,
an approximate absorbed dose in the salivary glands is estimated and included in the
dose table. This organ is not included in the presently used tables of S values.
Johansson (1996) presented S values for self-irradiation of the salivary glands for
99m
Tc. The calculation method lined up in this report has also been used by the Task
Group for other radionuclides, using the unit density sphere model in the formerly
freely available MIRDOSE3 program (Stabin, 1996). The S values have been calcu-
lated considering the three pairs of salivary glands (parotid, submaxillary, and sub-
lingual) with masses according to Publication 23 (ICRP, 1975). Those masses do not
deviate significantly from those reported in the updated version, Publication 89
(ICRP, 2002). To estimate the absorbed dose from source in other organs, the
brain is used as a substitute target organ, except in cases when the brain is also a
source.

A.10. References for Annex A

Atkins, H.L., Cloutier, R.J., Lathrop, K.A., et al., 1975. Technetium-99m-sulfur colloid in
various liver conditions. MIRD Dose Estimate Report No. 3. J. Nucl. Med. 16,
108A–108B.
Bouchet, L.G., Bolch, W.E., Howell, R.W., Rao, D.V., 2000. S values for radionuclides
localized within the skeleton. J. Nucl. Med. 41, 189–212.
Brown, P.H., Krishnamurthy, G.T., Bobba, V.R., Kingston, E., 1981. Radiation-dose calcu-
lation 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., Turner, F.E., 1982.
Radiation-dose calculation for five Tc-99m IDA hepatobiliary agents. J. Nucl. Med. 23,
1025–1030.
Cloutier, R.J., Freeman, L.M., McAfee, J.G., et al., 1975. Summary of current radiation dose
estimates to humans with various liver conditions from 198Au colloidal gold. MIRD Dose
Estimate Report No. 4. J. Nucl. Med. 16, 173–174.
Cristy, M., Eckerman, K., 1987. Specific Absorbed Fractions of Energy at Various Ages from
Internal Photon Sources. Oak Ridge National Laboratory, Oak Ridge, TN.
Eckerman, K.F., Stabin, M.G., 2000. Electron absorbed fractions and dose conversion factors
for marrow and bone by skeletal region. Health Phys. 78, 199–214.

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 Radiation dose to patients from radiopharmaceuticals

Gössner, W., Masse, R., Stather, J.W., 2000. Cells at risk for dosimetric modelling relevant to
bone tumour induction. Radiat. Prot. Dosim. 92, 209–213.
Groshar, D., Slobodin, G., Zuckerman, E., 2002. Quantitation of liver and spleen uptake of
99mTc-phytate colloid using SPECT: detection of liver cirrhosis. J. Nucl. Med. 43,
312–317.
Herzog, H., Spohr, G., Notohamiprodjo, G., Feinendegen, L.E., 1987. Absolute quantifica-
tion of pharmacokinetic distribution of RES colloids in individuals with normal liver
function. Nucl. Med. Commun. 8, 157–175.
ICRP, 1975. Report of the Task Group on Reference Man. ICRP Publication 23. Pergamon
Press, Oxford.
ICRP, 1979. Limits for intakes of radionuclides by workers. ICRP Publication 30, Part 1.
Ann. ICRP 2(3/4).
ICRP, 1991a. 1990 Recommendations of the International Commission on Radiological
Protection. ICRP Publication 60. Ann. ICRP 21(1–3).
ICRP, 2002. Basic anatomical and physiological data for use in radiological protection: refer-
ence values. ICRP Publication 89. Ann. ICRP 31(3/4).
ICRP, 2006. Human alimentary tract model for radiological protection. ICRP Publication
100. Ann. ICRP 35(1/2).
Johansson, L., 1996. Absorbed dose in the salivary glands from technetium-99m labeled
radiopharmaceuticals. In: Schlafke-Stelson, A., Stabin, M.G., Sparks, R.B. (Eds.), Sixth
International Radiopharmaceutical Dosimetry Symposium, Gatlinburg, TN, USA, May
7–10, 1996, Oak Ridge Associated Universities, Oak Ridge, TN, USA, pp. 513–521.
Leggett, R.W., Williams, L.R., 1991. Suggested reference values for regional blood volumes in
humans. Health Phys. 60, 139–154.
Leggett, R.W., Williams, L.R., 1995. A proposed blood circulation model for reference man.
Health Phys. 69, 187–201.
Ryan, J., Cooper, M., Loberg, M., Harvey, E., Sikorski, S., 1977. Technetium-99m-labelled
N-(2,6-dimethylphenyl carbamoylmethyl)-iminodiacetic acid (Tc99mHIDA): a new radio-
pharmaceutical for hepatobiliary imaging studies. J. Nucl. Med. 18, 997–1004.
Smith, T., Veall, N., Wootton, R., 1982. Bladder wall dose from administered radiopharma-
ceuticals: the effect of variation in urine flow rate, voiding interval and initial bladder
content. Radiat. Prot. Dosim. 2, 183–189.
Snyder, W.S., Ford, M.R., 1976. Estimation of doses to the urinary bladder and to the gonads.
In: Cloutier, R.J., Coffey, J.L., Snyder, W.S., Watson, E.E. (Eds.), Radiopharmaceutical
Dosimetry Symposium, Oak Ridge, TN, USA, April 26–29, 1976. HEW Publication (FDA
76-8044). Department of Health, Education and Welfare, Bureau of Radiological Health,
Rockville, MD, USA, pp. 313–349.
Stabin, M.G., 1996. MIRDOSE: personal computer software for internal dose assessment in
nuclear medicine. J. Nucl. Med. 37, 538–546.
Stabin, M.G., Siegel, J.A., 2003. Physical models and dose factors for use in internal dose
assessment. Health Phys. 85, 294–310.
Stabin, M.G., Sparks, R.B., Crowe, E., 2005. OLINDA/EXM: the second-generation personal
computer software for internal dose assessment in nuclear medicine. J. Nucl. Med. 46,
1023–1027.
Syed, I.B., 1976. Dosimetry of indium-113m radiopharmaceuticals with special attention to
the urinary bladder. In: Cloutier, R.J., Coffey, J.L., Snyder, W.S., Watson, E.E. (Eds.),
Radiopharmaceutical Dosimetry Symposium, Oak Ridge, TN, USA. HEW Publication

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(FDA 76-8044). Department of Health, Education and Welfare, Bureau of Radiological

Health, Rockville, MD, USA, pp. 360–369.
Taavitsainen, M., Riihimäki, E., Tähti, E., 1980. Body disappearance and liver mean transit
time of 99m-Tc-diethyl-IDA. Eur. J. Nucl. Med. 5, 147–150.
Thomas, S.R., Stabin, M.G., Chen, C-T., Samaratunga, R.C., 1999. A dynamic urinary
bladder model for radiation dose calculations. MIRD Pamphlet No. 14, revised. J. Nucl.
Med. 40, 102S–123S.
Williams, L.R., Leggett, R.W., 1989. Reference values for resting blood flow to organs of
man. Clin. Phys. Physiol. Meas. 10, 187–217.
Wistow, B.W., Subramanian, G., Van Heertum, R.L., et al., 1977. An evaluation of 99mTc-
labeled hepatobiliary agents. J. Nucl. Med. 18, 455–461.
Wu, R.K., Siegel, J.A., Rattner, Z., Malmud, L.S., 1984. Tc-99m HIDA dosimetry in patients
with various hepatic disorders. J. Nucl. Med. 25, 905–912.

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 ANNEX B. EXPLANATIONS
B.1. Presentation of data
(B1) In Annex C, the data on each substance are presented in three types of
information showing: a biokinetic model in text form and references to that, a
biokinetic data table, and one or more tables over absorbed dose per unit of activity
administered. The Biokinetic data table contains the weghted summary of the infor-
mation given in the text section and its references. Unless otherwise stated, the model
refers to intravenous administration.
(B2) The rate of the biological process (e.g. uptake, metabolism, and excretion) is
usually given as the half-time of the corresponding exponential function. If the
process is assumed to be multi-exponential, the fraction (a) of the organ content
belonging to each exponential component is given in the next column. When rates
are given as fractions per time unit (k) as reported in cited publications, they are
transformed into half-times according to the formula T ¼ 0.693/k.
(B3) The following abbreviations have been used:
. S, source organ or tissue;
. Fs, fractional distribution to organ or tissue S;
. T, biological half-time for an uptake or elimination component;
. a, fraction of Fs taken up or eliminated with the corresponding half-time;
. -, uptake; and
. Ãs/Ao, cumulated activity in organ or tissue S per unit of administered activity.
(B4) The tables sometimes contain empty spaces under the headings T and a, usually
because the kinetics are described by complex exponential, or non-exponential, expres-
sions, that cannot be defined easily. This is the case for activity in the gastrointestinal
tract, the gallbladder, and the urinary bladder. In these cases, the tables only present
the cumulated activities together with the fractional distribution.
(B5) The relative cumulated activities are presented in hours (h). Average organ or
tissue absorbed doses are given as milligrays (mGy) per megabecquerel (MBq). The
effective dose is given as millisieverts (mSv) per MBq. All dose values are given in
exponential notation (e.g. 2.6E-02 ¼ 2.6  102 or 0.026 and 4.9Eþ01 ¼ 4.9  10þ1 or
49). The calculations have been performed without rounding, but the final result is
given with two digits.
(B6) Dose calculations have been performed for adults and 15-, 10-, 5-, and 1-year-
old children. The organs (or tissues) are presented in alphabetical order except
‘Remaining organs’, which is placed at the end. The dose to organs or tissues not
mentioned in the table can usually be approximated with the value given for
‘Remaining organs’.

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 ANNEX C. BIOKINETIC MODELS AND DOSE RATES
C.1. 3H-neutral fat and free fatty acids

C.1.1. Biokinetic model

(C1) Orally administered fat is absorbed rapidly and completely from the gastro-
intestinal tract. Within 3–4 h, all activity has reached the blood via the lymphatic
system. After transient uptake and chemical modification in the liver, the fat is
transported to the adipose tissue, which occurs principally in subcutaneous tissue,
yellow marrow, and the abdominal cavity, and to the muscles. Other organs and
tissues receive small amounts. It is then metabolised by b-oxidation, with water and
carbon dioxide (CO2) as end products. The turnover rate is highly dependent on the
nutritional state, especially the supply of carbohydrates.
(C2) Pedersen and Marqversen (1981) measured 14CO2 in expired air in five
healthy subjects who were given labelled neutral fat in a test meal after an 8-h
fast. Unrestricted food was allowed from 6 h later. After 1 day, 15–33% of ingested
fat had been metabolised, and this increased to 25–40% by 10 days. The residue
was retained for a much longer time with a calculated half-time of 304–493 days.
Malmendier et al. (1974) injected 14C-labelled palmitic acid into four fasting
normal subjects and measured expired air for 24 h. They found that 45% of the
fatty acid was oxidised directly to CO2. No carbohydrate was given simultaneously,
which may explain the larger fraction that was metabolised more rapidly than in
the study of Pedersen and Marqversen (1981). Hirsch et al. (1960) studied the
turnover of neutral fat incorporated into adipose tissue, and found half-times up
to 750 days.
(C3) The model adopted here is intended for fat containing unbranched long-
chain (13–18 C atoms) fat molecules and labelled with 14C or 3H, administered
orally or intravenously. Rapid and complete resorption is assumed. After transient
uptake in the liver, the activity is deposited in the adipose tissue (85%), in muscles
(10%), and in all other organs and tissues (5%) according to their fat content as
given in Publication 23 (ICRP, 1975). Assuming adequate supply of carbohy-
drates, 30% is metabolised rapidly (T1/2 ¼ 2 days) and 70% is retained for a
longer time (T1/2 ¼ 400 days). The half-time of 400 days assumed for the
longer-term component of retention of 3H (and 14C) in the body fat is longer
than the overall half-time of 40 days assumed for the total body hydrogen (and
carbon) in Publication 30 (ICRP, 1979) and Publication 56 (ICRP, 1990). This
long-lived component refers only to the fraction of the body fat which is labelled
following administration of a single dose of labelled fat (Gunnarsson et al., 2000),
and which probably represents only a small fraction of the total body carbon
pool. The long-lived component refers in this case to the fraction of body fat
which becomes labelled with the administered radiopharmaceutical. This probably
only represents a small fraction of the total carbon pool in the body.

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(C4) This model is intended for adults only. It is possible that the metabolism is
significantly different in children, with longer half-times in some tissues (e.g. the
nervous system). The absorbed dose per unit activity administered for adults are
presented in Table C.2.

C.1.2. References for 3H-neutral fat and free fatty acids

Gunnarsson, M., Mattsson, S., Stenström, K., et al., 2000. AMS-studies of the long-term
turnover of 14C-labelled fat in man. Nucl. Instr. Meth. B. 172, 939–943.
Hirsch, J., Farquhar, J.W., Ahrens, J.E.H., et al., 1960. Studies of adipose tissue in man.
J. Clin. Nutr. 8, 499–510.
Malmendier, C.L., Delcroix, C., Berman, M., 1974. Interrelations in oxidative metabolism of
free fatty acids, glucose and glycerol in normal and hyperlipemic patients. A compartmen-
tal model. J. Clin. Invest. 54, 461–476.
Pedersen, N.T., Marqversen, J., 1981. Metabolism of ingested 14C-triolein. Estimation of
radiation dose in tests of lipid assimilation using 14C- and 3H-labelled fatty acids. Eur. J.
Nucl. Med. 6, 327–329.
ICRP, 1975. Report of the Task Group on Reference Man, ICRP Publication 23. Pergamon
Press, Oxford.
ICRP, 1979. Limits for intakes of radionuclides by workers. ICRP Publication 30, Part 1.
Ann. ICRP 2(3/4).
ICRP, 1990. Age-dependent doses to members of the public from intake of radionuclides.
Part 1. ICRP Publication 56. Ann. ICRP 20(2).

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 Radiation dose to patients from radiopharmaceuticals

Table C.1. Biokinetic data for 3H-neutral fat and free fatty acids.

Organ (S) Fs T (h) a Ãs/A0 (h)

Adipose tissue 0.85 48 0.30 7600

9600 0.70
Muscles 0.10 48 1.0 6.9
Other organs and tissues 0.05 9600 1.0 640
Adrenals 0.0002 2.5
Breast 0.0006 7.6
Stomach 0.0005 6.4
Small intestine 0.0022 28
Upper large intestine 0.0007 8.9
Lower large intestine 0.0005 6.4
Heart 0.0018 23
Kidneys 0.0009 11
Liver 0.0064 81
Lungs 0.0005 6.4
Ovaries 0.00001 0.13
Pancreas 0.0004 5.1
Red marrow 0.0322 410
Bone (cortical) 0.0020 27
Bone (trabecular) 0.0005 6.4
Spleen 0.0002 2.5
Testes 0.0001 1.3
Thyroid 0.0001 1.3

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 ICRP Publication 128

Table C.2. Absorbed doses for 3H-neutral fat and free fatty acids.

Absorbed dose per unit activity

Organ administered (mGy MBq1)

Adrenals 5.1E01
Bone surfaces 6.1E01
Breast 6.9E02
Gastrointestinal tract
Stomach wall 1.3E01
Small intestine wall 1.1E01
Colon wall 1.3E01
(Upper large intestine wall 1.3E01)
(Lower large intestine wall 1.3E01)
Heart wall 2.4E01
Kidneys 1.3E01
Liver 1.4E01
Lungs 2.1E02
Muscles 4.4E04
Ovaries 4.9E02
Pancreas 1.8E01
Red marrow 1.2Eþ00
Spleen 4.6E02
Testes 1.1E01
Thyroid 2.0E01
Remaining organs 2.0E03

Effective dose (mSv MBq1) 2.2E01

The physical half-life of 3H is 12.35 years.

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 C.2. [1-11C]-acetate
C.2.1. Biokinetic model

(C5) Acetate labelled with 11C in the carboxyl position, [1-11C]-acetate, is used for
dynamic positron emission tomography (PET) studies of myocardial metabolism
(Armbrecht et al., 1990; van den Hoff et al., 1996; Sun et al., 1997), and in renal
(Shreve et al., 1995), pancreatic (Shreve and Gross, 1997), and nasopharyngeal dis-
ease (Yeh et al., 1999).
(C6) In most tissues, after extraction from the blood, [1-11C]-acetate is activated to
acetyl co-enzyme A (CoA) and enters the tricarboxylic acid (TCA) cycle. From the
TCA cycle, the label is lost mainly in the form of 11CO2 (Armbrecht et al., 1990). In
resting myocardium, the behaviour of [1-11C]-acetate can be summarised as follows
(Armbrecht et al., 1990):
. extraction of approximately two-thirds of the activity in a single capillary
transit;
. a very rapid initial washout phase (T1/2 < 5 s);
. activation of [1-11C]-acetate to [1-11C]-acetyl-CoA within a few seconds;
. labelling of TCA cycle intermediates takes several minutes;
. onset of rapid 11CO2 release after 2–3 min; and
. 11CO2 release is bi-exponential.
(C7) In all the tissues studied, peak uptake appears to be reached within less than
3 min. After 3–5 min, 50% of the tissue activity is present as 11CO2, 24% as non-
ionised species, and 13% each as acetate and TCA-amino acid intermediates (Sun
et al., 1997). The rate of metabolism of the radiopharmaceutical reflects the rate of
oxidative metabolism in the tissue, and thus the oxygen supply.
(C8) Clinical studies indicate that in both myocardium and kidney parenchyma,
the initial uptake is complete by 2.5–3 min post injection, and that between 3 and
30 min, the 11C is lost from the tissues with a half-time of approximately 10 min. In
normal pancreas, the uptake is also complete in 3 min, and by 30 min, the activity is
lost from the tissue with a half-time of 38 min. In the liver, uptake is again rapid,
peaking at approximately 3 min; thereafter, loss of 11C from the tissue follows a tri-
exponential clearance, with 35% being cleared with a half-time of 10 min and the
remainder with half-times of 1 (30%) and 2 h (35%).
(C9) Few data on the fractional deposition of [1-11C]-acetate in human tissues
appear to be available in the literature. However, as there is a high extraction rate for
[1-11C]-acetate in most tissues and its rate of metabolism reflects the tissue oxygen
supply, the rate of blood flow, expressed as a fraction of cardiac output, in the tissue
may be used as an approximation of the tissue uptake of [1-11C]-acetate. Leggett and
Williams (1995) have tabulated blood flow data for most human tissues, and these
values have been used to construct the biokinetic model illustrated in Table C.3
below. In this model, uptake in all tissues is assumed to be rapid, with a half-time
of 1 min.

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 ICRP Publication 128

C.2.2. References for [1-11C]-acetate

Armbrecht, J.J., Burton, D.B., Schelbert, H.R., 1990. Validation of [1-11C]acetate as a tracer
for non-invasive assessment of oxidative metabolism with positron emission tomography in
normal, ischemic, postischemic and hyperaemic canine myocardium. Circulation 81,
1594–1605.
Leggett, R.W., Williams, L.R., 1995. A proposed blood circulation model for reference man.
Health Phys. 69, 187–201.
Shreve, P., Chiao, P.C., Humes, H.D., Schwaiger, M., Gross, M.D., 1995. Carbon-11-acetate
PET imaging in renal disease. J. Nucl. Med. 36, 1595–1601.
Shreve, P.D., Gross, M.D., 1997. Imaging of the pancreas and related diseases with PET
carbon-11-acetate. J. Nucl. Med. 38, 1305–1310.
Sun, K.T., Chen, K., Huang, S-C., et al., 1997. Compartment model for measuring myocardial
oxygen consumption using [1-11C]acetate. J. Nucl. Med. 38, 459–466.
van den Hoff, J., Burchert, W., Wolpers, H.G., Meyer, G.J., Hundeshagen, H., 1996. A kinetic
model for cardiac PET with [1-11C]acetate. J. Nucl. Med. 37, 521–529.
Yeh, S.H., Liu, R.S., Wu, L.C., Yen, S.H., Chang, C.W., Chen, K.Y., 1999. 11C-acetate
clearance in nasopharyngeal carcinoma. Nucl. Med. Commun. 20, 131–134.

Table C.3. Biokinetic data for [1-11C]-acetate.

Organ (S) Fs T (h) a Ãs/A0 (h)

Blood 1.0 0.017 1.0 0.023

Heart wall 0.045 0.017 1.0 0.014
0.17 0.50
8.0 0.50
Kidneys 0.19 0.017 1.0 0.059
0.17 0.50
24 0.50
Liver 0.25 0.017 1.0 0.075
0.17 0.35
1.0 0.30
2.0 0.35
Pancreas 0.01 0.017 1.0 0.0035
0.67 0.50
2.0 0.50
Other organs and tissues 0.505 0.017 1.0 0.15
0.17 0.50
8.0 0.50
14
This biokinetic model is not applicable for C.

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 Radiation dose to patients from radiopharmaceuticals

Table C.4. Absorbed doses for [1-11C]-acetate.

Absorbed dose per unit activity administered (mGy MBq1)

Organ Adult 15 years 10 years 5 years 1 year

Adrenals 3.4E03 4.3E03 6.6E03 1.0E02 1.8E02

Bone surfaces 1.5E03 1.9E03 3.0E03 4.8E03 9.6E03
Brain 9.8E04 1.2E03 2.1E03 3.5E03 6.6E03
Breast 1.2E03 1.5E03 2.5E03 4.0E03 7.6E03
Gallbladder wall 3.4E03 3.9E03 5.5E03 8.7E03 1.6E02
Gastrointestinal tract
Stomach wall 2.0E03 2.4E03 3.9E03 6.0E03 1.1E02
Small intestine wall 1.7E03 2.2E03 3.5E03 5.6E03 1.0E02
Colon wall 1.6E03 1.9E03 3.2E03 5.0E03 9.5E03
(Upper large intestine wall 1.8E03 2.2E03 3.7E03 5.7E03 1.1E02)
(Lower large intestine wall 1.3E03 1.5E03 2.5E03 4.1E03 7.5E03)
Heart wall 1.3E02 1.7E02 2.6E02 4.1E02 7.4E02
Kidneys 5.2E02 6.3E02 8.8E02 1.3E01 2.3E01
Liver 1.3E02 1.8E02 2.7E02 4.0E02 7.5E02
Lungs 2.4E03 3.1E03 4.8E03 7.6E03 1.5E02
Muscles 1.3E03 1.7E03 2.6E03 4.2E03 8.0E03
Oesophagus 1.5E03 1.9E03 2.8E03 4.4E03 8.1E03
Ovaries 1.4E03 1.8E03 2.8E03 4.6E03 8.6E03
Pancreas 1.2E02 1.6E02 3.3E02 4.2E02 9.1E02
Red marrow 1.8E03 2.2E03 3.3E03 5.1E03 9.2E03
Skin 1.0E03 1.2E03 2.0E03 3.3E03 6.4E03
Spleen 2.9E03 3.6E03 5.8E03 8.9E03 1.6E02
Testes 1.0E03 1.3E03 2.0E03 3.2E03 6.4E03
Thymus 1.5E03 1.9E03 2.8E03 4.4E03 8.1E03
Thyroid 1.2E03 1.6E03 2.6E03 4.4E03 8.5E03
Urinary bladder wall 1.2E03 1.4E03 2.3E03 3.9E03 7.0E03
Uterus 1.4E03 1.7E03 2.8E03 4.5E03 8.4E03
Remaining organs 1.4E03 1.7E03 2.7E03 4.4E03 8.1E03

Effective dose (mSv MBq1) 3.5E03 4.3E03 6.5E03 9.9E03 1.8E02

11
The physical half-life of C is 20.4 min.

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 11
C.3. C-labelled amino acids (generic model)
C.3.1. Biokinetic model

(C10) The methionine analogue [75Se]-selenomethionine has been used in nuclear

medicine for many years (ICRP, 1987), and more recently, a number of other amino
acids labelled with 11C or 18F have been used, or proposed, for clinical applications
such as l-[methyl-11C]-methionine (Deloar et al., 1998), L-[2-18F]-fluorotyrosine
(Cottrall et al., 1973; Taylor and Cottrall, 1973; Coenen et al., 1989), [18F]-p-fluor-
ophenylalanine (Cottrall et al., 1973), 6-[18F]-fluorotryptophan (Atkins et al., 1972;
Taylor and Cottrall, 1973), cis-4-[18F]-fluoroproline and trans-4-[18F]-fluoroproline
(Wester et al., 1999a,b), and L-3-[18F]-fluoro-a-methyl tyrosine (Inoue et al., 1998).
(C11) The Commission has only published biokinetic models for [75Se]-seleno-
methionine (ICRP, 1987) and L-[methyl-11C]-methionine (ICRP, 2008). Taylor
(2000) developed the generic biokinetic model described in Table C.5 below for
use in assessment of the internal dose received by human subjects injected intrave-
nously with amino acids labelled with 11C, 18F, or 75Se. Comparison of the radiation
doses to adults calculated using this generic model with those calculated using com-
pound-specific models for [11C]-labelled and [18F]-labelled amino acids and [75Se]-
selenomethionine indicated that, in general, the effective doses, as well as the organ
and tissue doses, calculated using the generic model agreed within a factor of two or
less with those calculated using compound-specific models. It was further noted that
the generic model tended to overestimate, rather than underestimate, the organ and
tissue doses. It was concluded that for [11C]-, [18F]-, and [75Se]-labelled amino acids
or their analogues, the generic biokinetic model could be applied for general radia-
tion protection purposes.
(C12) The generic model assumes that, following entry of a labelled amino acid
into the blood stream, the radiopharmaceutical is taken up instantaneously by the
organs and tissues. This is followed by a phase of rapid elimination of that fraction
of the injected material which goes directly into the excretory pathways or is excreted
following early metabolism, a second phase that represents loss due to metabolic
breakdown of labelled proteins and other compounds with relatively rapid turnover
times, and a final phase representing elimination of the small fraction of the radio-
nuclide that had been incorporated into structural proteins or other body compo-
nents with very slow turnover.
(C13) In the model, elimination of the radionuclide from the various organs and
tissues is assumed to approximate a three-component exponential relationship with
biological half-times of 0.5, 50, and 5000 days. The long biological half-time assigned
to the small final component of the model reflects the evidence that 14C incorporated
into structural tissues such as bone is retained with a very long half-time (Stenhouse
and Baxter, 1977; Stenström et al., 1996).
(C14) The generic model assumes that 20% of the administered activity is excreted
directly from the blood to the urinary bladder with biological half-times of 0.2 h

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(0.25) and 6 h (0.75) in the blood. It has also been assumed that 3% of the injected
activity is excreted into the small intestine; half with a biological half-time of 6 h and
half with a biological half-time of 12 h. As labelled amino acids are potentially
important for studies of protein synthesis in the brain (Bergmann et al., 1995;
Schmidt et al., 1997; Shoup et al., 1999), it is assumed that 1.5% of the injected
activity deposits in brain, from where it is released back to the circulation with
biological half-times of 50 (70%) and 5000 days (30%). The parameters of this
generic model are shown in Table C.5.
(C15) Taylor (2000) noted that the biokinetic data from humans or animals that
were used to derive both the compound-specific and the generic models are subject to
fairly large uncertainties (coefficients of variation ranging from approximately 20% to
approximately 80%); therefore, when comparing doses calculated by the generic and
compound-specific biokinetic models, differences in individual tissue or organ doses of
a factor of two, or even three, should be regarded as good agreement.
(C16) This agreement appears to be close enough for the single generic biokinetic
model to be used for normal prospective radiation dosimetry, and for general assess-
ment of the risk from the use of amino acids labelled with 11C, 14C, 18F, or 75Se. In
situations where compound-specific retrospective dosimetry is necessary (e.g. in the
case of accidental intake of a large amount of a radionuclide compound), it might
reasonably be expected that some subject- and compound-specific biokinetic infor-
mation would be available upon which a more accurate person-specific dose assess-
ment could be based. This model is not appropriate for the interpretation of
bio-assay data following intake of 14C-labelled amino acids.

11
C.3.2. References for C-labelled amino acids (generic model)
Atkins, H.L., Christman, D.R., Fowler, J.S., et al., 1972. Organic radiopharmaceuticals
labeled with isotopes of short half-life. V. 18F-labeled 5- and 6-fluorotryptophan. J.
Nucl. Med. 13, 713–719.
Bergmann, R., Brust, P., Kampf, G., Coenen, H.H., Stöcklin, G., 1995. Evaluation of radio-
selenium labeled selenomethionine, a potential tracer for brain protein synthesis by PET.
Nucl. Med. Biol. 22, 475–481.
Coenen, H.H., Kling, P., Stöcklin, G., 1989. Cerebral metabolism of L-[2-18F]fluorotyrosine, a
new PET tracer of protein synthesis. J. Nucl. Med. 30, 1367–1372.
Cottrall, M.F., Taylor, D.M., McElwain, T.J., 1973. Investigations of 18F-p-fluorophenylala-
nine for pancreas scanning. Br. J. Radiol. 46, 277–288.
Deloar, H.M., Fujiwara, T., Nakamura, T., et al., 1998. Estimation of internal absorbed dose
of L-[methyl-11C] methionine using whole body positron emission tomography. Eur. J.
Nucl. Med. 25, 629–633.
Inoue, T., Tomiyoshi, K., Higuichi, T., et al., 1998. Biodistribution studies on L-3-[fluorine-
18]fluoro-a-methyl tyrosine: a potential tumor-detecting agent. J. Nucl. Med. 39, 663–667.
ICRP, 1987. Radiation dose to patients from radiopharmaceuticals. ICRP Publication 53.
Ann. ICRP 18(1–4).
ICRP, 2008. Radiation dose to patients from radiopharmaceuticals. Addendum 3 to ICRP
Publication 53. Ann. ICRP 38(1/2).

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Schmidt, D., Langen, K-J., Herzog, H., et al., 1997. Whole-body kinetics and dosimetry of L-
3-[123I]iodo-a-methyltyrosine. Eur. J. Nucl. Med. 24, 1162–1166.
Shoup, T.M., Olson, J., Hoffman, J.M., et al., 1999. Synthesis and evaluation of [18F]1-amino-
3-fluorocyclobutane-1-carboxylic acid to image brain tumours. J. Nucl. Med. 40, 331–338.
Stenhouse, M.J., Baxter, M.S., 1977. Bomb 14C as a biological tracer. Nature (Lond.) 267,
828–832.
Stenström, K., Leide-Svegborn, S., Erlandsson, B., et al., 1996. Application of accelerator
mass spectrometry (AMS) for high-sensitivity measurements of 14CO2 in long-term studies
of fat metabolism. Appl. Radiat. Isot. 47, 417–422.
Taylor, D.M., 2000. Generic models for radionuclide dosimetry: 11C, 18F or 75Se-labelled
amino acids. Appl. Radiat. Isot. 52, 911–922.
Taylor, D.M., Cottrall, M.F., 1973. Evaluation of amino acids labelled with 18F for pancreas
scanning. In: Radiopharmaceuticals and Labelled Compounds. Vol. I. IAEA, Vienna, pp.
443–441.
Wester, H.J., Herz, M., Senkowitsch-Schmidtke, R., Schwaiger, M., Stöcklin, G., Hamacher,
K., 1999a. Preclinical evaluation of 4-[18F]fluoroprolines: diasteromeric effect on metabo-
lism and uptake in mice. Nucl. Med. Biol. 26, 259–265.
Wester, H.J., Herz, M., Weber, W., et al., 1999b. Synthesis and radiopharmacology of O-(2-
[18F]fluoroethyl)-L-tyrosine for tumor imaging. J. Nucl. Med. 40, 205–212.

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Table C.5. Biokinetic data for C-labelled amino acids (generic model).

Organ (S) Fs T (h) a Ãs/A0 (h)

Blood 0.20 0.2 0.25 0.079

6.0 0.75
Brain 0.0015 1200 0.70 0.0073
1 0.30
Thyroid 0.0007 1200 0.70 0.00034
1 0.30
Lungs 0.02 12 0.10 0.0098
1200 0.85
1 0.05
Kidneys 0.02 12 0.15 0.0098
1200 0.80
1 0.05
Kidney excretion 0.02 0.0030
Liver 0.08 12 0.40 0.039
1200 0.55
1 0.05
Spleen 0.004 12 0.33 0.0019
1200 0.67
Pancreas 0.03 12 0.85 0.014
1200 0.15
Small intestine wall 0.03 6.0 0.50 0.014
12 0.50
Ovaries 0.0002 1200 0.70 0.000098
1 0.30
Testes 0.00092 1200 0.70 0.00045
1 0.30
Muscles 0.24 12 0.15 0.12
1200 0.45
1 0.40
Other organs and tissues 0.359 12 0.15 0.18
1200 0.45
1 0.40
Urinary bladder contents 0.20
Adult, 15 years, 10 years 0.016
5 years 0.016
1 year 0.016
For L-[methyl-11C]-methionine, the compound-specific data (ICRP, 2001) should be used.

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Table C.6. Absorbed doses for C-labelled amino acids (generic model).

Absorbed dose per unit activity administered (mGy MBq1)

Organ Adult 15 years 10 years 5 years 1 year

Adrenals 4.5E03 5.4E03 8.4E03 1.3E02 2.4E02

Bone surfaces 3.1E03 3.7E03 5.7E03 8.8E03 1.9E02
Brain 2.3E03 2.4E03 2.9E03 3.7E03 5.9E03
Breast 2.3E03 2.6E03 4.0E03 6.2E03 1.2E02
Gallbladder wall 4.1E03 4.7E03 7.3E03 1.1E02 2.0E02
Gastrointestinal tract
Stomach wall 3.5E03 3.9E03 5.9E03 9.0E03 1.7E02
Small intestine wall 7.3E03 9.0E03 1.5E02 2.4E02 4.8E02
Colon wall 3.4E03 3.8E03 5.9E03 9.1E03 1.7E02
(Upper large 3.6E03 4.0E03 6.2E03 9.7E03 1.8E02)
intestine wall
(Lower large 3.2E03 3.5E03 5.5E03 8.3E03 1.5E02)
intestine wall
Heart wall 6.0E03 7.4E03 1.1E02 1.8E02 3.3E02
Kidneys 1.4E02 1.7E02 2.5E02 3.8E02 6.9E02
Liver 9.0E03 1.2E02 1.8E02 2.7E02 5.2E02
Lungs 6.3E03 8.6E03 1.3E02 2.1E02 4.1E02
Muscles 2.3E03 3.4E03 6.5E03 1.7E02 2.9E02
Oesophagus 2.8E03 3.2E03 4.8E03 7.3E03 1.4E02
Ovaries 4.7E03 4.7E03 1.1E02 1.9E02 4.2E02
Pancreas 4.1E02 5.8E02 1.2E01 1.5E01 3.4E01
Red marrow 3.6E03 4.1E03 6.3E03 9.6E03 1.8E02
Skin 2.1E03 2.3E03 3.6E03 5.5E03 1.1E02
Spleen 6.3E03 8.6E03 1.3E02 2.1E02 3.9E02
Testes 4.3E03 9.2E03 6.4E02 7.4E02 1.0E01
Thymus 2.8E03 3.2E03 4.8E03 7.3E03 1.4E02
Thyroid 5.2E03 7.9E03 1.2E02 2.6E02 5.0E02
Urinary bladder wall 1.3E02 1.6E02 2.4E02 3.8E02 7.1E02
Uterus 3.6E03 4.1E03 6.5E03 9.9E03 1.9E02
Remaining organs 2.6E03 3.8E03 6.8E03 1.4E02 2.2E02

Effective dose (mSv MBq1) 5.6E03 7.5E03 1.8E02 2.5E02 4.5E02

11
The physical half-life of C is 20.4 min.

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C.4. C-labelled brain receptor substances (generic model)
C.4.1. Biokinetic model

(C17) A large number of radiopharmaceuticals labelled with 11C are being devel-
oped for PET studies of different types of receptor in the human brain. For most of
these agents, the available biokinetic data are insufficient to construct realistic com-
pound-specific biokinetic models for calculating the internal radiation dose delivered
to persons undergoing investigation. Table C.7 shows a list of references and avail-
able data. A generic model for brain receptor substances that predicts the internal
dose with sufficient accuracy for general radiation protection purposes has, therefore,
been developed (Nosslin et al., 2002).
(C18) Biokinetic data for 13 11C radiopharmaceuticals used clinically for imaging
different brain receptors indicate that, despite differences in chemical structure, their
uptake and retention in the human brain and other tissues are broadly similar. The
proposed model, which is shown in Table C.8, assumes instantaneous deposition of
5% of the injected activity in the brain, with the remaining activity being distributed
rapidly and uniformly throughout all other tissues. Elimination from all tissues is
assumed to occur with a half-time of 2 h. It is further assumed that 75% of the injected
11
C is excreted in the urine and 25% via the gallbladder, with a half-time of 2 h.

11
C.4.2. References for C-labelled brain receptor substances (generic model)
Burns, H.D., Dannals, R.F., Langström, B., et al., 1984. 3-N-[11C]methylspiperone, a ligand
binding to dopamine receptors: radiochemical synthesis and biodistribution studies in mice.
J. Nucl. Med. 25, 1222–1227.
Farde, L., Hall, H., Ehrin, E., Sedvall, G., 1986. Quantitative analysis of D2 dopamine
receptor binding in the living human brain. Science 231, 258–261.
Farde, L., Suhara, T., Nyberg, S., et al., 1997. A PET study of [11C]FLB 457 binding to
extrastriatal D2-dopamine receptors in healthy subjects and antipsychotic drug-treated
patients. Psychopharmacology 133, 394–404.
Frost, J.J., Mayberg, H.S., Sadzot, B., et al., 1990. Comparison of [11C]diprenorphine and
[11C]carfentanil binding to opiate receptors in humans by positron emission tomography. J.
Cereb. Blood Flow Metab. 10, 484–492.
Herscovitch, P., Schmall, B., Doudet, D., Carson, R., Eckelman, W., 1997. Biodistribution
and radiation dose estimates for [11-C]raclopride (abstract). J. Nucl. Med. 5(Suppl.), 224.
Houle, S., DaSilva, J.N., Wilson, A.A., 2000a. Imaging the 5-HT1A receptors with PET:
WAY-100635 and analogues. Nucl. Med. Biol. 27, 463–466.
Houle, S., Ginovart, N., Hussey, D., Meyer, J.H., Wilson, A.A., 2000b. Imaging the serotonin
transporter system with positron emission tomography: initial human studies with
[11C]DAPP and [11C]DASB. Eur. J. Nucl. Med. 27, 1719–1722.
ICRP, 1987. Radiation dose to patients from radiopharmaceuticals. ICRP Publication 53.
Ann. ICRP 18(1–4).
Iyo, M., Namba, H., Fukushi, K., et al., 1997. Measurement of acetylcholinesterase by posi-
tron emission tomography in the brains of healthy controls and patients with Alzheimer’s
disease. Lancet 349, 1805–1809.

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Kim, S., Wagner, H.N. Jr, Villemagne, V.L., et al., 1997. Longer occupancy of opioid recep-
tors by nalmefene compared to naloxone as measured in vivo by a dual detector system. J.
Nucl. Med. 38, 1726–1731.
McClain, D.A., Hug, C.C. Jr, 1980. Intravenous fentanyl kinetics. Clin. Pharmacol. Ther. 28,
106–114.
Mulholland, G.K., Kilbourn, M.R., Sherman, P., et al., 1995. Synthesis, in vivo biodistribu-
tion and dosimetry of [11C]N-methylpiperidyl benzilate ([11C]NMPB), a muscarinic acet-
ylcholine receptor antagonist. Nucl. Med. Biol. 22, 13–17.
Nosslin, B., Johansson, L., Leide-Svegborn, S., Liniecki, J., Mattsson, S., Taylor, D., 2003. A
generic model for 11C-labelled radiopharmaceuticals for imaging receptors in the human
brain. Presented at Workshop of Internal Dosimetry of Radionuclides in Oxford, 9–12
September 2002. Rad. Prot. Dosim. 105, 587–591.
Olsson, H., Halldin, C., Swahn, G., Farde, L., 1999. Quantification of [11C]FLB 457 binding
to extrastriatal dopamine receptors in the human brain. J. Cereb. Blood Flow Metab. 19,
1164–1173.
Osman, S., Lundkvist, C., Pike, V.W., et al., 1996. Characterization of the radioactive meta-
bolites of the 5-HT1A receptor radioligand, [O-methy-11C]WAY-100635, in monkey and
human plasma by HPLC: comparison of the behaviour of an identified radioactive meta-
bolite with parent radioligand in monkey using PET. Nucl. Med. Biol. 23, 627–634.
Pappata, S., Samson, Y., Chavoix, C., Prenant, C., Mazière, M., Baron, J.C., 1988. Regional
specific binding of [11C]RO 15 1788 to central type benzodiazepine receptors in human
brain: quantitative evaluation by PET. J. Cereb. Blood Flow Metab. 8, 304–313.
Persson, A., Pauli, S., Swahn, C.G., Halldin, C., Sedvall, G., 1989. Cerebral uptake of 11C-Ro
15 1788 and its acid metabolite 11C-Ro 15 3890: PET study in human volunteers. Hum.
Psychopharmacol. 4, 215–220.
Pike, V.W., McCarron, J.A., Hume, S.P., et al., 1995. Preclinical development of a radioligand for
studies of central 5-HT1A receptors in vivo – [11C]WAY-100635. Med. Chem. Res. 5, 208–227.
Szabo, Z., Scheffel, U., Mathews, W.B., et al., 1999. Kinetic analysis of [11C]McN5652: a
serotonin transporter radioligand. J. Cereb. Blood Flow Metab. 19, 967–981.
Tanaka, N., Fukushi, K., Shinotoh, H., et al., 2001. Positron emission tomographic measure-
ment of brain acetylcholinesterase activity using N-[11C]methylpiperidin-4-yl acetate with-
out arterial blood sampling: methodology of shape analysis and its diagnostic power for
Alzheimer’s disease. J. Cereb. Blood Flow Metab. 21, 295–306.
Verhoeff, N.P., Buseman Sokole, E.B., Hengst, D., Stubbs, J.B., van Royen, E.A., 1993.
Dosimetry of iodine-123 iomazenil in humans. Eur. J. Nucl. Med. 20, 580–584.
Volkow, N.D., Ding, Y-S., Fowler, J.S., et al., 1995. A new PET ligand for the dopamine
transporter: studies in human brain. J. Nucl. Med. 36, 2162–2168.
Votaw, J.R., Ansari, M.S., Scott Mason, N., et al., 1995. Dosimetry of iodine-123-epidepride:
a dopamine D2 receptor ligand. J. Nucl. Med. 36, 1316–1321.
Westera, G., Buck, A., Burger, C., Leenders, K.L., von Schultness, G.K., Schubiger, A.P.,
1996. Carbon-11 and iodine-123 labelled iomazenil: a direct PET-SPECT comparison. Eur.
J. Nucl. Med. 23, 5–12.
Wilson, A.A., Inaba, T., Fischer, N., et al., 1998. Derivatives of WAY 100635 as potential
imaging agents for 5-HT1A receptors: syntheses, radiosyntheses, and in vitro and in vivo
evaluation. Nucl. Med. Biol. 25, 769–776.

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11
Table C.7. Brain receptor substances – comparison of C retention in brain up to approxi-
mately 90 min.
Brain

Uptake Tmax Tb
Substance (%) (h) (h) Other tissues References

Acetylcholine esterase receptor agents

N-Methylpiperidyl- 5.0 0.20 0.10–/ No human information Mulholland et al., 1995;
acetate but some animal data Iyo et al., 1997;
N-Methylpiperidyl- Tanaka et al., 2001
propionate
Benzodiazepine receptor agents
Flumazenil 7.0 0.10 0.50 No human data for Pappata et al., 1988;
[11C]-flumazenil, dosim- Persson et al., 1989;
etry based on data for Verhoeff et al., 1993;
[123I]-flumazenil Westera et al., 1996
Dopamine receptor agents
Raclopride 1.5 0.40 3.0 No human data, data Farde et al., 1986;
from positron emission Herscovitch et al., 1997
tomography imaging in
monkeys
FLB-457 5.0 0.30 0.50–12 No human data Votaw et al., 1995;
Farde et al., 1997;
Olsson et al., 1999
Epidepride n.a. n.a. Human data for [123I]-
epidepride
Spiperone 1.0 0.50 0.50 Human data for [76Br]- Burns et al., 1984;
spiperone, mouse data ICRP, 1987
for [11C]-
methylspiperone
Dopamine transporter agents
Methylphenidate 9.0 0.10–0.20 1.3þ No human data Volkow et al., 1995
Opiate receptor agents
Carfentanil 3.0 0.10 1.0–20 Human data for plasma McClain and Hug, 1980;
clearance of fentanyl Frost et al., 1990;
Kim et al., 1997
Serotonin receptor agents
OMeWAY-100634 9.0 0.10 1.0 Human plasma clear- Osman et al., 1996;
ance data Pike et al., 1995;
Wilson et al., 1998
COWAY 3.0–4.0 0.10 0.050–3.0 Human plasma clear- Houle et al., 2000a
ance data
McN-5652 3.0 0.20 3.0þ No human data Szabo et al., 1999
DASB 8.0 0.80–1.8 No human data Houle et al., 2000b

n.a., not available.

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Table C.8. Biokinetic data for C-labelled brain receptor substances (generic model).

Organ (S) Fs T (h) a Ãs/A0 (h)

Brain 0.05 2.0 1.0 0.021

Other organs and tissues 0.95 2.0 1.0 0.40
Gallbladder contents 0.0875 0.0062
Gastrointestinal tract contents
Small intestine 0.25 0.010
Upper large intestine 0.25 0.0012
Urinary bladder contents 0.75
Adult, 15 years, 10 years 0.045
5 years 0.044
1 year 0.042

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Table C.9. Absorbed doses for C-labelled brain receptor substances (generic model).

Absorbed dose per unit activity administered (mGy MBq1)

Organ Adult 15 years 10 years 5 years 1 year

Adrenals 2.8E03 3.6E03 5.7E03 9.5E03 1.8E02

Bone surfaces 2.8E03 3.5E03 5.5E03 8.9E03 1.7E02
Brain 5.2E03 5.3E03 5.6E03 6.5E03 9.2E03
Breast 2.1E03 2.8E03 4.3E03 7.2E03 1.5E02
Gallbladder wall 1.7E02 1.9E02 2.5E02 4.6E02 1.6E01
Gastrointestinal tract
Stomach wall 2.8E03 3.5E03 5.6E03 9.2E03 1.8E02
Small intestine wall 4.4E03 5.6E03 9.5E03 1.5E02 2.9E02
Colon wall 3.3E03 4.1E03 6.6E03 1.0E02 1.9E02
(Upper large intestine wall 3.2E03 4.0E03 6.4E03 1.0E02 1.9E02)
(Lower large intestine wall 3.5E03 4.2E03 6.9E03 1.1E02 2.0E02)
Heart wall 2.7E03 3.5E03 5.7E03 9.1E03 1.8E02
Kidneys 2.8E03 3.5E03 5.6E03 9.3E03 1.8E02
Liver 2.8E03 3.6E03 5.6E03 9.4E03 1.8E02
Lungs 2.5E03 3.2E03 5.1E03 8.3E03 1.6E02
Muscles 2.6E03 3.3E03 5.3E03 8.7E03 1.7E02
Oesophagus 2.5E03 3.3E03 5.2E03 8.5E03 1.7E02
Ovaries 3.6E03 4.5E03 7.1E03 1.1E02 2.1E02
Pancreas 3.0E03 3.8E03 6.2E03 1.0E02 1.9E02
Red marrow 2.7E03 3.5E03 5.4E03 8.4E03 1.6E02
Skin 2.1E03 2.6E03 4.3E03 7.2E03 1.4E02
Spleen 2.7E03 3.4E03 5.5E03 9.2E03 1.8E02
Testes 2.8E03 3.7E03 6.1E03 9.7E03 1.9E02
Thymus 2.5E03 3.3E03 5.2E03 8.5E03 1.7E02
Thyroid 2.6E03 3.3E03 5.4E03 8.9E03 1.8E02
Urinary bladder wall 3.2E02 4.1E02 6.3E02 9.7E02 1.7E01
Uterus 4.3E03 5.4E03 8.6E03 1.4E02 2.5E02
Remaining organs 2.8E03 3.6E03 5.6E03 8.5E03 1.5E02

Effective dose (mSv MBq1) 4.3E03 5.5E03 8.6E03 1.4E02 2.6E02

11
The physical half-life of C is 20.4 min.

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 C.5. L-[methyl-11C]-methionine
C.5.1. Biokinetic model

(C19) The amino acid L-[methyl-11C]-methionine can be applied in tumour diag-

nosis and in the study of protein synthesis using PET. Deloar et al. (1998) reported
quantitative PET studies on the distribution of L-[methyl-11C]-methionine in five
healthy, male volunteers aged 22–40 years. The data suggested that approximately
90% of the activity was lost from all tissues during the first 90 min after injection,
with biological half-times of approximately 20–30 min. Thereafter, the activity
appeared to be lost more slowly, with a half-time that could be considered to be
long in relation to the physical half-life of 11C.
(C20) The biokinetic model presented in Table C.10 below was developed on the
basis of the human data of Deloar et al. (1998b), who estimated the uptake of L-
[methyl-11C]-methionine into the brains of the five volunteers to be 2.8  0.7% of the
injected activity; some seven times higher than the value of 0.4% previously esti-
mated by Comar et al. (1976).

C.5.2. References for L-[methyl-11C]-methionine

Comar, D., Catron, J.C., Maziere, M., Marazanop, C., 1976. Labelling and metabolism of
methionine-methyl-11C. Eur. J. Nucl. Med. 1, 11–14.
Deloar, H.M., Fujiwara, T., Nakamura, T., et al., 1998. Estimation of internal absorbed dose
of L-[methyl-11C]-methionine using whole body positron emission tomography. Eur. J.
Nucl. Med. 25, 629–633.

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Table C.10. Biokinetic data for L-[methyl-11C]-methionine.

Organ (S) Fs T (h) a Ãs/A0 (h)

Brain 0.030 0.4 0.90 0.0086

12 0.10
Lungs 0.050 0.4 0.90 0.014
12 0.10
Kidneys 0.022 0.4 0.90 0.0063
12 0.10
Kidney excretion 0.026
Liver 0.22 0.4 0.90 0.063
12 0.10
Spleen 0.010 0.4 0.90 0.0029
12 0.10
Pancreas 0.016 0.4 0.90 0.0046
12 0.10
Other organs and tissues 0.652 0.4 0.90 0.19
12 0.10
Gallbladder contents 0.077 0.0033
Gastrointestinal tract contents
Small intestine 0.22 0.0055
Upper large intestine 0.22 0.00064
Lower large intestine 0.22 0.000024
Urinary bladder contents 0.78
Adult, 15 years, 10 years 0.13
5 years 0.13
1 year 0.13
14
This biokinetic model is not applicable for C.

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Table C.11. Absorbed doses for L-[methyl-11C]-methionine.

Absorbed dose per unit activity administered (mGy MBq1)

Organ Adult 15 years 10 years 5 years 1 year

Adrenals 3.1E03 3.9E03 6.1E03 9.6E03 1.7E02

Bone surfaces 1.9E03 2.4E03 3.6E03 5.8E03 1.1E02
Brain 2.2E03 2.2E03 2.4E03 2.8E03 4.1E03
Breast 1.3E03 1.7E03 2.8E03 4.7E03 9.2E03
Gallbladder wall 4.0E02 4.6E02 5.9E02 1.1E01 4.1E01
Gastrointestinal tract
Stomach wall 2.6E03 3.2E03 5.3E03 8.5E03 1.6E02
Small intestine wall 1.9E02 2.5E02 4.3E02 7.1E02 1.4E01
Colon wall 6.4E03 8.1E03 1.3E02 2.1E02 3.7E02
(Upper large intestine wall 8.1E03 1.0E02 1.7E02 2.7E02 5.1E02)
(Lower large intestine wall 4.1E03 5.2E03 7.8E03 1.2E02 2.0E02)
Heart wall 2.0E03 2.6E03 4.2E03 6.6E03 1.2E02
Kidneys 2.9E02 3.5E02 5.0E02 7.4E02 1.3E01
Liver 1.2E02 1.6E02 2.4E02 3.5E02 6.7E02
Lungs 4.6E03 6.7E03 9.6E03 1.5E02 2.9E02
Muscles 2.2E03 2.7E03 4.2E03 6.8E03 1.3E02
Oesophagus 1.5E03 1.9E03 3.1E03 5.0E03 9.7E03
Ovaries 4.7E03 6.0E03 9.1E03 1.4E02 2.4E02
Pancreas 1.5E02 2.1E02 4.2E02 5.5E02 1.2E01
Red marrow 2.3E03 2.8E03 4.2E03 6.1E03 1.1E02
Skin 1.4E03 1.7E03 2.8E03 4.6E03 9.1E03
Spleen 5.9E03 8.3E03 1.3E02 2.0E02 3.7E02
Testes 2.5E03 3.5E03 6.1E03 9.8E03 1.8E02
Thymus 1.5E03 1.9E03 3.1E03 5.0E03 9.7E03
Thyroid 1.3E03 1.7E03 2.8E03 4.7E03 9.4E03
Urinary bladder wall 9.2E02 1.2E01 1.8E01 2.8E01 5.1E01
Uterus 6.8E03 8.3E03 1.3E02 2.1E02 3.6E02
Remaining organs 3.1E03 4.3E03 7.2E03 1.3E02 2.1E02

Effective dose (mSv MBq1) 8.2E03 1.1E02 1.6E02 2.5E02 4.7E02

The physical half-life of 11C is 20.4 min.
The urinary bladder wall contributes 56% of the effective dose.

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 11
C.6. C-labelled thymidine
C.6.1. Biokinetic model

(C21) 11C-labelled thymidine is a DNA precursor that can be used as an in-vivo

marker for cell proliferation in malignant tumours. It also has applications in
tumour staging and for monitoring the effectiveness of treatment. It has been used
in two forms: labelled with 11C in the methyl group, [methyl-11C]-thymidine, or
labelled with 11C on C2 of the pyrimidine ring, [2-11C]-thymidine. The two forms
differ in respect of the metabolic fate of the 11C label. [Methyl-11C]-thymidine is
metabolised to [11C]-b-amino-iso-butyric acid, while the C2-labelled molecule is
metabolised to [11C]CO2. For dosimetric purposes, it is necessary to develop appro-
priate biokinetic models to describe the fate of the 11C following administration of
each of the two compounds.

[Methyl-11C]-thymidine
(C22) PET studies in a small number of patients (Martiat et al., 1988; Thierens
et al., 1994) have provided information for the distribution of [methyl-11C]-thymidine
over a period of 40 min following intravenous injection. Thierens et al. (1994)
observed that 95% of the activity was cleared rapidly from the blood (T1/2 ¼ 1 min)
and deposited in the liver (40–45%), skeletal muscle (30–34%), and kidneys (5–6%),
with much smaller quantities going to other tissues. At 10 min after injection, less than
15% of the activity remaining in the blood was present as [methyl-11-C]thymidine; this
amounts to less than 0.75% of the injected activity.
(C23) Martiat et al. (1988) reported ‘substantial’ uptake in lungs, spleen, and
intestine, but Thierens et al. (1994) stated that the concentration in spleen and
lungs does not exceed that observed in muscle. Using the data of Martiat et al.
(1988) to calculate organ contents at 30-min post injection suggests uptake of 40%
in liver, 10% in kidneys, 2% in lungs and spleen, and 13% in muscle. Analysis of the
tissue retention data reported by Martiat et al. (1988) and Thierens et al. (1994)
suggests biological half-times of retention ranging from 60 min in the lungs to
460 min in muscle.
(C24) The data of Martiat et al. (1988) and Thierens et al. (1994) have been used to
derive the biokinetic model for [methyl-11C]-thymidine.

[2-11C]-thymidine
(C25) Van der Borght et al. (1992) compared the retention of [2-11C]-thymidine
and [methyl-11C]-thymidine in a PET study involving five patients. Although the
masses of labelled thymidine injected, 3.1 mmol [2-11C]-thymidine and 0.17 mmol
[methyl-11C]-thymidine, differed by a factor of 18, they were both small in relation
to the plasma levels of non-radioactive thymidine, and mass-related changes in the
biokinetics of the two labelled compounds appear unlikely. The initial plasma clear-
ance was very rapid, with more than 99% of the injected activity being removed with
a half-time of less than 1 min. Although there were some differences in the retention
of the small fraction of the injected activity remaining in the plasma at 10 min, these

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 ICRP Publication 128

were quite small. At 10-min post injection, 70% of the plasma activity was in the
form of [11C]CO2. The retention of 11C in the liver and kidneys was seven and three
times less for [2-11C]-thymidine than for [methyl-11C]-thymidine, respectively.
(C26) The dosimetric model for [2-11C]-thymidine, as shown in Table C.12, is
based on the assumption that 70% of the injected compound is converted rapidly
to [11C]CO2, which then follows the biokinetic model for continuous inhalation of
[11C]CO2 proposed in Publication 53 (ICRP, 1987); the remaining activity is assumed
to follow a model derived from that for [methyl-11C]-thymidine, but with uptake
values for liver and kidneys based on the observations of Van der Borght et al.
(1992).

11
C.6.2. References for C-labelled thymidine
ICRP, 1987. Radiation doses to patients from radiopharmaceuticals. ICRP Publication 53.
Ann. ICRP 18(1–4).
Martiat, Ph., Ferrant, A., Labar, D., et al., 1988. In vivo measurement of carbon-11 thymidine
uptake in non-Hodgkin’s lymphoma using positron emission tomography. J. Nucl. Med.
29, 1633–1637.
Thierens, H., van Eijkeren, M., Goethals, P., 1994. Biokinetics and dosimetry for
[methyl-11C]thymidine. Br. J. Radiol. 67, 292–295.
Van der Borght, T., de Maeght, S., Labar, D., et al., 1992. Comparison of thymidine labelled
in methyl group and in 2C-ring position in human PET studies. Eur. J. Nucl. Med. 19, 578.

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Table C.12. Biokinetic data for C-labelled thymidine.

Organ (S) Fs T (h) a Ãs/A0 (h)

[Methyl-11C]-thymidine
Blood 1.00 0.017 0.95 0.046
24 0.05
Liver 0.45 0.017 1.00 0.18
2.0 1.00
Kidneys 0.07 0.017 1.00 0.032
24 1.00
Muscles 0.30 0.0178.0 1.00 0.13
1.00
Other organs and tissues 0.13 0.017 1.00 0.056
4.0 1.00
[2-11C]-thymidine
Blood 1.00 0.017 0.99 0.028
24 0.01
Liver 0.07 0.017 1.00 0.024
0.67 0.70
2.0 0.30
Kidneys 0.03 0.017 1.00 0.011
0.67 0.70
24 0.30
Other organs and tissues 0.90 0.017 1.00 0.31
0.67 0.70
8.0 0.30

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Table C.13. Absorbed doses for C-labelled thymidine.

Absorbed dose per unit activity administered (mGy MBq1)

Organ Adult 15 years 10 years 5 years 1 year

[Methyl-11C]-thymidine
Adrenals 4.3E03 5.3E03 7.9E03 1.2E02 2.0E02
Bone surfaces 1.8E03 2.2E03 3.3E03 5.1E03 1.0E02
Brain 9.6E04 1.1E03 1.7E03 2.6E03 5.1E03
Breast 1.3E03 1.5E03 2.6E03 3.9E03 7.5E03
Gallbladder wall 5.5E03 6.2E03 8.1E03 1.3E02 2.6E02
Gastrointestinal tract
Stomach wall 2.2E03 2.5E03 4.1E03 6.5E03 1.3E02
Small intestine wall 2.0E03 2.4E03 3.8E03 6.1E03 1.1E02
Colon wall 1.9E03 2.2E03 3.5E03 5.6E03 1.0E02
(Upper large intestine wall 2.3E03 2.6E03 4.3E03 6.8E03 1.3E02)
(Lower large intestine wall 1.4E03 1.6E03 2.5E03 3.9E03 7.0E03)
Heart wall 4.0E03 5.1E03 7.9E03 1.2E02 2.2E02
Kidneys 3.1E02 3.8E02 5.4E02 8.0E02 1.4E01
Liver 3.2E02 4.2E02 6.4E02 9.4E02 1.8E01
Lungs 3.5E03 4.4E03 6.9E03 1.1E02 2.1E02
Muscles 2.2E03 3.4E03 6.7E03 1.8E02 3.1E02
Oesophagus 1.6E03 1.9E03 2.7E03 4.2E03 7.5E03
Ovaries 1.6E03 1.9E03 3.0E03 4.8E03 8.9E03
Pancreas 3.5E03 4.2E03 6.6E03 1.0E02 1.7E02
Red marrow 2.2E03 2.5E03 3.8E03 5.6E03 1.0E02
Skin 1.1E03 1.3E03 1.9E03 3.0E03 5.7E03
Spleen 3.1E03 3.9E03 6.1E03 9.5E03 1.8E02
Testes 1.1E03 1.3E03 2.0E03 3.1E03 5.9E03
Thymus 1.6E03 1.9E03 2.7E03 4.2E03 7.5E03
Thyroid 1.5E03 1.9E03 3.1E03 5.0E03 9.6E03
Urinary bladder wall 1.4E03 1.5E03 2.4E03 4.0E03 6.6E03
Uterus 1.5E03 1.9E03 3.0E03 4.8E03 8.8E03
Remaining organs 2.4E03 3.7E03 6.7E03 1.4E02 2.2E02

Effective dose (mSv MBq1) 3.5E03 4.4E03 6.8E03 1.1E02 2.0E02

(continued on next page)

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 Radiation dose to patients from radiopharmaceuticals

Table C.13. (continued)

Absorbed dose per unit activity administered (mGy MBq1)

Organ Adult 15 years 10 years 5 years 1 year

[2-11C]-thymidine
Adrenals 2.9E03 3.7E03 5.8E03 9.3E03 1.7E02
Bone surfaces 2.4E03 3.0E03 4.7E03 7.6E03 1.5E02
Brain 1.9E03 2.4E03 4.0E03 6.7E03 1.3E02
Breast 1.8E03 2.3E03 3.6E03 5.9E03 1.1E02
Gallbladder wall 2.8E03 3.4E03 5.2E03 7.9E03 1.5E02
Gastrointestinal tract
Stomach wall 2.4E03 2.9E03 4.6E03 7.3E03 1.4E02
Small intestine wall 2.4E03 3.1E03 4.9E03 7.8E03 1.5E02
Colon wall 2.4E03 2.9E03 4.7E03 7.4E03 1.4E02
(Upper large intestine wall 2.4E03 3.0E03 4.8E03 7.7E03 1.4E02)
(Lower large intestine wall 2.3E03 2.7E03 4.5E03 7.1E03 1.3E02)
Heart wall 3.4E03 4.3E03 6.8E03 1.1E02 2.0E02
Kidneys 1.1E02 1.3E02 1.9E02 2.8E02 5.1E02
Liver 5.2E03 6.8E03 1.0E02 1.6E02 2.9E02
Lungs 3.0E03 3.9E03 6.2E03 9.9E02 1.9E02
Muscles 2.1E03 2.6E03 4.1E03 6.6E03 1.3E02
Oesophagus 2.2E03 2.8E03 4.3E03 6.9E03 1.3E02
Ovaries 2.4E03 3.0E03 4.8E03 7.6E03 1.4E02
Pancreas 2.7E03 3.4E03 5.3E03 8.3E03 1.6E02
Red marrow 2.5E03 3.1E03 4.8E03 7.6E03 1.4E02
Skin 1.7E03 2.1E03 3.4E03 5.6E03 1.1E02
Spleen 3.0E03 3.7E03 5.9E03 9.6E03 1.8E02
Testes 2.0E03 2.5E03 3.9E03 6.2E03 1.2E02
Thymus 2.2E03 2.8E03 4.3E03 6.9E03 1.3E02
Thyroid 2.3E03 2.9E03 4.7E03 7.8E03 1.5E02
Urinary bladder wall 2.3E03 2.7E03 4.3E03 7.1E03 1.3E02
Uterus 2.4E03 3.0E03 4.8E03 7.6E03 1.4E02
Remaining organs 2.1E03 2.6E03 4.2E03 6.8E03 1.3E02

Effective dose (mSv MBq1) 2.7E03 3.4E03 5.3E03 8.4E03 1.6E02

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The physical half-life of C is 20.4 min.

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C.7. C-labelled substances (realistic maximum)
C.7.1. Biokinetic model

(C27) It is assumed that 50% of the decay occurs while the substance passes the
urinary bladder, and the remaining 50% of the total disintegration occurs when it is
distributed homogeneously throughout the whole body.

11
Table C.14. Biokinetic data for C-labelled substances (realistic maximum).

Organ (S) Fs T (h) a Ãs/A0 (h)

Other organs and tissues 0.50 1 1.0 0.25

Urinary bladder contents 0.50 1 1.0
Adult, 15 years, 10 years 0.25
5 years 0.25
1 year 0.25

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Table C.15. Absorbed doses for C-labelled substances (realistic maximum).

Absorbed dose per unit activity administered (mGy MBq1)

Organ Adult 15 years 10 years 5 years 1 year

Adrenals 1.7E03 2.2E03 3.5E03 5.7E03 1.1E02

Bone surfaces 1.9E03 2.4E03 3.7E03 5.8E03 1.1E02
Brain 1.3E03 1.7E03 2.8E03 4.6E03 8.8E03
Breast 1.3E03 1.7E03 2.6E03 4.3E03 8.4E03
Gallbladder wall 2.0E03 2.4E03 4.0E03 6.2E03 1.2E02
Gastrointestinal tract
Stomach wall 1.8E03 2.2E03 3.5E03 5.7E03 1.1E02
Small intestine wall 3.0E03 4.0E03 6.2E03 9.7E03 1.8E02
Colon wall 3.7E03 4.7E03 7.2E03 1.1E02 1.8E02
(Upper large intestine wall 2.7E03 3.4E03 5.4E03 8.7E03 1.5E02)
(Lower large intestine wall 5.1E03 6.4E03 9.6E03 1.4E02 2.3E02)
Heart wall 1.6E03 2.1E03 3.3E03 5.3E03 1.0E02
Kidneys 1.8E03 2.2E03 3.6E03 5.9E03 1.1E02
Liver 1.7E03 2.1E03 3.5E03 5.8E03 1.1E02
Lungs 1.5E03 1.9E03 3.0E03 4.8E03 9.4E03
Muscles 2.3E03 2.8E03 4.5E03 7.1E03 1.3E02
Oesophagus 1.5E03 1.9E03 3.1E03 4.9E03 9.5E03
Ovaries 4.9E03 6.3E03 9.1E03 1.4E02 2.4E02
Pancreas 1.8E03 2.3E03 3.7E03 6.1E03 1.2E02
Red marrow 2.1E03 2.7E03 4.0E03 5.9E03 1.0E02
Skin 1.5E03 1.9E03 3.0E03 5.0E03 9.5E03
Spleen 1.7E03 2.2E03 3.3E03 5.5E03 1.1E02
Testes 3.7E03 5.3E03 9.2E03 1.4E02 2.6E02
Thymus 1.5E03 1.9E03 3.1E03 4.9E03 9.5E03
Thyroid 1.5E03 1.9E03 3.1E03 5.1E03 9.8E03
Urinary bladder wall 1.7E01 2.1E01 3.2E01 5.0E01 9.5E01
Uterus 9.2E03 1.1E02 1.8E02 2.7E02 4.6E02
Remaining organs 2.3E03 2.8E03 4.3E03 6.4E03 1.2E02

Effective dose (mSv MBq1) 1.1E02 1.4E02 2.1E02 3.3E02 6.1E02

The physical half-life of 11C is 20.4 min.
The urinary bladder wall contributes 79% of the effective dose.

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C.8. C-raclopride
C.8.1. Biokinetic model

(C28) Raclopride is a synthetic compound of the salicylamide series with high

selectivity and affinity for central D2-dopamine receptors. It can be labelled with
11
C and used in PET. The neurotransmitter dopamine may be involved in various
neuropsychiatric diseases. 11C-raclopride is cleared rapidly from both plasma and
whole blood, and crosses the blood–brain barrier. After intravenous administration,
11
C-raclopride localises in the basal ganglia, a region with a high density of dopa-
mine receptors. PET images show the concentration of 11C-raclopride in the region
of the putamen relative to the rest of the brain. Images can be taken immediately
after injection and continued for approximately 60 min (Glatting et al., 2004;
Slifstein et al., 2007).
(C29) The proposed biokinetic model shown in Table C.16 is mainly based on
experimental data from Ribeiro et al. (2005) (11 measurements from 2 to 112 min
after application). The source organs have been grouped according to three retention
half-times. Slifstein et al. (2011) used the LLI and cortical bone, but not muscle, as
source regions. They also reported a lower kidney uptake.

11
C.8.2. References for C-raclopride
Glatting, G., Mottaghy, F.M., Karitzky, J., et al., 2004. Improving binding potential analysis
in [11C]raclopride PET studies using cluster analysis. Med. Phys. 31, 902–906.
ICRP, 1987. Radiation dose to patients from radiopharmaceuticals. ICRP Publication 53.
Ann. ICRP 18(1–4).
Ribeiro, M-J., Ricard, M., Bourgeois, S., et al., 2005. Biodistribution and radiation dosimetry
of [11C]raclopride in healthy volunteers. Eur. J. Nucl. Mol. Imag. 32, 952–958.
Slifstein, M., Lawrence, S., Kegeles, L.S., et al., 2007. [11C]NNC 112 selectivity for dopamine
D1 and serotonin 5-HT2A receptors: a PET study in healthy human subjects. J. Cerebr.
Blood Flow Metab. 27, 1733–1741.
Slifstein, M., Suckow, R.F., Javitch, J.A., Cooper, T., 2011. Characterization of in vivo
pharmacokinetic properties of the dopamine D1 receptor agonist DAR-0100A in non-
human primates using PET with [11C] NNC112 and [11C] raclopride. J. Cerebr. Blood
Flow Metab. 31, 293–304.

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Table C.16. Biokinetic data for C-raclopride.

Organ (S) Fs T (h) a Ãs/A0 (h)

Liver 0.18 4.0 1.0 0.081

Kidneys 0.06 1.0 1.0 0.023
(from excretion process) 0.0054
Brain 0.03 1.0 1.0 0.011
Red marrow 0.02 1 1.0 0.0098
Lungs 0.02 1.0 1.0 0.0073
Heart wall 0.01 1.0 1.0 0.0037
Small intestine wall 0.08 0.33 0.019
Gallbladder contents 0.16 0.0062
Other organs and tissues 0.60 0.33 0.1 0.27
4.0 0.45
1 0.45
Gastrointestinal tract contents
Small intestine 0.40 0.023
Upper large intestine 0.40 0.0027
Lower large intestine 0.40 0.00010
Urinary bladder contents 0.31
Adult, 15 years, 10 years 0.029
5 years, 1 year 0.028
Activity in liver is excreted according to the Publication 53 (ICRP, 1987) gallbladder model (90% passes
the gallbladder). Activity in the small intestine wall and half of the activity in other tissues with the long
half-time goes directly to the gastrointestinal tract contents. Remaining activity with finite biological half-
time is excreted via the urinary bladder.

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Table C.17. Absorbed doses after intravenous administration of C-raclopride.

Absorbed dose per unit activity administered (mGy MBq1)

Organ Adult 15 year 10 year 5 year 1 year

Adrenals 3.6E03 4.5E03 7.0E03 1.1E02 2.0E02

Bone surfaces 2.6E03 3.2E03 5.1E03 8.3E03 1.7E02
Brain 2.8E03 2.9E03 3.2E03 3.7E03 5.4E03
Breast 1.8E03 2.3E03 3.8E03 6.2E03 1.2E02
Gallbladder wall 1.8E02 2.1E02 2.7E02 4.9E02 1.7E01
Gastrointestinal tract contents
Stomach wall 2.8E03 3.4E03 5.7E03 9.1E03 1.8E02
Small intestine wall 1.4E02 1.8E02 3.2E02 4.7E02 9.2E02
Colon wall 4.1E03 5.1E03 8.3E03 1.2E02 2.2E02
(Upper large intestine wall 5.2E03 6.4E03 1.1E02 1.5E02 2.8E02)
(Lower large intestine wall 2.7E03 3.3E03 5.3E03 7.9E03 1.4E02)
Heart wall 4.5E03 5.9E03 9.1E03 1.4E02 2.5E02
Kidneys 2.6E02 3.1E02 4.4E02 6.6E02 1.2E01
Liver 1.5E02 1.9E02 3.0E02 4.4E02 8.3E02
Lungs 3.1E03 4.4E03 6.3E03 9.6E03 1.9E02
Muscles 2.3E03 2.9E03 4.6E03 7.4E03 1.4E02
Oesophagus 2.1E03 2.7E03 4.3E03 6.9E03 1.4E02
Ovaries 3.6E03 4.5E03 7.1E03 1.1E02 2.0E02
Pancreas 3.5E03 4.3E03 7.1E03 1.1E02 2.0E02
Red marrow 3.1E03 3.6E03 5.6E03 9.0E03 1.8E02
Skin 1.7E03 2.1E03 3.5E03 5.8E03 1.2E02
Spleen 2.7E03 3.5E03 5.6E03 9.1E03 1.7E02
Testes 2.1E03 2.7E03 4.6E03 7.4E03 1.5E02
Thymus 2.1E03 2.7E03 4.3E03 6.9E03 1.4E02
Thyroid 1.9E03 2.5E03 4.1E03 6.9E03 1.4E02
Urinary bladder wall 2.2E02 2.8E02 4.2E02 6.5E02 1.2E01
Uterus 3.9E03 4.9E03 8.0E03 1.2E02 2.3E02
Remaining organs 2.7E03 3.6E03 5.9E03 9.2E03 1.8E02

Effective dose (mSv MBq1) 5.0E03 6.4E03 9.8E03 1.5E02 3.0E02

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The physical half-life of C is 20.4 min.

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C.9. C-neutral fat and free fatty acids
C.9.1. Biokinetic model

(C30) Orally administered fat is absorbed rapidly and completely from the gastro-
intestinal tract. Within 3–4 h, all activity has reached the blood via the lymphatic
system. After transient uptake and chemical modification in the liver, the fat is
transported to the adipose tissue, which occurs principally in subcutaneous tissue,
yellow marrow, and the abdominal cavity, and to the muscles. Other organs and
tissues only receive small amounts. It is then metabolised by b-oxidation, with water
and CO2 as end products. The turnover rate is highly dependent on the nutritional
state, especially the supply of carbohydrates.
(C31) Pedersen and Marqversen (1981) measured 14CO2 in expired air in five
healthy subjects, who were given labelled neutral fat in a test meal after an 8-h
fast. From 6 h later, unrestricted food was allowed. After 1 day, 15–33% of ingested
fat was metabolised, and this increased to 25–40% by 10 days. The residue was
retained for a much longer time with a calculated half-time of 304–493 days.
Malmendier et al. (1974) injected 14C-labelled palmitic acid into four fasting
normal subjects and measured expired air over 24 h. They found that 45% of the
fatty acid was oxidised directly to CO2. No carbohydrate was given simultaneously,
which may explain the larger fraction metabolised more rapidly than in the study of
Pedersen and Marqversen (1981). Hirsch et al. (1960) studied the turnover of neutral
fat incorporated into adipose tissue and found half-times up to 750 days.
(C32) The model adopted here and shown in Table C.18 is intended for fat con-
taining unbranched long-chain (13–18 C atoms) fat molecules and labelled with 14C
or 3H, administered orally or intravenously. Rapid and complete resorption is
assumed. After transient uptake in the liver, the activity is deposited in the adipose
tissue (85%), in muscles (10%), and in all other organs and tissues (5%) according to
their fat content as given in Publication 23 (ICRP, 1975). Assuming adequate supply
of carbohydrates, 30% is metabolised rapidly (T1/2 ¼ 2 days) and 70% is retained for
a longer time (T1/2 ¼ 400 days). The half-time of 400 days assumed for the longer-
term component of retention of 3H (and 14C) in the body fat is longer than the
overall half-time of 40 days assumed for the total body hydrogen (and carbon) in
Publications 30 and 56 (ICRP, 1981, 1990). This long-lived component refers only to
that fraction of the body fat that is labelled following administration of a single dose
of labelled fat administered as a radiopharmaceutical, and which probably represents
only a small fraction of the total body carbon pool. The long-lived component refers
in this case to the fraction of body fat which becomes labelled with the administered
radiopharmaceutical. This probably only represents a small fraction of the total
carbon pool in the body.
(C33) This model is intended for adults only. It is possible that the metabolism is
significantly different in children, with longer half-times in some tissues (e.g. the
nervous system).

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C.9.2. References for C-neutral fat and free fatty acids
Hirsch, J., Farquhar, J.W., Ahrens, J.E.H., Petersen, M.L., Stoffel, W., 1960. Studies of
adipose tissue in man. J. Clin. Nutr. 8, 499–510.
ICRP, 1975. Report of the Task Group on Reference Man. ICRP Publication 23. Pergamon
Press, Oxford.
ICRP, 1981. Limits for intakes of radionuclides by workers. ICRP Publication 30, Part 3.
Ann. ICRP 6(2/3).
ICRP, 1990. Age-dependent doses to members of the public from intake of radionuclides. Part
1. ICRP Publication 56. Ann. ICRP 20(2).
Malmendier, C.L., Delcroix, C., Berman, M., 1974. Interrelations in oxidative metabolism of
free fatty acids, glucose and glycerol in normal and hyperlipemic patients. A compartmen-
tal model. J. Clin. Invest. 54, 461–476.
Pedersen, N.T., Marqversen, J., 1981. Metabolism of ingested 14C-triolein. Estimation of
radiation dose in tests of lipid assimilation using 14C- and 3H-labelled fatty acids. Eur. J.
Nucl. Med. 6, 327–329.

14
Table C.18. Biokinetic data for C-neutral fat and free fatty acids.

Organ (S) Fs T (h) a Ãs/A0 (h)

Adipose tissue 0.85 48 0.30 8300

9600 0.70
Muscles 0.10 48 1.0 6.9
Other organs and tissues 0.05 9600 1.0 690
Adrenals 0.0002 2.8
Breast 0.0006 8.3
Stomach 0.0005 6.9
Small intestine 0.0022 30
Upper large intestine 0.0007 9.7
Lower large intestine 0.0005 6.9
Heart 0.0018 25
Kidneys 0.0009 13
Liver 0.0064 89
Lungs 0.0005 6.9
Ovaries 0.00001 0.14
Pancreas 0.0004 5.5
Red marrow 0.0322 450
Bone (cortical) 0.0020 29
Bone (trabecular) 0.0005 6.9
Spleen 0.0002 2.8
Testes 0.0001 1.4
Thyroid 0.0001 1.4

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Table C.19. Absorbed doses for C-neutral fat and free fatty acids.

Absorbed dose per unit activity

Organ administered (mGy MBq1)

Adrenals 4.8Eþ00
Bone surfaces 5.8Eþ00
Breast 6.5E01
Gastrointestinal tract
Stomach wall 1.2Eþ00
Small intestine wall 1.0Eþ00
Colon wall 1.3Eþ00
(Upper large intestine wall 1.3Eþ00)
(Lower large intestine wall 1.2Eþ00)
Heart wall 2.3Eþ00
Kidneys 1.2Eþ00
Liver 1.3Eþ00
Lungs 2.0E01
Muscles 3.8E03
Ovaries 4.6E01
Pancreas 1.7Eþ00
Red marrow 1.1Eþ01
Spleen 4.3E01
Testes 1.0Eþ00
Thyroid 1.9Eþ00
Remaining organs 1.8E02

Effective dose (mSv MBq1) 2.1Eþ00

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 14
C.10. C-labelled urea
C.10.1. Biokinetic model

(C34) Urea (carbamide, H2NCONH2) is the main end product in the human
catabolism of proteins, polypeptides, amino acids, and other nitrogen-containing
substances. It is freely water soluble and distributes rapidly into the total body
water. The main part is excreted unchanged by the kidneys, while a small part
diffuses into the intestinal content where it is broken down by urease-producing
bacteria to ammonia and CO2. The CO2 is reabsorbed and equilibrates with bicar-
bonate, thus entering the CO2/bicarbonate pools in the body and finally being
exhaled by the lungs (Walser and Bodenlos, 1959).
14
C urea
(C35) A breath test employing per-oral administration of 14C-urea is commonly
used to detect the presence of Helicobacter pylori in the stomach of patients with peptic
ulcer and other gastric diseases. Normally, the stomach does not contain urease-pro-
ducing bacteria, so the urea is rapidly absorbed unchanged into body water. H. pylori,
on the other hand, produces urease and therefore brings about extensive early expira-
tion of labelled CO2, resulting in a positive breath test (Marshall and Surveyor, 1988;
Combs et al., 1999; Walser and Bodenlos, 1959).
(C36) In the model for per-oral administration, there is, in the normal case,
complete and rapid (T1/2 ¼ 5 min) resorption from the stomach. In the case of H.
pylori infection in the stomach, it is assumed that 65% is immediately converted to
CO2, which is treated further according to the dosimetric model for CO2/bicarbonate
(see below). The remaining 35% is resorbed from the stomach in the same way as in
the normal case.
(C37) Urea resorbed in the stomach is distributed rapidly in the total body water.
Eighty percent is excreted by the kidneys with a half-time of 6 h, and 20% is broken
down rapidly in the same way as intravenously administered urea to ammonia and
CO2, treated according to the dosimetric model for CO2/bicarbonate.
14
C carbon dioxide/bicarbonate
(C38) CO2 is formed continuously in the metabolism of all organic substances in
the body. Together with water, it forms carbonic acid (H2CO3), which dissociates
and equilibrates with bicarbonate ions (HCO3). The substances are present in all
body fluids. Winchell et al. (1970) presented a kinetic model with two compartments,
one (Compartment I) with rapid (within 3 min) equilibration with CO2/HCO3 in
blood and another (Compartment II) with slower equilibration. CO2 leaves the
system from Compartment I by exhalation. A certain small fraction was assumed
to be ‘relatively fixed’ in the body, presumably in the form of bone bicarbonate and
as a constituent of larger molecules with slow turnover. Compartment I included
organs with high vascular perfusion (heart, liver, kidneys, intestinal tract, etc.), while
Compartment II was represented by muscle, skin, and fat with a lower blood
flow rate.

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(C39) Stubbs and Marshall (1993) modified this model slightly by defining a
Compartment III, corresponding to the ‘fixed’ fraction and having a flow back to
Compartment I with a half-time of 1000 h in accordance with the assumption for
carbon metabolism in Publication 30 (ICRP, 1981). This half-time of 1000 h may not
be sufficient to account for carbon deposited in the bone compartments with
slow metabolic turnover, as there is experimental evidence for a much longer turn-
over time.
(C40) The biokinetic model adopted here (Fig. C.1) is based on the models men-
tioned above with the following modifications. Compartment III has been further
divided into three compartments, one (Compartment 3) being assumed to represent
uptake in large molecules having a slow turnover with a biological half-time of
1000 h. The other compartments are assumed to represent bone. In the present
model, bone has been divided into trabecular bone (Compartment 4) and cortical
(compact) bone (Compartment 5), from which the activity is lost at a rate of 0.18 per
year (half-time 3.9 years) and 0.03 per year (half-time 23 years), respectively (ICRP,
1995). Eighty percent of the bone mass is assumed to be cortical bone and 20% is
assumed to be trabecular bone (ICRP, 1995). The rate of inflow to Compartments 3,
4, and 5 is chosen so that realistic carbonate/bicarbonate pool sizes are reached
during a lifetime. This means that the inflow rate constants to the bone compart-
ments have been set to twice the steady-state value calculated to give a carbonate/
bicarbonate pool in the bone of 300 g. The model is shown in Fig. C.1, and the tables
in this subsection show values used for the transfer constants. The numerical values

Fig. C.1. Biokinetic model for carbon dioxide/bicarbonate. The model presented is valid
for adults. The transfer constants are given as h1. Compartment 1 represents organs with
high vascular perfusion (heart, liver, kidneys, intestinal tract, etc.), and Compartment 2
represents tissues with a lower blood flow rate (muscle, skin, and fat).

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 ICRP Publication 128

for transfer constants not taken from Publication 70 (ICRP, 1995) or calculated from
steady-state conditions are taken from Winchell et al. (1970).

14
C.10.2. References for C-labelled urea including carbon dioxide/bicarbonate
Combs, M.J., Stubbs, J.B., Agarwal, A.K., et al., 1999. Dose estimates for a capsule-based
14
C-urea breath test. In: S-Stelson, A.T., Stabin, M.G., Sparks, R.B. (Eds.), Proceedings of
the Sixth International Radiopharmaceutical Dosimetry Symposium, Gatlinburg, TN,
USA, May 7–10, 1996. Oak Ridge Associated Universities, Oak Ridge, TN, USA, pp.
620–630.
ICRP, 1981. Limits for intakes of radionuclides by workers. ICRP Publication 30, Part 3.
Ann. ICRP 6(2/3).
ICRP, 1995. Basic anatomical and physiological data for use in radiation protection: the
skeleton. ICRP Publication 70. Ann. ICRP 25(2).
Marshall, B.J., Surveyor, I., 1988. Carbon-14 urea breath test for the diagnosis of
Campylobacter pylori associated gastritis. J. Nucl. Med. 29, 11–16.
Stubbs, J.B., Marshall, B.J., 1993. Radiation dose estimates for the carbon-14-labeled urea
breath test. J. Nucl. Med. 34, 821–825.
Walser, M., Bodenlos, L.J., 1959. Urea metabolism in man. J. Clin. Invest. 38, 1617–1626.
Winchell, H.S., Stahelin, H., Kusubov, N., et al., 1970. Kinetics of CO2-HCO3 in normal
adult males. J. Nucl. Med. 12, 711–715.

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14
Table C.20. Biokinetic data for C-labelled urea.

Organ (S) Fs T (h) a Ãs/A0 (h)

Normal case
Oral administration
Stomach contents 1.00 0.083 1.00 0.12
Total body (excluding contents) 0.80 0.083 1.00 6.9
6.0 1.00
Urinary bladder contents 0.80 1.5
CO2 pool 0.20 (Immediate transfer in the body)
Cortical bone 5.0
Trabecular bone 1.4
Other organs and tissues 50

Helicobacter-positive patient
Oral administration
Stomach contents 1.00 0.083 1.00 0.12
Total body (excluding contents) 0.28 0.083 1.00 2.4
6.0 1.00
Urinary bladder contents 0.28 0.52
CO2 pool 0.65 (Immediate conversion in the stomach)
0.07 (Immediate transfer in the body)
Cortical bone 18
Trabecular bone 5.0
Other organs and tissues 180

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14
Table C.21. Absorbed doses for C-labelled urea.

Absorbed dose per unit activity

Organ administered (mGy MBq1)

Normal case, intravenous or oral administration

Adrenals 2.4E02
Bone surfaces 3.3E02
Brain 2.4E02
Breast 2.4E02
Gallbladder wall 2.4E02
Gastrointestinal tract
Stomach wall 3.0E02
Small intestine wall 2.4E02
Colon wall 2.4E02
(Upper large intestine wall 2.4E02)
(Lower large intestine wall 2.4E02)
Heart wall 2.4E02
Kidneys 2.4E02
Liver 2.4E02
Lungs 2.4E02
Muscles 2.4E02
Oesophagus 2.4E02
Ovaries 2.4E02
Pancreas 2.4E02
Red marrow 2.9E02
Skin 2.4E02
Spleen 2.4E02
Testes 2.4E02
Thymus 2.4E02
Thyroid 2.4E02
Urinary bladder wall 1.2E01
Uterus 2.4E02
Remaining organs 2.4E02

Effective dose (mSv MBq1) 3.1E02

(continued on next page)

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Table C.21. (continued)

Absorbed dose per unit activity

Organ administered (mGy MBq1)

Helicobacter-positive patient, oral administration

Adrenals 7.6E02
Bone surfaces 1.2E01
Brain 7.6E02
Breast 7.6E02
Gallbladder wall 7.6E02
Gastrointestinal tract
Stomach wall 8.3E02
Small intestine wall 7.6E02
Colon wall 7.6E02
(Upper large intestine wall 7.6E02)
(Lower large intestine wall 7.6E02)
Heart wall 7.6E02
Kidneys 7.6E02
Liver 7.6E02
Lungs 7.6E02
Muscles 7.6E02
Oesophagus 7.6E02
Ovaries 7.6E02
Pancreas 7.6E02
Red marrow 9.7E02
Skin 7.6E02
Spleen 7.6E02
Testes 7.6E02
Thymus 7.6E02
Thyroid 7.6E02
Urinary bladder wall 1.1E01
Uterus 7.6E02
Remaining organs 7.6E02

Effective dose (mSv MBq1) 8.1E02

14
The physical half-life of C is 5730 years.

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 15
C.11. O-water
C.11.1. Biokinetic model

(C41) Water labelled with 15O is widely used to evaluate regional cerebral blood
flow using PET, and has been proposed for blood flow measurement in other organs
and tissues. Early biokinetic models based on equilibrium tracer distribution in body
water are inaccurate for use with 15O-water. On account of the short physical half-
life of 15O (2.04 min), uniform radionuclide concentration in body water is not
attained; consequently, such models underestimate dose values for this substance.
(C42) A more satisfactory method of kinetic modelling is based on organ blood
flow rates. Using this model, the concentration of 15O-water in a given organ is
derived by convolution of the arterial blood concentration (arterial input function)
and the transit time function (impulse response) of the organ. The latter is given by
exp[- (F/Vd þ )t], where F (ml min1 g1) is the organ blood flow, Vd (ml g tissue1/
ml  ml blood1) is its relative water distribution space, and  (min1) is the radio-
active decay constant of 15O. Thus, following intravenous administration of
15
O-water and measurement of the arterial blood concentration, a retention equation
can be derived for organs for which values of F and Vd are known.
(C43) In practice, a measured amount of 15O-water activity is injected via a fore-
arm vein, and the arterial blood concentration is monitored continuously from the
other forearm. Residence time (min) in a given organ is calculated as the product of
the areas under the curves of the arterial input function (min ml1 per administered
MBq) and the organ transit time function (min), multiplied by the total blood flow to
the organ (ml min1). The latter is given by F  M, where M is the mass (g) of the
organ. Table C.22 lists organ residence times that lead to organ doses equal to the
mean values that have been estimated using the blood flow model at four different
centres (Berridge et al., 1991; Herscovich et al., 1993; Brihaye et al., 1995; Eichling
et al., 1997). Direct measurements of the retention in some organs by PET (Smith
et al., 1994) have shown good agreement with the model for brain, heart, liver, and
spleen.

15
C.11.2. References for O-water
Berridge, M.S., Adler, L.P., Rao, P.S., 1991. Radiation absorbed dose for O-15-butanol and
O-15 water estimated by positron emission tomography. J. Nucl. Med. 32, 1043.
Brihaye, C., Depresseux, J.C., Comar, D., 1995. Radiation dosimetry for bolus administration
of oxygen-15 water. J. Nucl. Med. 36, 651–656.
Eichling, J.O., Bergman, S.R., Schwarz, S.W., et al., 1997. Equivalent dose estimates in adults
for intravenously administered O-15 water. Unpublished; personal communication through
S.W. Schwarz.
Herscovitch, P., Carson, R.E., Stabin, M., et al., 1993. A new kinetic approach to estimate the
radiation dosimetry of flow-based radiotracers. J. Nucl. Med. 34, 155.
Smith, T., Tong, C., Lammertsma, A.A., et al., 1994. Dosimetry of intravenously administered
oxygen-15 labelled water in man: a model based on experimental human data from 21
subjects. Eur. J. Nucl. Med. 21, 1126–1134.

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15
Table C.22. Biokinetic data for O-water.

Organ (S) Ãs/A0 (h)

Adrenals 0.000044
Brain 0.0036
Bone 0.0012
Gastrointestinal tract
Stomach wall 0.00047
Small intestine wall 0.0018
Upper large intestine wall 0.00061
Lower large intestine wall 0.00047
Heart contents 0.0015
Heart wall 0.00067
Kidneys 0.0010
Liver 0.0053
Lungs 0.0031
Muscles 0.011
Ovaries* 0.000014
Pancreas 0.00025
Red marrow 0.0016
Spleen 0.00056
Testes* 0.000056
Thyroid 0.000064
Other organs and tissues 0.016
*For adults, the ratio between cumulated activity in the gonads and that in the total
body is proportional to the ratio of gonad weight and total body weight. For chil-
dren, the same assumption is made.

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Table C.23. Absorbed doses for O-water.

Absorbed dose per unit activity administered (mGy MBq1)

Organ Adult 15 years 10 years 5 years 1 year

Adrenals 1.4E03 2.2E03 3.1E03 4.3E03 6.6E03

Bone surfaces 6.3E04 8.0E04 1.3E03 2.3E03 5.5E03
Brain 1.3E03 1.3E03 1.4E03 1.6E03 2.2E03
Breast 2.8E04 3.5E04 6.0E04 9.9E04 2.0E03
Gallbladder wall 4.5E04 5.5E04 8.6E04 1.4E03 2.7E03
Gastrointestinal tract
Stomach wall 1.7E03 2.2E03 3.1E03 5.3E03 1.2E02
Small intestine wall 1.3E03 1.7E03 3.0E03 5.0E03 9.9E03
Colon wall 1.6E03 2.1E03 3.7E03 6.2E03 1.2E02
(Upper large intestine wall 1.6E03 2.1E03 3.7E03 6.2E03 1.2E02)
(Lower large intestine wall 1.6E03 2.1E03 3.7E03 6.2E03 1.2E02)
Heart wall 1.9E03 2.4E03 3.8E03 6.0E03 1.1E02
Kidneys 1.7E03 2.1E03 3.0E03 4.5E03 8.1E03
Liver 1.6E03 2.1E03 3.2E03 4.8E03 9.3E03
Lungs 1.6E03 2.4E03 3.4E03 5.2E03 1.0E02
Muscles 2.9E04 3.7E04 6.1E04 1.0E03 2.0E03
Oesophagus 3.3E04 4.2E04 6.7E04 1.1E03 2.1E03
Ovaries 8.5E04 1.1E03 1.8E03 2.8E03 5.8E03
Pancreas 1.4E03 2.0E03 4.2E03 5.4E03 1.2E02
Red marrow 8.9E04 9.7E04 1.6E03 3.0E03 6.1E03
Skin 2.5E04 3.1E04 5.2E04 8.8E04 1.8E03
Spleen 1.6E03 2.3E03 3.7E03 5.8E03 1.1E02
Testes 7.4E04 9.3E04 1.5E03 2.6E03 5.1E03
Thymus 3.3E04 4.2E04 6.7E04 1.1E03 2.1E03
Thyroid 1.5E03 2.5E03 3.8E03 8.5E03 1.6E02
Urinary bladder wall 2.6E04 3.1E04 5.0E04 8.4E04 1.5E03
Uterus 3.5E04 4.4E04 7.2E04 1.2E03 2.3E03
Remaining organs 4.0E04 5.6E04 9.4E04 1.7E03 2.9E03

Effective dose (mSv MBq1) 1.1E03 1.4E03 2.3E03 3.8E03 7.7E03

15
The physical half-life of O is 2.04 min.

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 18
C.12. F-labelled amino acids (generic model)
C.12.1. Biokinetic model

(C44) The generic biokinetic model for 18F-labelled amino acids is the same as the
generic biokinetic model for 11C-labelled amino acids (see Section C.3.1). It is based
on the following references: Coenen et al., 1989; Cottrall et al., 1973; Inoue et al.,
1998; ICRP, 1987, 2008; Schmidt et al., 1997; Shoup et al., 1999; Stenhouse and
Baxter, 1977; Stenström et al., 1996; Taylor, 2000; Taylor et al., 1973; Wester et al.,
1999a, 1999b.

18
C.12.2. References for F-labelled amino acids (generic model)
Coenen, H.H., Kling, P., Stöcklin, G., 1989. Cerebral metabolism of L-[2-18F]fluorotyrosine, a
new PET tracer of protein synthesis. J. Nucl. Med. 30, 1367–1372.
Cottrall, M.F., Taylor, D.M., McElwain, T.J., 1973. Investigations of 18F-p-fluorophenylala-
nine for pancreas scanning. Br. J. Radiol. 46, 277–288.
Inoue, T., Tomiyoshi, K., Higuichi, T., et al., 1998. Biodistribution studies on l-3-[fluorine-
18]fluoro-a-methyl tyrosine: a potential tumor-detecting agent. J. Nucl. Med. 39, 663–667.
ICRP, 1987. Radiation dose to patients from radiopharmaceuticals. ICRP Publication 53.
Ann. ICRP 18(1–4).
ICRP, 2008. Radiation dose to patients from radiopharmaceuticals. Addendum 3 to ICRP
Publication 53. Ann. ICRP 38(1/2).
Schmidt, D., Langen, K-J., Herzog, H., et al., 1997. Whole-body kinetics and dosimetry of
123
L-3-[ I]iodo-a-methyltyrosine. Eur. J. Nucl. Med. 24, 1162–1166.
Shoup, T.M., Olson, J., Hoffman, J.M., et al., 1999. Synthesis and evaluation of [18F]1-amino-
3-fluorocyclobutane-1-carboxylic acid to image brain tumours. J. Nucl. Med. 40, 331–338.
Stenhouse, M.J., Baxter, M.S., 1977. Bomb 14C as a biological tracer. Nature (Lond.) 267,
828–832.
Stenström, K., Leide-Svegborn, S., Erlandsson, B., et al., 1996. Application of accelerator
mass spectrometry (AMS) for high-sensitivity measurements of 14CO2 in long-term studies
of fat metabolism. Appl. Radiat. Isot. 47, 417–422.
Taylor, D.M., 2000. Generic models for radionuclide dosimetry: 11C, 18F or 75Se-labelled
amino acids. Appl. Radiat. Isot. 52, 911–922.
Taylor, D.M., Cottrall, M.F., 1973. Evaluation of amino acids labelled with 18F for pancreas
scanning. In: Radiopharmaceuticals and Labelled Compounds. Vol. I. IAEA, Vienna,
pp. 443–441.
Wester, H.J., Herz, M., Senkowitsch-Schmidtke, R., Schwaiger, M., Stöcklin, G., Hamacher,
K., 1999a. Preclinical evaluation of 4-[18F]fluoroprolines: diasteromeric effect on metabo-
lism and uptake in mice. Nucl. Med. Biol. 26, 259–265.
Wester, H.J., Herz, M., Weber, W., et al., 1999b. Synthesis and radiopharmacology of O-(2-
[18F]fluoroethyl)-L-tyrosine for tumor imaging. J. Nucl. Med. 40, 205–212.

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Table C.24. Biokinetic data for F-labelled amino acids (generic model).

Organ (S) Fs T (h) a Ãs/A0 (h)

Blood 0.20 0.2 0.25 0.32

6.0 0.75
Brain 0.015 1200 0.70 0.040
1 0.30
Thyroid 0.0007 1200 0.70 0.0019
1 0.30
Lungs 0.02 12 0.10 0.052
1200 0.85
1 0.05
Kidneys 0.02 12 0.15 0.052
1200 0.80
1 0.05
Kidney excretion 0.20 0.0066
Liver 0.08 12 0.40 0.20
1200 0.55
1 0.05
Spleen 0.004 12 0.33 0.010
1200 0.67
Pancreas 0.03 12 0.85 0.070
1200 0.15
Small intestine wall 0.03 6.0 0.50 0.065
12 0.50
Ovaries 0.0002 1200 0.70 0.00053
1 0.30
Testes 0.00092 1200 0.70 0.0024
1 0.30
Muscles 0.24 12 0.15 0.62
1200 0.45
1 0.40
Other organs and tissues 0.359 12 0.15 0.93
1200 0.45
1 0.40
Urinary bladder contents 0.20
Adult, 15 years, 10 years 0.13
5 years 0.12
1 year 0.086

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18
Table C.25. Absorbed doses for F-labelled amino acids (generic model).

Absorbed dose per unit activity administered (mGy MBq1)

Organ Adult 15 years 10 years 5 years 1 year

Adrenals 1.9E02 2.2E02 3.4E02 5.2E02 9.5E02

Bone surfaces 1.3E02 1.5E02 2.3E02 3.5E02 7.0E02
Brain 9.6E03 1.0E02 1.2E02 1.5E02 2.4E02
Breast 9.5E03 1.1E02 1.6E02 2.5E02 4.9E02
Gallbladder wall 1.9E02 2.1E02 3.3E02 4.8E02 8.8E02
Gastrointestinal tract
Stomach wall 1.5E02 1.7E02 2.6E02 3.9E02 7.3E02
Small intestine wall 2.7E02 3.3E02 5.5E02 8.7E02 1.7E01
Colon wall 1.5E02 1.7E02 2.7E02 4.0E02 7.2E02
(Upper large intestine wall 1.6E02 1.8E02 2.8E02 4.3E02 7.8E02)
(Lower large intestine wall 1.4E02 1.6E02 2.5E02 3.7E02 6.5E02)
Heart wall 2.2E02 2.7E02 4.1E02 6.2E02 1.1E01
Kidneys 4.9E02 5.9E02 8.5E02 1.3E01 2.3E01
Liver 3.5E02 4.6E02 6.9E02 1.0E01 1.9E01
Lungs 2.3E02 3.1E02 4.6E02 7.2E02 1.4E01
Muscles 1.0E02 1.5E02 2.7E02 6.5E02 1.1E01
Oesophagus 1.2E02 1.4E02 2.0E02 3.1E02 5.9E02
Ovaries 2.0E02 2.1E02 4.5E02 7.5E02 1.6E01
Pancreas 1.4E01 2.0E01 4.1E01 5.2E01 1.1Eþ00
Red marrow 1.4E02 1.6E02 2.4E02 3.6E02 6.7E02
Skin 8.4E03 9.4E03 1.4E02 2.2E02 4.4E02
Spleen 2.5E02 3.3E02 5.1E02 8.0E02 1.5E01
Testes 1.6E02 3.3E02 2.1E01 2.5E01 3.4E01
Thymus 1.2E02 1.4E02 2.0E02 3.1E02 5.9E02
Thyroid 2.1E02 3.3E02 5.1E02 1.1E01 2.0E01
Urinary bladder wall 7.4E02 9.4E02 1.4E01 2.0E01 2.8E01
Uterus 1.7E02 2.0E02 3.2E02 4.8E02 8.3E02
Remaining organs 1.1E02 1.6E02 2.7E02 5.2E02 8.4E02

Effective dose (mSv MBq1) 2.3E02 3.1E02 6.6E02 9.3E02 1.6E01

18
The physical half-life of F is 1.83 h.

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 18
C.13. F-labelled brain receptor substances (generic model)
C.13.1. Biokinetic model

(C45) A large number of radiopharmaceuticals labelled with 18F and 123I have
been developed for PET and single photon emission computer tomographic
(SPECT) studies of different types of receptor in the human brain. For many of
these substances, the available biokinetic data are insufficient to construct realistic
compound-specific biokinetic models for the calculation of absorbed dose to persons
undergoing an investigation. Therefore, a generic model for radionuclide-labelled
brain receptor substances that would predict the internal radiation dose with suffi-
cient accuracy for general radiation protection purposes has been developed.
(C46) A generic model for 11C-labelled brain receptor substances has been pub-
lished previously (Nosslin et al., 2003). A review of the literature has identified
biokinetic and dosimetric data for five 18F-labelled and 15 123I-labelled compounds
considered to be potential substances for the clinical imaging of brain receptors (e.g.
acetylcholinesterase receptors, benzodiazepine receptors, dopamine receptors, dopa-
mine transporters, and serotonin receptors). These data indicate that despite fairly
large differences in chemical structure, the patterns of uptake in the human brain,
and other tissues for which information is available, appear to be sufficiently similar
to justify a generic model for each radionuclide. For details, the reader is referred to
Booij et al. (1998a, 1998b), Boundy et al. (1995), Deterding et al. (2001), Gründer et
al. (2001, 2003), Kauppinen et al. (2003), Kuikka et al. (1994), Mitterhauser et al.
(2004), Mozley et al. (1995, 1996), Taylor (2000), van de Wiele et al. (1999), Verhoeff
et al. (1993a, 1993b), Versijpt et al. (2000), Votaw et al. (1995), Volkow et al. (1995),
and Waterhouse et al. (2003).
(C47) For some compounds, the published data on the dosimetry of 18F- and 123I-
labelled receptor radiopharmaceuticals were derived from PET and SPECT studies
in humans, and for other compounds, the biokinetic models were derived, at least in
part, from studies of biodistribution in experimental animals.
(C48) The generic model proposed for 18F-labelled substances assumes that frac-
tions of 0.07, 0.08, 0.05, 0.02, 0.02, and 0.002 of the administered activity are dis-
tributed instantaneously to the brain, liver, lungs, kidneys, stomach wall, and
thyroid, respectively, from where they are excreted with a biological half-time of
10 h. The remaining activity is assumed to be distributed uniformly throughout the
rest of the body, and eliminated with a biological half-time of 10 h. A biological half-
time of 10 h means that approximately 98% of the 18F will decay in the tissue of
interest. It is assumed that of the activity entering the liver, 30% is eliminated via the
gallbladder and the remainder would pass directly into the small intestine. A total of
90% of the administered activity is assumed to be excreted in the urine and 10% via
the gastrointestinal tract.

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18
C.13.2. References for F-labelled brain receptor substances (generic model)
Booij, J., Sokole, E.B., Stabin, M.G., Janssen, A.G.M., de Bruin, K., van Royen, E.A., 1998a.
Human biodistribution and dosimetry of [123I]FP-CIT: a potent radioligand for imaging of
dopamine transporters. Eur. J. Nucl. Med. 25, 24–30.
Booij, J., Sokole, E.B., Stabin, M.G., Janssen, A.G.M., de Bruin, K., van Royen, E.A., 1998b.
Human biodistribution and dosimetry of [123I]FP-CIT: a potent radioligand for imaging of
dopamine transporters: erratum. Eur. J. Nucl. Med. 25, 458.
Boundy, K.L., Barnden, L.R., Rowe, C.C., et al., 1995. Human dosimetry and biodistribution
of iodine-123-iododexetimide: a SPECT imaging agent for cholinergic muscarinic neuror-
eceptors. J. Nucl. Med. 36, 1332–1338.
Deterding, T.A., Votaw, J.R., Wang, C.K., et al., 2001. Biodistribution and radiation dosi-
metry of the dopamine transporter ligand [18F]FECNT. J. Nucl. Med. 42, 376–381.
Gründer, G., Siessmeier, T., Lange-Asschenfeldt, C., et al., 2001. [18F]Fluoroethylflumaazenil:
a novel tracer for PET imaging of human benzodiazepine receptors. Eur. J. Nucl. Med. 28,
1463–1470.
Gründer, G., Siessmeier, T., Piel, M., et al., 2003. Quantification of D2-like dopamine recep-
tors in the human brain with [18F]-desmethoxyfallypride. J. Nucl. Med. 44, 109–116.
Kauppinen, T.A., Bergström, K.A., Heikman, P., Hiltunen, J., Ahonen, A.K., 2003.
Biodistribution and radiation dosimetry of [123I]ADAM in healthy human subjects: pre-
liminary results. Eur. J. Nucl. Med. 30, 132–136.
Kuikka, J.T., Bergström, K.A., Ahonen, A., Länsimies, E., 1994. The dosimetry of iodine-123
labelled 2b-carbomethoxy-3b-(4-iodophenyl)tropane. Eur. J. Nucl. Med. 21, 53–56.
Mitterhauser, M., Wadsak, W., Wabnegger, L., et al., 2004. Biological evaluation of 2’-
[18F]fluoroflumazenil ([18F]FFMZ): a potential GABA receptor ligand for PET. Nucl.
Med. Biol. 31, 291–295.
Mozley, P.D., Stubbs, J.T., Kim, H-J., et al., 1995. Dosimetry of a D2/D3 dopamine receptor
antagonist that can be used with PET or SPECT. J. Nucl. Med. 36, 1322–1331.
Mozley, P.D., Stubbs, J.T., Kim, H-J., et al., 1996. Dosimetry of an iodine-123-labeled tro-
pane to image dopamine transporters. J. Nucl. Med. 37, 151–159.
Nosslin, B., Johansson, L., Leide-Svegborn, S., Liniecki, J., Mattsson, S., Taylor, D.M., 2003.
A generic model for [11C]-labelled radiopharmaceuticals for imaging receptors in the
human brain. Rad. Prot. Dosim. 105, 587–591.
Taylor, D.M., 2000. Unpublished assessments.
van de Wiele, C., De Vos, F., De Sutter, J., et al., 1999. Biokinetics and dosimetry of (iodine-
123)-iodomethyl-N,N-dimethyltamoxifen, an (anti)oestrogen receptor radioligand. Eur. J.
Nucl. Med. 26, 1259–1264.
Verhoeff, N.P., Sokole, E.B., Stabin, M., et al., 1993a. Dosimetry of iodine-123 iodobenza-
mide in healthy volunteers. Eur. J. Nucl. Med. 20, 747–752.
Verhoeff, N.P., Busemann Sokole, E., Hengst, D., Stubbs, J.B., van Royen, E.A., 1993b.
Dosimetry of iodine-123 iomazenil in humans. Eur. J. Nucl. Med. 20, 580–584.
Versijpt, J., Dumont, F., Thierens, H., et al., 2000. Biodistribution and dosimetry of [123I]iodo-
PK 11195: a potential agent for SPET imaging of the peripheral benzodiazepine receptor.
Eur. J. Nucl. Med. 27, 1326–1333.
Votaw, J.R., Ansari, M.S., Scott Mason, N., et al., 1995. Dosimetry of iodine-123-epidepride:
a dopamine D2 receptor ligand. J. Nucl. Med. 36, 1316–1321.
Volkow, N.D., Ding, Y.S., Fowler, J.S., et al., 1995. A new PET ligand for the dopamine
transporter: studies in human brain. J. Nucl. Med. 36, 2162–2168.

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Waterhouse, R.N., Stabin, M.G., Page, J.G., 2003. Preclinical acute toxicity studies and
rodent-based dosimetry estimates of the novel sigma-1 receptor radiotracer [18F]FPS.
Nucl. Med. Biol. 30, 555–563.

18
Table C.26. Biokinetic data for F-labelled brain receptor substances (generic model).

Organ (S) Fs T (h) a Ãs/A0 (h)

Brain 0.07 10 1.0 0.16

Thyroid 0.002 10 1.0 0.0045
Lungs 0.05 10 1.0 0.11
Kidneys 0.02 10 1.0 0.045
Kidney excretion 0.90 0.011
Liver 0.08 10 1.0 0.18
Stomach wall 0.02 10 1.0 0.045
Other organs and tissues 0.758 10 1.0 1.7
Gallbladder contents 0.024 0.080
Gastrointestinal tract contents
Stomach 0.02 0.0022
Small intestine 0.10 0.019
Upper large intestine 0.10 0.011
Lower large intestine 0.10 0.0020
Urinary bladder contents 0.90
Adult, 15 years, 10 years 0.20
5 years 0.17
1 year 0.12

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18
Table C.27. Absorbed doses for F-labelled brain receptor substances (generic model).

Absorbed dose per unit activity administered (mGy MBq1)

Organ Adult 15 years 10 years 5 years 1 year

Adrenals 1.1E02 1.3E02 2.0E02 3.0E02 5.0E02

Bone surfaces 6.9E03 8.4E03 1.2E02 1.8E02 3.3E02
Brain 2.8E02 2.9E02 3.0E02 3.4E02 4.8E02
Breast 3.7E03 4.6E03 8.4E03 1.3E02 2.3E02
Gallbladder wall 1.4E01 1.6E01 2.1E01 3.8E01 1.4Eþ00
Gastrointestinal tract
Stomach wall 5.5E02 7.2E02 1.0E01 1.7E01 3.6E01
Small intestine wall 4.7E02 6.1E02 1.1E01 1.7E01 3.3E01
Colon wall 1.7E02 2.1E02 3.2E02 5.1E02 8.2E02
(Upper large intestine wall 2.0E02 2.4E02 3.8E02 6.2E02 1.0E01)
(Lower large intestine wall 1.4E02 1.6E02 2.4E02 3.6E02 5.7E02)
Heart wall 7.4E03 9.7E03 1.4E02 2.2E02 3.7E02
Kidneys 4.3E02 5.2E02 7.4E02 1.1E01 1.9E01
Liver 3.0E02 3.9E02 5.8E02 8.6E02 1.6E01
Lungs 2.5E02 3.7E02 5.2E02 8.0E02 1.6E01
Muscles 1.7E02 2.6E02 5.2E02 1.4E01 2.4E01
Oesophagus 6.5E03 8.2E03 1.2E02 1.8E02 3.1E02
Ovaries 1.4E02 1.8E02 2.7E02 4.1E02 6.7E02
Pancreas 1.2E02 1.5E02 2.4E02 3.7E02 6.2E02
Red marrow 7.8E03 9.6E03 1.3E02 1.8E02 2.8E02
Skin 4.4E03 5.2E03 7.6E03 1.2E02 2.1E02
Spleen 8.5E03 1.1E02 1.6E02 2.5E02 4.2E02
Testes 7.1E03 9.5E03 1.6E02 2.3E02 3.7E02
Thymus 6.5E03 8.2E03 1.2E02 1.8E02 3.1E02
Thyroid 4.2E02 6.7E02 1.0E01 2.2E01 4.3E01
Urinary bladder wall 1.1E01 1.3E01 2.0E01 2.7E01 3.5E01
Uterus 1.7E02 2.1E02 3.4E02 4.9E02 7.7E02
Remaining organs 1.8E02 2.8E02 5.1E02 1.0E01 1.7E01

Effective dose (mSv MBq1) 2.8E02 3.7E02 5.4E02 8.7E02 1.8E01

18
The physical half-life of F is 1.83 h.

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 18
C.14. F-choline
C.14.1. Biokinetic model

(C49) Choline uptake is increased in cancerous tissues because the high metabolic
rates of tumour cells require choline for the synthesis of phospholipids. For example,
choline kinase is overexpressed in prostate cancer cells (Ramirez de Molina et al.,
2002; Ackerstaff et al., 2003), thus making choline a suitable indicator for early and
differential diagnosis of prostate cancer. PET with radiolabelled choline is therefore
used for diagnosis of malignant and recurrent tumours, and metastases in prostate
cancer patients (DeGrado et al., 2002; Schmid et al., 2005; Kwee et al., 2006; Steiner
et al., 2009). Correct evaluation of the patient dose and optimisation of the imaging
protocols imply knowledge of the biodistribution and kinetics of the administered
compounds. The biokinetics of 18F-choline (18F-FCH) in four prostate cancer
patients were investigated in a study conducted in the frame of the European
Collaborative project MADEIRA (Hoeschen et al., 2010; Uusijärvi et al., 2010).
Six new patients were later included in the study. In these investigations, biodistribu-
tion and excretion data were collected for up to 4 h after injection of the radio-
pharmaceutical (Janzen et al., 2010; Giussani et al., 2012; Tavola et al., 2012).
Previous human studies with 11C- or 18F-choline were limited up to 1 h after admin-
istration (Roivainen et al., 2000; DeGrado et al., 2002; Schmid et al., 2005; Kwee
et al., 2006; Steiner et al., 2009; Sutinen et al., 2004).
(C50) The biokinetics of 11C-choline and 18F-choline differ due to the different
interactions of carbon and fluorine in the organism. A paper with dosimetric data on
11
C-choline has been published by Tolvanen et al. (2010), and the biokinetics and
dosimetry of 11C-choline will be subject to further evaluation by ICRP.

18
C.14.2. References for F-choline
Ackerstaff, E., Glunde, K., Bhujwalla, Z., 2003. Choline phospholipid metabolism: a target in
cancer cells? J. Cell Biochem. 90, 525–533.
DeGrado, T.R., Reiman, R.E., Price, D.T., Shuyan, W., Coleman, R.E., 2002.
Pharmacokinetics and radiation dosimetry of 18F-fluorocholine. J. Nucl. Med. 43, 92–96.
Giussani, A., Janzen, T., Uusijärvi-Lizana, H., et al., 2012. A compartmental model for
biokinetics and dosimetry of 18F-choline in prostate cancer patients. J. Nucl. Med. 53,
985–993.
Hoeschen, C., Mattsson, S., Cantone, M-C., et al., 2010. Minimising activity and dose with
enhanced image quality by radiopharmaceutical administrations. Radiat. Prot. Dosim. 139,
250–253.
Janzen, T., Tavola, F., Giussani, A., et al., 2010. Compartmental model of 18F-choline. In:
Molthen, R.C., Weaver, J.B. (Eds.), Medical Imaging 2010, Biomedical Applications in
Molecular, Structural, and Functional Imaging. SPIE, Bellingham, WA.
Kwee, S.A., Wei, H., Sesterhenn, I., Yun, D., Coel, M.N., 2006. Localization of primary
prostate cancer with dual-phase 18F-fluorocholine PET. J. Nucl. Med. 47, 262–269.

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Roivainen, A., Forsback, S., Grönroos, T., et al., 2000. Blood metabolism of [methyl-11C]
choline; implications for in vivo imaging with positron emission tomography. Eur. J. Nucl.
Med. Mol. Imag. 27, 25–32.
Ramirez de Molina, A., Rodriguez-Gonzalez, A., Gutierrez, R., et al., 2002. Overexpression of
choline kinase is a frequent feature in human tumor-derived cell lines and in lung, prostate,
and colorectal human cancers. Biochem. Biophys. Res. Commun. 296, 580–583.
Schmid, D.T., John, H., Zweifel, R., et al., 2005. Fluorocholine PET/CT in patients with
prostate cancer: initial experience. Radiology 235, 623–628.
Steiner, C., Vees, H., Zaidi, H., et al., 2009. Three-phase 18F-fluorocholine PET/CT in the
evaluation of prostate cancer recurrence. Nuklearmedizin 48, 1–9.
Sutinen, E., Nurmi, M., Roivainen, A., et al., 2004. Kinetics of [11C]choline uptake in prostate
cancer: a PET study. Eur. J. Nucl. Med. Mol. Imag. 31, 317–324.
Tavola, F., Janzen, T., Giussani, A., et al., 2012. Non-linear compartmental model of 18F-
choline. Nucl. Med. Biol. 39, 261–268.
Tolvanen, T., Yli-Kerttula, T., Ujula, T., et al., 2010. Biodistribution and radiation dosimetry
of [11C]choline: a comparison between rat and human data. Eur. J. Nucl. Med. Mol. Imag.
37, 874–883.
Uusijärvi, H., Nilsson, L.E., Bjartell, A., Mattsson, S., 2010. Biokinetics of 18F-choline studied
in four prostate cancer patients. Radiat. Prot. Dosim. 139, 240–244.

18
Table C.28. Biokinetic data for F-choline.

Organ (S) Fs T (h) a Ãs/A0 (h)

Blood 1.0 0.080 0.5 0.27

0.35 0.5
Liver 0.175 0.080 0.5 0.42
0.35 0.5
1 1.0
Spleen 0.012 0.080 0.5 0.022
0.35 0.5
7 1.0
Kidneys 0.097 0.080 0.5 0.14
0.35 0.5
0.50 0.4
7 0.6
Other organs and tissues 0.71 0.080 0.5 1.63
0.35 0.5
52 1.0
Urinary bladder contents 0.825
Adult, 15 years, 10 years 0.10
5 years 0.093
1 year 0.066

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18
Table C.29. Absorbed doses for F-choline.

Absorbed dose per unit activity administered (mGy MBq1)

Organ Adult 15 years 10 years 5 years 1 year

Adrenals 2.0E02 2.4E02 3.8E02 5.9E02 1.0E01

Bone surfaces 1.2E02 1.5E02 2.3E02 3.7E02 7.0E02
Brain 8.7E03 1.1E02 1.8E02 3.0E02 5.6E02
Breast 9.0E03 1.1E02 1.8E02 2.8E02 5.4E02
Gallbladder wall 2.1E02 2.5E02 3.5E02 5.4E02 1.0E01
Gastrointestinal tract contents
Stomach wall 1.3E02 1.6E02 2.5E02 4.0E02 7.6E02
Small intestine wall 1.3E02 1.7E02 2.7E02 4.2E02 7.7E02
Colon wall 1.3E02 1.6E02 2.6E02 4.0E02 7.2E02
(Upper large intestine wall 1.4E02 1.7E02 2.7E02 4.3E02 7.8E02)
(Lower large intestine wall 1.2E02 1.5E02 2.4E02 3.7E02 6.4E02)
Heart wall 2.0E02 2.6E02 4.1E02 6.3E02 1.1E01
Kidneys 9.7E02 1.2E01 1.6E01 2.4E01 4.3E01
Liver 6.1E02 8.0E02 1.2E01 1.8E01 3.3E01
Lungs 1.7E02 2.2E02 3.5E02 5.6E02 1.1E01
Muscles 1.1E02 1.3E02 2.1E02 3.3E02 6.1E02
Oesophagus 1.1E02 1.4E02 2.1E02 3.3E02 6.2E02
Ovaries 1.3E02 1.6E02 2.6E02 4.0E02 7.2E02
Pancreas 1.7E02 2.2E02 3.4E02 5.2E02 9.3E02
Red marrow 1.3E02 1.6E02 2.4E02 3.6E02 6.6E02
Skin 8.0E03 9.8E03 1.6E02 2.5E02 4.9E02
Spleen 3.6E02 5.0E02 7.7E02 1.2E01 2.2E01
Testes 9.8E03 1.3E02 2.0E02 3.1E02 5.7E02
Thymus 1.1E02 1.4E02 2.1E02 3.3E02 6.2E02
Thyroid 1.1E02 1.4E02 2.2E02 3.7E02 7.0E02
Urinary bladder wall 5.9E02 7.5E02 1.1E01 1.6E01 2.2E01
Uterus 1.5E02 1.8E02 2.9E02 4.4E02 7.6E02
Remaining organs 1.1E02 1.4E02 2.1E02 3.4E02 6.2E02

Effective dose (mSv MBq1) 2.0E02 2.4E02 3.7E02 5.7E02 1.0E01

18
The physical half-life of F is 1.83 h.

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 C.15. 2-[18F]-fluoro-2-deoxy-D-glucose (FDG)
C.15.1. Biokinetic model

(C51) 18F-fluoro-2-deoxy-D-glucose (FDG) is a glucose analogue used in the char-

acterisation of glucose metabolism for diagnosis or follow-up of cancer diseases, and
for investigation of myocardial and cerebral glucose metabolism. Following intrave-
nous administration, most of the radiopharmaceutical is cleared rapidly from the
circulation with a half-time of less than 1 min as it mixes within a large distribution
space, although there are longer-term components with half-times of up to 1.5 h.
Data from Hays et al. (2002) together with data obtained by Deloar et al. (1998) are
used in this biokinetic model for the dose assessments to patients administered with
18
F-FDG. These data confirm the assumption in Publication 53 (ICRP, 1987) of
uptake of 0.04 in the heart wall, while uptake in the brain seems to be higher
(0.07–0.1) than was given in the Publication 53 model (0.06).
(C52) Additionally, there is an indication of significant uptake in the liver and the
lungs. For the liver, uptake values of approximately 0.05 were derived by Deloar
et al. (1998) and Meija et al. (1991). The model of Hays and Segall (1999) predicts
greater uptake in the liver but it decreases rapidly to similar values. For uptake in the
lungs, results range from 0.009 (Meija et al., 1991) to 0.029 (Deloar et al., 1998). Here
again, the model by Hays and Segall (2002) indicates greater uptake followed by a
rapid decrease. There are indications that there is a slight increase in activity in heart
and brain, and a steep decrease in activity in lungs and liver (Meija et al., 1991; Hays
and Segall, 1999). It is assumed that all activity is excreted by urine.
(C53) The following biokinetic model has been derived (ICRP, 2008) based on this
information. There is initial uptake of 18F-FDG in heart (0.04), brain (0.08), liver
(0.05), lungs (0.03), and all other tissues (0.80). Retention in the specified source
organs is considered to be infinite (without consideration of a delayed uptake). A
fraction of 0.3 of the activity in other organs and tissues is considered to be excreted
by urine with biological half-times of 12 min (25%) and 1.5 h (75%), according to the
kidney–bladder model.

18
C.15.2. References for F-fluoro-2-deoxy-D-glucose
Deloar, H.M., Fujiwara, T., Shidahara, M., et al., 1998. Estimation of absorbed dose for 2-[F-
18]fluoro-2-deoxy-D-glucose using whole-body positron emission tomography and mag-
netic resonance imaging. Eur. J. Nucl. Med. 25, 565–574.
Hays, M.T., Segall, G.M., 1999. A mathematical model for the distribution of fluorodeox-
yglucose in humans. J. Nucl. Med. 40, 1358–1366.
Hays, M.T., Watson, E.E., Thomas, S.R., Stabin, M., 2002. Radiation absorbed dose esti-
mates from 18F-FDG. MIRD Dose Estimate Report No. 19. J. Nucl. Med. 43, 210–214.
ICRP, 1987. Radiation dose to patients from radiopharmaceuticals. ICRP Publication 53.
Ann. ICRP 18(1–4).
ICRP, 2008. Radiation dose to patients from radiopharmaceuticals. ICRP Publication 106.
Addendum 3 to ICRP Publication 53. Ann. ICRP 28(3).

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Meija, A.A., Nakamura, T., Masatoshi, I., Hatazawa, J., Mazaki, M., Watanuki, S., 1991.
Estimation of absorbed doses in humans due to intraveneous administration of fluorine-18-
fluorodeoxyglucose in PET studies. J. Nucl. Med. 32, 699–706.

18
Table C.30. Biokinetic data for F-fluoro-2-deoxy-D-glucose.

Organ (S) Fs T (h) a Ãs/A0 (h)

Brain 0.08 1 1.0 0.21

Heart wall 0.04 1 1.0 0.11
Lungs 0.03 1 1.0 0.079
Liver 0.05 1 1.0 0.13
Other organs and tissues 0.80 0.2 0.075 1.7
1.5 0.225
1 0.70
Urinary bladder contents 0.24
Adult, 15 years, 10 years 0.26
5 years 0.23
1 year 0.16

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18
Table C.31. Absorbed doses for F-fluoro-2-deoxy-D-glucose.

Absorbed dose per unit activity administered (mGy MBq1)

Organ Adult 15 years 10 years 5 years 1 year

Adrenals 1.2E02 1.6E02 2.4E02 3.9E02 7.1E02

Bone surfaces 1.1E02 1.4E02 2.2E02 3.4E02 6.4E02
Brain 3.8E02 3.9E02 4.1E02 4.6E02 6.3E02
Breast 8.8E03 1.1E02 1.8E02 2.9E02 5.6E02
Gallbladder wall 1.3E02 1.6E02 2.4E02 3.7E02 7.0E02
Gastrointestinal tract
Stomach wall 1.1E02 1.4E02 2.2E02 3.5E02 6.7E02
Small intestine wall 1.2E02 1.6E02 2.5E02 4.0E02 7.3E02
Colon wall 1.3E02 1.6E02 2.5E02 3.9E02 7.0E02
(Upper large intestine wall 1.2E02 1.5E02 2.4E02 3.8E02 7.0E02)
(Lower large intestine wall 1.4E02 1.7E02 2.7E02 4.1E02 7.0E02)
Heart wall 6.7E02 8.7E02 1.3E01 2.1E01 3.8E01
Kidneys 1.7E02 2.1E02 2.9E02 4.5E02 7.8E02
Liver 2.1E02 2.8E02 4.2E02 6.3E02 1.2E01
Lungs 2.0E02 2.9E02 4.1E02 6.2E02 1.2E01
Muscles 1.0E02 1.3E02 2.0E02 3.3E02 6.2E02
Oesophagus 1.2E02 1.5E02 2.2E02 3.5E02 6.6E02
Ovaries 1.4E02 1.8E02 2.7E02 4.3E02 7.6E02
Pancreas 1.3E02 1.6E02 2.6E02 4.0E02 7.6E02
Red marrow 1.1E02 1.4E02 2.1E02 3.2E02 5.9E02
Skin 7.8E03 9.6E03 1.5E02 2.6E02 5.0E02
Spleen 1.1E02 1.4E02 2.1E02 3.5E02 6.6E02
Testes 1.1E02 1.4E02 2.4E02 3.7E02 6.6E02
Thymus 1.2E02 1.5E02 2.2E02 3.5E02 6.6E02
Thyroid 1.0E02 1.3E02 2.1E02 3.4E02 6.5E02
Urinary bladder wall 1.3E01 1.6E01 2.5E01 3.4E01 4.7E01
Uterus 1.8E02 2.2E02 3.6E02 5.4E02 9.0E02
Remaining organs 1.2E02 1.5E02 2.4E02 3.8E02 6.4E02

Effective dose (mSv MBq1) 1.9E02 2.4E02 3.7E02 5.6E02 9.5E02

18
The physical half-life of F is 1.83 h.

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 C.16. O-(2-[18F]-fluoroethyl)-L-tyrosine (FET)
C.16.1. Biokinetic model

(C54) O-(2-[18F]-fluoroethyl)-L-tyrosine ([18F]FET) is actively taken up in tumour

cells via amino acid transport system L, but is neither incorporated into proteins nor
readily degraded, resulting in high intracellular concentrations of this imaging agent.
Reflecting the increased amino acid transport capacity of tumour cells, [18F]FET is
useful in PET brain tumour imaging because 18F-FDG, commonly used in PET
tumour imaging, is relatively insensitive for detecting tumours in the brain due to
the high levels of glycolytic metabolism in the normal cortex and, to a lesser extent,
in white matter.
(C55) The currently available information about the biokinetics, organ, and tissue
distribution of [18F]FET in humans or animals is limited to the first 3–5 h after
intravenous injection. Studies in mice and humans after administration of [18F]FET
(Heiss et al., 1999; Wester et al., 1999; Pauleit et al., 2003; Tang et al., 2003; Abe et al.,
2006; Langen et al., 2006) showed that the activity was removed rapidly from the
blood plasma. Clinical PET studies with [18F]FET, performed in seven patients
(Pauleit et al., 2003) and four normal men (Abe et al., 2006), showed that uptake
of the radiopharmaceutical in the tissues studied was maximal within 0.25 h, and then
decreased mono-exponentially with a biological half-time of between 8 and 12 h. The
removal of the radioactivity from the blood plasma appeared to be bi-exponential
with biological half-times of <0.05 h (40%) and &14 h (60%) (Pauleit et al., 2003).
Approximately 25% of the administered substance was excreted in the urine in 5 h,
suggesting an elimination half-time of 14 h (Pauleit et al., 2003; Langen et al., 2006).
(C56) Estimates of radiation dose to human tissues after injection of [18F]FET
based on biokinetic data for mice were published by Taylor (2000) and Tang et al.
(2003), and an estimate based on clinical PET studies was reported by Pauleit et al.
(2003). In general, these agree relatively well with each other. In order to take
account of the human data published by Abe et al. (2006), all the available biokinetic
data have been re-analysed, and a cautious biokinetic model for [18F]FET was
developed (see below).
(C57) It is assumed that [18F]FET entering the systemic circulation is distributed
rapidly into the organs and tissues and then eliminated with a biological half-time of
14 h. The fractional uptake in the various organs is shown in the first two columns of
Table C.32. It is also assumed that 99% of the 18F from [18F]FET is excreted through
the urinary bladder with a biological half-time of 14 h; the remaining 1% of the
administered activity is assumed to be eliminated via the small intestine and
faeces. The selection of 14 h as the elimination half-time means that 99% of the
administered activity decays in the body.
(C58) The effective dose is nearly the same as that calculated by Pauleit et al.
(2003) for [18F]FET (1.65E–02 mSv MBq1). However, the dose to the urinary blad-
der is higher than that calculated by Pauleit et al. (2003) (6.0E-02 mGy MBq1)
because a longer bladder voiding interval (3.5 h) is assumed here compared with
that assumed by Pauleit et al. (2003) (2 h).

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C.16.2. References for 2-[18F]-fluoroethyl-L-tyrosine

Abe, K., Hayashi, K., Sasaki, M., et al., 2006. O-(2-[18F]fluoroethyl)-L-tyrosine (18FET)
uptake in mouse thymoma cells, and its biodistribution in mice and human volunteers.
Acta Radiol. 47, 1042–1048.
Heiss, P., Mayer, S., Herz, M., Wester, H-J., Schwaiger, M., Senekowitsch-Schmidtke, R.,
1999. Investigation of transport mechanism and uptake kinetics of O-(2-[18F]fluoroethyl)-
L-tyrosine in vitro and in vivo. J. Nucl. Med. 40, 1367–1373.
Langen, K-J., Hamacher, K., Weckesser, M., et al., 2006. O-(2-[18F]fluoroethyl)-L-tyrosine:
uptake mechanisms and clinical applications. Nucl. Med. Biol. 33, 287–294.
Pauleit, D., Floeth, F., Herzog, F., et al., 2003. Whole-body distribution and dosimetry of O-
(2-[18F]fluoroethyl)-L-tyrosine. Eur. J. Nucl. Med. Mol. Imag. 30, 519–524.
Tang, G., Wang, M., Tang, X., Luo, L., Gan, M., 2003. Pharmacokinetics and radiation
dosimetry estimation of O-(2-[18F]fluoroethyl)-L-tyrosine as oncologic PET tracer. Appl.
Radiat. Isot. 58, 219–225.
Taylor, D.M., 2000. Generic models for radionuclide dosimetry: 11C-, 18F- or 75Se-labelled
amino acids. Appl. Radiat. Isot. 52, 911–922.
Wester, H.J., Herz, M., Weber, W., et al., 1999. Synthesis and radiopharmacology of O-(2-
[18F]fluoroethyl)-L-tyrosine for tumor imaging. J. Nucl. Med. 40, 205–212.

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Table C.32. Biokinetic data for 2-[18F]-fluoroethyl-L-tyrosine.

Organ (S) Fs T (h) a Ãs/A0 (h)

Liver 0.04 14 1.0 0.093

Lungs 0.02 14 1.0 0.047
Red marrow 0.02 14 1.0 0.047
Kidneys 0.01 14 1.0 0.023
(from excretion process) 0.0093
Other organs and tissues 0.90 14 1.0 2.1
Gastrointestinal tract contents
Small intestine 0.01 0.0018
Upper large intestine 0.01 0.00010
Lower large intestine 0.01 0.00018
Urinary bladder contents 0.99
Adult, 15 years, 10 years 0.15
5 years 0.14
1 year 0.10

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Table C.33. Absorbed doses for 2-[18F]-fluoroethyl-L-tyrosine.

Absorbed dose per unit activity administered (mGy MBq1)

Organ Adult 15 years 10 years 5 years 1 year

Adrenals 1.4E02 1.7E02 2.6E02 4.2E02 7.7E02

Bone surfaces 1.3E02 1.6E02 2.4E02 3.9E02 7.4E02
Brain 1.0E02 1.3E02 2.1E02 3.4E02 6.4E02
Breast 9.5E03 1.2E02 1.8E02 3.0E02 5.7E02
Gallbladder wall 1.4E02 1.7E02 2.6E02 3.8E02 6.8E02
Gastrointestinal tract
Stomach wall 1.3E02 1.6E02 2.4E02 3.8E02 6.9E02
Small intestine wall 7.6E03 9.4E03 1.4E02 2.0E02 3.2E02
Colon 1.1E02 1.3E02 2.1E02 3.2E02 5.4E02
(Upper large intestine wall 1.0E02 1.3E02 2.0E02 3.1E02 5.4E02)
(Lower large intestine wall 1.2E02 1.4E02 2.2E02 3.3E02 5.4E02)
Heart wall 1.3E02 1.6E02 2.6E02 3.9E02 7.2E02
Kidneys 2.7E02 3.3E02 4.6E02 6.9E02 1.2E01
Liver 1.7E02 2.2E02 3.2E02 4.8E02 8.8E02
Lungs 1.4E02 2.0E02 2.8E02 4.2E02 8.1E02
Muscles 1.2E02 1.4E02 2.3E02 3.6E02 6.7E02
Oesophagus 1.2E02 1.5E02 2.3E02 3.6E02 6.9E02
Ovaries 1.5E02 1.8E02 2.8E02 4.3E02 7.7E02
Pancreas 1.4E02 1.8E02 2.7E02 4.3E02 7.8E02
Red marrow 1.3E02 1.6E02 2.4E02 3.8E02 7.2E02
Skin 9.0E03 1.1E02 1.8E02 2.9E02 5.5E02
Spleen 1.3E02 1.6E02 2.4E02 4.0E02 7.3E02
Testes 1.2E02 1.6E02 2.5E02 3.8E02 7.0E02
Thymus 1.2E02 1.5E02 2.3E02 3.6E02 6.9E02
Thyroid 1.2E02 1.5E02 2.4E02 3.9E02 7.3E02
Urinary bladder wall 8.5E02 1.1E01 1.6E01 2.2E01 3.0E01
Uterus 1.7E02 2.1E02 3.4E02 5.1E02 8.6E02
Remaining organs 1.2E02 1.4E02 2.2E02 3.5E02 6.6E02

Effective dose (mSv MBq1) 1.6E02 2.1E02 3.1E02 4.7E02 8.2E02

18
The physical half-life of F is 1.83 h.

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 C.17. [18F]-fluoro-L-DOPA
C.17.1. Biokinetic model

(C59) The amino acid analogue 6-fluoro-L-dopa (L-DOPA) is taken up rapidly in

the human brain and transformed into the important catecholamine neurotransmit-
ter, dopamine (Luxen et al., 1992; Pauwels et al., 1994). After labelling with the
positron-emitting radioisotope 18F, the resulting 18F-DOPA can be used for the
scintigraphic investigation of normal and pathological dopamine metabolism in
the human brain and tumours (Luxen et al., 1992; Meyer et al., 1995; Heiss et al.,
1996), and for the quantitative assessment of dopaminergic function in Parkinson’s
disease and other conditions.
(C60) Studies in normal human volunteers and dogs after administration of
18
F-DOPA have shown that the activity is more or less uniformly distributed
throughout the body tissues, and is removed by a bi-exponential process with bio-
logical half-times of approximately 12 h (67–94%) and 1.7–3.9 h (6–33%) (Harvey
et al., 1985; Boyes et al., 1986). Both these half-times appear to be age-dependent
(Harvey et al., 1985). 18F is excreted through the kidneys: 50% with a half-time of
0.7 h and 50% with a half-time of approximately 12 h (Harvey et al., 1985).
(C61) On the basis of the biokinetic data given by Harvey et al. (1985) and
Dhawan et al. (1996), the biokinetic model for 18F-DOPA illustrated in
Table C.34 was developed. This model assumes that 100% of 18F is distributed
homogeneously in the body and eliminated through the kidneys with biological
half-times of 1 h (50%) and 12 h (50%). This model was, in spite of observations
cited above, assumed to be independent of age.
(C62) Human studies have shown that the uptake of 18F-DOPA in the striatum
and cerebellum can be increased approximately two-fold by administration of the
amino decarboxylase inhibitor, carbidopa (Melega et al., 1990; Hoffman et al., 1992;
Brown et al., 1998).

C.17.2. References for [18F]-fluoro-L-DOPA

Boyes, R.E., Cumming, P., Martin, W.R.W., McGeer, E.G., 1986. Determination of plasma
[18F]-6-fluorodopa during positron emission tomography; elimination and metabolism in
carbidopa treated subjects. Life Sci. 39, 2243–2252.
Brown, W.D., Oakes, T.R., DeJesus, O.T., et al., 1998. Fluorine-18-fluoro-L-DOPA dosime-
try with carbidopa pretreatment. J. Nucl. Med. 39, 1884–1891.
Dhawan, V., Belakhlef, A., Robeson, W., et al., 1996. Bladder wall radiation dose in humans
from fluorine-18-FDOPA. J. Nucl Med. 37, 1850–1852.
Harvey, J., Firnau, G., Garnett, E.S., 1985. Estimation of the radiation dose in man due to 6-
[18F]fluoro-L-dopa. J. Nucl. Med. 26, 931–935.
Heiss, W.D., Wienhard, K., Wagner, R., et al., 1996. F-DOPA as an amino acid tracer to
detect brain tumors. J. Nucl. Med. 37, 1180–1182.
Hoffman, J.M., Melega, W.P., Hawk, T.C., et al., 1992. The effects of carbidopa administra-
tion of 6-[18F]fluoro-L-DOPA kinetics in positron emission tomography. J. Nucl. Med. 33,
1472–1477.

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Luxen, A., Guillaume, M., Melega, W.P., Pike, V.W., Solin, O., Wagner, R., 1992. Production
of 6 [18F]fluoro-L-DOPA and its metabolism in vivo – a critical review. Nucl. Med. Biol. 19,
149–158.
Melega, W.P., Hoffman, J.M., Luxen, A., Nissenson, C.H.K., Phelps, M.E., Barrio, J.P.,
1990. The effects of carbidopa on the metabolism of 6-[18F]fluoro-L-dopa in rats, monkeys
and humans. Life Sci. 47, 149–157.
Meyer, G-J., Waters, S.L., Coenen, H.H., Luxen, A., Maziere, B., Långström, B., 1995. PET
radiopharmaceuticals in Europe: current use and data relevant for the formulation of
summaries of product characteristics (SPCs). Eur. J. Nucl. Med. 22, 1420–1432.
Pauwels, T., Dethy, S., Goldman, S., Monclus, M., Luxen, A., 1994. Effect of catechol-O-
methyl transferase inhibition on peripheral and central metabolism of 6-[18F]fluoro-L-
DOPA. Eur. J. Pharmacol. 257, 53–58.

Table C.34. Biokinetic data for [18F]-fluoro-L-DOPA.

Organ (S) Fs T (h) a Ãs/A0 (h)

Total body 1.0 1.0 0.50 1.6

12 0.50
Kidney excretion 1.0 0.032
Urinary bladder contents 1.0
Adult, 15 years, 10 years 0.60
5 years 0.53
1 year 0.37

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Table C.35. Absorbed doses for [18F]-fluoro-L-DOPA.

Absorbed dose per unit activity administered (mGy MBq1)

Organ Adult 15 years 10 years 5 years 1 year

Adrenals 9.9E03 1.3E02 1.9E02 3.1E02 5.5E02

Bone surfaces 9.6E03 1.2E02 1.8E02 2.8E02 5.1E02
Brain 7.1E03 8.8E03 1.5E02 2.4E02 4.4E02
Breast 6.7E03 8.5E03 1.3E02 2.1E02 3.9E02
Gallbladder wall 1.0E02 1.3E02 2.0E02 2.9E02 5.0E02
Gastrointestinal tract
Stomach wall 9.5E03 1.2E02 1.8E02 2.8E02 5.0E02
Small intestine wall 1.3E02 1.7E02 2.6E02 3.9E02 6.5E02
Colon wall 1.5E02 1.8E02 2.7E02 4.1E02 6.3E02
(Upper large intestine wall 1.2E02 1.5E02 2.3E02 3.6E02 5.9E02)
(Lower large intestine wall 1.8E02 2.2E02 3.3E02 4.7E02 6.9E02)
Heart wall 8.9E03 1.1E02 1.8E02 2.8E02 5.0E02
Kidneys 3.1E02 3.7E02 5.2E02 7.8E02 1.4E01
Liver 9.1E03 1.2E02 1.8E02 2.9E02 5.2E02
Lungs 7.9E03 1.0E02 1.6E02 2.5E02 4.6E02
Muscles 9.9E03 1.2E02 1.9E02 3.0E02 5.1E02
Oesophagus 8.2E03 1.0E02 1.6E02 2.5E02 4.7E02
Ovaries 1.7E02 2.2E02 3.3E02 4.7E02 7.4E02
Pancreas 1.0E02 1.3E02 2.0E02 3.1E02 5.6E02
Red marrow 9.8E03 1.2E02 1.9E02 2.7E02 4.7E02
Skin 7.0E03 8.5E03 1.4E02 2.2E02 4.0E02
Spleen 9.5E03 1.2E02 1.8E02 2.9E02 5.3E02
Testes 1.3E02 1.8E02 3.0E02 4.5E02 7.0E02
Thymus 8.2E03 1.0E02 1.6E02 2.5E02 4.7E02
Thyroid 8.1E03 1.0E02 1.7E02 2.7E02 5.0E02
Urinary bladder wall 3.0E01 3.8E01 5.7E01 7.8E01 1.0Eþ00
Uterus 2.8E02 3.3E02 5.3E02 7.5E02 1.1E01
Remaining organs 1.0E02 1.3E02 1.9E02 3.0E02 5.2E02

Effective dose (mSv MBq1) 2.5E02 3.2E02 4.9E02 7.0E02 1.0E01

The physical half-life of 18F is 1.83 h.
The urinary bladder wall contributes 51% of the effective dose.

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 18
C.18. F-fluoride
C.18.1. Biokinetic model

(C63) Considering the high uptake in mineral bone, and given that the skeleton
model has been improved considerably since Publication 53 (ICRP, 1987) was pub-
lished, ICRP has re-reviewed the literature and proposes a new biokinetic model and
a new dose table for this substance.
(C64) 18F-fluoride is a highly effective bone-seeking PET tracer used for the
detection of skeletal abnormalities (Fair et al., 2010). The uptake mechanism of
18
F-fluoride resembles that of 99mTc-methylene diphosphonate, but has better
pharmacokinetic characteristics, including faster blood clearance and two-fold
higher uptake in bone. Uptake of 18F-fluoride reflects blood flow and bone
remodelling. The proposed biokinetic model is mainly based on the compartment
model of Blake et al. (2001) and Park-Holohan et al. (2001). Additional infor-
mation was extracted from Hawkins et al. (1992) and Doot et al. (2010). The
Task Group has agreed on the following simple model: with a 15-min uptake
half-time, the fraction of the administered activity in the skeleton is estimated to
be 60%. Retention on the bone surface is considered to be infinitive.
The immediate uptake of 40% of the administered activity in other organs and
tissues is assumed to be retained with biological half-times of 15 min (75%) and
13 h (25%).

18
C.18.2. References for F-fluoride
Blake, G.M., Park-Holohan, S., Cook, G.J.R., Fogelman, I., 2001. Quantitative studies of
bone with use of 18F-fluoride and 99mTc-methylene diphosphonate. Sem. Nucl. Med. 31,
28–49.
Doot, R.K., Muzi, M., Peterson, L.M., et al., 2010. Kinetic analysis of 18F-fluoride PET
images of breast cancer bone metastases. J. Nucl. Med. 51, 521–527.
Fair, J., Sajdak, R., Smith, G.T., 2010. SNM practice guideline for sodium 18F-fluoride PET/
CT bone scans. J. Nucl. Med. 51, 1813–1820.
Hawkins, R.A., Choi, Y., Huang, S-C., et al., 1992. Evaluation of the skeletal kinetics of
fluorine-18-fluoride ion with PET. J. Nucl. Med. 33, 633–642.
ICRP, 1987. Radiation dose to patients from radiopharmaceuticals. ICRP Publication 53.
Ann. ICRP 18(1–4).
Park-Holohan, S-J., Blake, G.M., Fogelman, I., 2001. Quantitative studies of bone using 18F-
fluoride and 99mTc-methylene diphosphonate: evaluation of renal and whole-blood
kinetics. Nucl. Med. Commun. 22, 1037–1044.

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18
Table C.36. Biokinetic data for F-fluoride.

Organ Fs T (h) a Ãs/A0 (h)

Other organs and tissues 0.4 0.25 0.75 0.33

13 0.25
Bone surfaces 0.6 0.25 1 1.4
1 1
Trabecular bone
Adult, 15 years, 10 years 0.83
5 years, 1 year 0.97
Cortical bone
Adult, 15 years, 10 years 0.55
5 years, 1 year 0.42
Urinary bladder contents 0.24
Adult, 15 years 0.29
10 years 0.26
5 years, 1 year 0.19

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18
Table C.37. Absorbed doses of F-fluoride.

Absorbed dose per unit activity administered (mGy MBq1)

Organ Adult 15 year 10 year 5 year 1 year

Adrenals 6.7E03 8.8E03 1.3E02 2.0E02 3.9E02

Bone surfaces 9.4E02 7.5E02 1.2E01 2.1E01 4.8E01
Brain 6.6E03 7.5E03 1.1E02 1.6E02 2.5E02
Breast 2.9E03 3.7E03 6.0E03 9.5E03 1.8E02
Gallbladder wall 4.2E03 5.1E03 8.2E03 1.2E02 2.3E02
Gastrointestinal tract contents
Stomach wall 3.7E03 4.6E03 7.9E03 1.1E02 2.0E02
Small intestine wall 5.8E03 7.5E03 1.1E02 1.7E02 3.0E02
Colon wall 6.8E03 8.4E03 1.3E02 1.9E02 3.0E02
(Upper large intestine wall 5.1E03 6.3E03 1.0E02 1.5E02 2.6E02)
(Lower large intestine wall 9.1E03 1.1E02 1.7E02 2.5E02 3.7E02)
Heart wall 4.2E03 5.1E03 7.9E03 1.2E02 2.2E02
Kidneys 1.3E02 1.6E02 2.4E02 3.6E02 6.7E02
Liver 4.0E03 5.2E03 7.8E03 1.2E02 2.3E02
Lungs 4.5E03 5.8E03 8.6E03 1.3E02 2.6E02
Muscles 5.8E03 7.1E03 1.1E02 1.6E02 2.8E02
Oesophagus 3.7E03 4.8E03 7.2E03 1.1E02 2.2E02
Ovaries 8.3E03 1.1E02 1.5E02 2.2E02 3.6E02
Pancreas 5.0E03 6.1E03 9.2E03 1.4E02 2.7E02
Red marrow 3.7E02 3.9E02 7.6E02 1.8E01 4.4E01
Skin 4.1E03 4.9E03 7.7E03 1.2E02 2.2E02
Spleen 4.2E03 5.5E03 8.4E03 1.3E02 2.6E02
Testes 6.1E03 8.3E03 1.4E02 2.0E02 3.2E02
Thymus 3.7E03 4.8E03 7.2E03 1.1E02 2.2E02
Thyroid 4.9E03 5.7E03 8.1E03 1.2E02 2.0E02
Urinary bladder wall 1.5E01 1.9E01 2.8E01 3.9E01 5.4E01
Uterus 1.3E02 1.5E02 2.4E02 3.5E02 5.0E02
Remaining organs 5.9E03 7.3E03 1.1E02 1.7E02 2.8E02

Effective dose (mSv MBq1) 1.7E02 2.0E02 3.3E02 5.6E02 1.1E01

18
The physical half-life of F is 1.83 h.

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 C.19. 30 -deoxy-[18F]-30 -fluorothymidine (FLT)
C.19.1. Biokinetic model

(C65) The antiviral nucleoside 30 -deoxy-[18F]-30 -fluorothymidine ([18F]FLT) is an

analogue of the natural nucleoside thymidine, an essential component of the DNA
molecule. The 18F-labelled compound can be applied for the scintigraphic visualisa-
tion of cell proliferation in tumours and other tissues using PET, and thus for the
monitoring of cancer therapy using cytotoxic drugs or radiation (Grierson et al.,
1995; Shields et al., 1996; Choi et al., 2003; Cobden et al., 2003; Vesselle et al., 2003;
Buchmann et al., 2004).
(C66) Non-radioactive FLT was developed for the treatment of human immuno-
deficiency virus infection (Shinazi et al., 1990). Clinical studies (Flexner et al., 1994)
showed that the administration of 0.5 mmol FLT day1 led to unacceptable toxi-
city in six out of 10 patients. At the biochemical level, FLT inhibits DNA synthesis
and leads to apoptotic cell death. In-vitro tests suggest that FLT exhibits a relatively
strong mutagenicity. It is, however, assumed that the single administration of 400
MBq and 0.01 mmol [18F]FLT would not cause any demonstrable chemical toxicity
or mutagenic effect.
(C67) Studies in humans (Cobden et al., 2003; Vesselle et al., 2003; Buchmann
et al., 2004), dogs, and monkeys (Shinazi et al., 1990) suggested that the substance
was not metabolised extensively in vivo, but was excreted largely unchanged, mainly
in the urine (Muzi et al., 2005). Shortly after injection, [18F]FLT is taken up by
rapidly proliferating cells, especially in bone marrow and tumours (Vesselle et al.,
2003; Buchmann et al., 2004). Studies in dogs suggested that during the first hour
after injection, the standardised uptake value in the bone marrow reached 4.2, and
significant uptake in the kidneys and urinary bladder were seen (Shields et al., 2002).
(C68) Clinical PET studies with [18F]FLT have indicated that the activity is dis-
tributed relatively rapidly throughout the body and then taken up by the body
tissues. The maximum uptake in kidneys, liver, and bone marrow was found
within 5 min of injection. The following standardised uptake values were calculated:
bone marrow, 10; liver, 4–8; kidneys, 2–6; spleen, 2–4; and lungs, 0.5–1.2 (Vesselle
et al., 2003; Buchmann et al., 2004). Little information is available regarding the
elimination rates from the tissues. Vesselle et al. (2003) reported that the maximum
uptake in the kidneys occurred within 1.5 min, and that thereafter, 80% of the radio-
activity was eliminated with a biological half-time of 0.05 h, and the remainder was
lost with a longer half-time. A clinical PET study suggested that 20% of the injected
[18F]FLT accumulated in the urinary bladder within 1.5 h (Vesselle et al., 2003).
(C69) Vesselle et al. (2003) calculated radiation doses for men and women follow-
ing intravenous injection of [18F]FLT. On the basis of the limited human data men-
tioned above, the following cautious biokinetic model was developed. It is assumed
that immediately after intravenous injection of [18F]FLT, the uptake in the liver,
bone marrow, kidneys, and spleen is 14, 10, 8, and 0.6% of the injected activity,
respectively. Of the activity deposited in the kidneys, it is assumed that 75% is
eliminated with a biological half-time of 0.05 h. As no good human data are available

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for the retention times in the various organs and tissues, a biological half-time of 24 h
is assumed for all tissues. It is further assumed that 15% of the total radioactivity
would be eliminated in the urine.

C.19.2. References for 30 -deoxy-[18F]-30 -fluorothymidine

Buchmann, I., Neumaier, B., Schreckenberger, M., Reske, E., 2004. [18F]-3;-deoxy-30 -fluor-
othymidine in NHL patients: whole-body distribution and imaging of lymphoma manifes-
tations – a pilot study. Cancer Biother. Radiopharm. 19, 436–442.
Choi, S.J., Kim, J.S., Kim, J.H., et al., 2003. [18F]-30 -deoxy-30 -fluorothymidine PET for the
diagnosis and grading of brain tumors. Eur. J. Nucl. Med. Mol. Imag. 32, 653–659.
Cobden, D.C., Jager, P.L., Elsinga, P.H., Maas, B., Suurmeijer, A.J., Hoekstra, H.J., 2003. 30 -
18F-fluoro-30 -deoxy-L-thymidine: a new tracer for staging melanoma. J. Nucl. Med. 44,
1927–1932.
Flexner, C., van der Horst, C., Jacobson, M.A., et al., 1994. Relationship between plasma
concentrations of 30 -deoxy-30 -fluorothymidine (Alovudine) and antiretroviral activity in
two concentration-controlled trials. J. Infect. Dis. 170, 1394–1403.
Grierson, J.R., Shields, A.F., Zheng, M., Kozawa, S.M., Courtier, J.H., 1995. Radiosynthesis
of labelled b-pseudothymidine [C-11]- and [H-3]methyl and its biodistribution and meta-
bolism in normal and tumored mice. Nucl. Med. Biol. 22, 671–678.
Muzi, M., Vesselle, H., Grierson, J.R., et al., 2005. Kinetic analysis of 30 -deoxy-30 -fluorothy-
midine PET studies: validation studies in patients with lung cancer. J. Nucl. Med. 46,
274–282.
Shields, A.F., Grierson, J.R., Kozawa, S.M., Zheng, M., 1996. Development of labelled
thymidine analogs for imaging tumour proliferation. Nucl. Med. Biol. 23, 17–22.
Shields, A.F., Grierson, J.R., Muzik, O., et al., 2002. Kinetics of 30 -deoxy-30 -
[18F]fluorothymidine uptake and retention in dogs. Mol. Imag. Biol. 4, 83–89.
Shinazi, R.F., Boudinot, F.D., Doshi, K.J., McClure, H.J., 1990. Pharmacokinetics of 30 -
fluoro-30 -deoxythymidine and 30 -deoxy-20 ,30 -didehydrothymidine in Rhesus monkeys.
Antimicrob. Agents Chemother. 34, 1214–1219.
Vesselle, H., Grierson, R.J., Peterson, L.M., Muzi, M., Mankoff, D.A., Krohn, K.A., 2003.
18
F-Fluorothymidine radiation dosimetry in human PET imaging studies. J. Nucl. Med. 44,
1482–1488.

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Table C.38. Biokinetic data for 30 -deoxy-[18F]-30 -fluorothymidine.

Organ (S) Fs T (h) a Ãs/A0 (h)

Red marrow 0.10 24 1.0 0.25

Liver 0.14 24 1.0 0.34
Kidneys 0.08 0.050 0.75 0.053
(from excretion process) 24 0.25 0.0015
Spleen 0.006 24 1.0 0.015
Other organs and tissues 0.674 24 1.0 1.7
Urinary bladder contents 0.15
Adult, 15 years, 10 years 0.030
5 years 0.027
1 year 0.020

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 Radiation dose to patients from radiopharmaceuticals

Table C.39. Absorbed doses of 30 -deoxy-[18F]-30 -fluorothymidine.

Absorbed dose per unit activity administered (mGy MBq1)

Organ Adult 15 years 10 years 5 years 1 year

Adrenals 1.6E02 1.9E02 2.9E02 4.4E02 7.7E02

Bone surfaces 1.9E02 2.4E02 3.7E02 6.1E02 1.3E01
Brain 8.2E03 1.0E02 1.7E02 2.8E02 5.2E02
Breast 8.2E03 1.0E02 1.6E02 2.5E02 4.9E02
Gallbladder wall 1.8E02 2.1E02 3.0E02 4.6E02 8.5E02
Gastrointestinal tract
Stomach wall 1.2E02 1.4E02 2.2E02 3.5E02 6.6E02
Small intestine wall 1.3E02 1.6E02 2.5E02 3.8E02 6.9E02
Colon wall 1.2E02 1.5E02 2.3E02 3.6E02 6.5E02
(Upper large intestine wall 1.3E02 1.5E02 2.4E02 3.8E02 6.9E02)
(Lower large intestine wall 1.2E02 1.4E02 2.2E02 3.4E02 5.9E02)
Heart wall 1.2E02 1.5E02 2.4E02 3.6E02 6.5E02
Kidneys 4.3E02 5.1E02 7.2E02 1.1E01 1.9E01
Liver 4.8E02 6.3E02 9.4E02 1.4E01 2.6E01
Lungs 1.1E02 1.4E02 2.1E02 3.2E02 6.0E02
Muscles 9.8E03 1.2E02 1.9E02 3.0E02 5.6E02
Oesophagus 9.8E03 1.3E02 1.9E02 3.0E02 5.6E02
Ovaries 1.2E02 1.5E02 2.4E02 3.6E02 6.6E02
Pancreas 1.5E02 1.9E02 2.9E02 4.4E02 7.9E02
Red marrow 2.6E02 3.0E02 4.8E02 8.6E02 1.9E01
Skin 7.5E03 9.2E03 1.5E02 2.4E02 4.6E02
Spleen 2.2E02 3.1E02 4.7E02 7.3E02 1.3E01
Testes 8.8E03 1.1E02 1.7E02 2.7E02 5.2E02
Thymus 9.8E03 1.3E02 1.9E02 3.0E02 5.6E02
Thyroid 9.4E03 1.2E02 1.9E02 3.1E02 5.8E02
Urinary bladder wall 2.3E02 2.8E02 4.2E02 6.2E02 9.2E02
Uterus 1.2E02 1.5E02 2.4E02 3.7E02 6.6E02
Remaining organs 1.0E02 1.3E02 2.0E02 3.3E02 6.0E02

Effective dose (mSv MBq1) 1.5E02 1.9E02 2.9E02 4.6E02 8.8E02

18
The physical half-life of F is 1.83 h.

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 51
C.20. Cr-labelled ethylenediaminetetraacetic acid (EDTA)
C.20.1. Biokinetic model

(C70) Intravenous administration of chromium ethylenediaminetetraacetic acid

(EDTA) results in initial distribution in the extracellular fluid, and the substance is
excreted exclusively by the renal system according to the model for GFR substances
and the kidney–bladder model [see Sections A.6 and A.5, respectively, in Publication
53 (ICRP, 1987)] (Bröchner-Mortensen et al., 1969; Chantler et al., 1969; O’Reilly
et al., 1979).
(C71) In the normal case, total body retention is described by a bi-exponential
function with half-times of 100 min (0.99) and 7 days (0.01). The fraction excreted by
the kidneys equals 1, and the renal transit time is 5 min.
(C72) For the abnormal case, it is assumed that the retention half-time of the
major component is 1000 min, and the renal transit time is increased to 20 min.
(C73) 51Cr-EDTA administered orally is only absorbed minimally (i.e. approxi-
mately l–5%) from the gastrointestinal tract in the normal case. In conditions of
abnormal gut permeability, absorption of this substance is increased significantly
(Bjarnason et al., 1983), followed by rapid clearance of the absorbed fraction from
extracellular fluid by glomerular filtration. The proportion of the administered activ-
ity appearing in the urine is an indication of the degree of permeability of the
gut wall.
(C74) For absorbed dose calculations, the gastrointestinal tract model [Section
A.3 in Publication 53 (ICRP, 1987)] was applied. In cases with increased gut perme-
ability, the absorbed activity is excreted more rapidly than the activity remaining in
the intestines. Thus, absorbed doses in abnormal cases are lower than in normal
cases and, for this reason, no separate absorbed dose values are presented for these
cases.

51
C.20.2. References for Cr-ethylenediaminetetraacetic acid
Bjarnason, I., Peters, T.J., Veall, N., 1983. A persistent defect in intestinal permeability in
coeliac disease demonstrated by a 51Cr-labelled EDTA absorption test. Lancet 321,
323–325.
Briichner-Mortensen, J., Giese, J., Rossing, N., 1969. Renal inulin clearance versus total
plasma clearance of 51Cr-EDTA. J. Lab. Clin. Invest. 23, 301–305.
ICRP, 1987. Radiation dose to patients from radiopharmaceuticals. ICRP Publication 53.
Ann. ICRP 18(1–4).
ICRP, 1998. Radiation dose to patients from radiopharmaceuticals. Addendum 2 to ICRP
Publication 53. ICRP Publication 80. Ann. ICRP 28(3).
Chantler, C., Garnett, E.S., Parsons, V., Veall, N., 1969. Glomerular filtration rate measure-
ment in man by the single injection method using 51Cr-EDTA. Clin. Sci. 37, 169–180.
O’Reilly, P.H., Shields, R.A., Testa, H.J., 1979. Nuclear Medicine in Urology and
Nephrology. Butterworths, London.

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51
Table C.40. Biokinetic data for Cr-ethylenediaminetetraacetic acid.

Organ (S) Fs T (h) a Ãs/A0 (h)

Intravenous administration, normal renal function

Normal renal function
Total body (excluding urinary 1.0 1.7 0.99 4.3
bladder contents) 170 0.01
Kidneys 1.0 0.10
Urinary bladder contents 1.0
Adult, 15 years, 10 years 2.2
5 years 1.8
1 year 1.1
Intravenous administration, abnormal renal function
Total body (excluding urinary 1.0 17 0.99 25
bladder contents) 170 0.01
Kidneys 1.0 0.44
Urinary bladder contents 1.0
Adult, 15 years, 10 years 1.7
5 years 1.5
1 year 1.0
Oral administration (f1 ¼ 0)
Gastrointestinal tract contents
Stomach 1.0 1.0
Small intestine 1.0 4.0
Upper large intestine 1.0 13
Lower large intestine 1.0 23

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51
Table C.41. Absorbed doses for Cr-ethylenediaminetetraacetic acid.

Absorbed dose per unit activity administered (mGy MBq1)

Organ Adult 15 years 10 years 5 years 1 year

Intravenous administration, normal renal function

Adrenals 7.3E4 9.1E4 1.4E3 2.1E3 3.9E3
Bone surfaces 8.2E4 1.0E3 1.5E3 2.1E3 3.8E3
Brain 4.8E4 6.0E4 9.8E4 1.6E3 2.9E3
Breast 4.3E4 5.6E4 8.2E4 1.3E3 2.5E3
Gallbladder wall 7.9E4 1.0E3 1.7E3 2.3E3 3.4E3
Gastrointestinal tract
Stomach wall 6.9E4 8.5E4 1.3E3 2.0E3 3.4E3
Small intestine wall 1.1E3 1.4E3 2.1E3 3.1E3 4.8E3
Colon wall 1.3E3 1.6E3 2.4E3 3.4E3 4.8E3
(Upper large intestine wall 9.7E4 1.2E3 1.9E3 2.8E3 4.3E3)
(Lower large intestine wall 1.7E3 2.1E3 3.0E3 4.1E3 5.5E3)
Heart wall 6.4E4 8.1E4 1.3E3 1.9E3 3.4E3
Kidneys 1.8E3 2.2E3 3.1E3 4.7E3 8.2E3
Liver 6.6E4 8.3E4 1.3E3 2.0E3 3.6E3
Lungs 5.6E4 7.2E4 1.1E3 1.7E3 3.1E3
Muscles 7.7E4 9.5E4 1.5E3 2.1E3 3.6E3
Oesophagus 5.8E4 7.3E4 1.1E3 1.7E3 3.2E3
Ovaries 1.6E3 2.0E3 3.0E3 4.0E3 5.8E3
Pancreas 7.6E4 9.4E4 1.5E3 2.3E3 3.9E3
Red marrow 7.5E4 9.2E4 1.4E3 1.9E3 3.2E3
Skin 4.8E4 5.8E4 9.1E4 1.4E3 2.5E3
Spleen 6.8E4 8.6E4 1.3E3 2.0E3 3.6E3
Testes 1.2E3 1.6E3 2.7E3 3.8E3 5.4E3
Thymus 5.8E4 7.3E4 1.1E3 1.7E3 3.2E3
Thyroid 5.7E4 7.3E4 1.1E3 1.9E3 3.4E3
Urinary bladder wall 2.4E2 3.1E2 4.5E2 5.7E2 6.6E2
Uterus 2.8E3 3.4E3 5.2E3 6.9E3 8.7E3
Remaining organs 7.8E4 9.7E4 1.4E3 2.1E3 3.5E3

Effective dose (mSv MBq1) 2.0E3 2.6E3 3.9E3 5.2E3 7.0E3

(continued on next page)

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 Radiation dose to patients from radiopharmaceuticals

Table C.41. (continued)

Absorbed dose per unit activity administered (mGy MBq1)

Organ Adult 15 years 10 years 5 years 1 year

Intravenous administration, abnormal renal function

Adrenals 3.9E3 4.9E3 7.4E3 1.1E2 2.1E2
Bone surfaces 4.2E3 5.1E3 7.5E3 1.1E2 2.1E2
Brain 2.9E3 3.6E3 5.8E3 9.6E3 1.7E2
Breast 2.6E3 3.3E3 4.8E3 7.6E3 1.5E2
Gallbladder wall 4.2E3 5.2E3 8.3E3 1.2E2 1.8E2
Gastrointestinal tract
Stomach wall 3.8E3 4.7E3 7.2E3 1.1E2 1.9E2
Small intestine wall 4.4E3 5.5E3 8.4E3 1.3E2 2.2E2
Colon wall 4.5E3 5.4E3 8.3E3 1.3E2 2.1E2
(Upper large intestine wall 4.2E3 5.2E3 7.8E3 1.2E2 2.1E2)
(Lower large intestine wall 4.8E3 5.7E3 8.9E3 1.3E2 2.2E2)
Heart wall 3.7E3 4.7E3 7.3E3 1.1E2 2.0E2
Kidneys 4.8E3 5.9E3 8.7E3 1.3E2 2.4E2
Liver 3.7E3 4.6E3 7.2E3 1.1E2 2.0E2
Lungs 3.3E3 4.2E3 6.3E3 9.7E3 1.8E2
Muscles 3.4E3 4.1E3 6.4E3 9.8E3 1.8E2
Oesophagus 3.4E3 4.3E3 6.5E3 1.0E2 1.9E2
Ovaries 4.9E3 6.1E3 9.0E3 1.4E2 2.3E2
Pancreas 4.2E3 5.2E3 7.8E3 1.2E2 2.2E2
Red marrow 3.6E3 4.4E3 6.7E3 9.9E3 1.7E2
Skin 2.4E3 2.9E3 4.6E3 7.4E3 1.4E2
Spleen 3.7E3 4.7E3 7.2E3 1.1E2 2.0E2
Testes 3.7E3 4.6E3 7.2E3 1.1E2 1.9E2
Thymus 3.4E3 4.3E3 6.5E3 1.0E2 1.9E2
Thyroid 3.4E3 4.3E3 6.8E3 1.1E2 2.0E2
Urinary bladder wall 2.2E2 2.8E2 4.1E2 5.4E2 6.9E2
Uterus 5.9E3 7.2E3 1.1E2 1.6E2 2.6E2
Remaining organs 3.4E3 4.2E3 6.5E3 1.0E2 1.8E2

Effective dose (mSv MBq1) 4.7E3 5.8E3 8.8E3 1.3E2 2.2E2

(continued on next page)

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 ICRP Publication 128

Table C.41. (continued)

Absorbed dose per unit activity administered (mGy MBq1)

Organ Adult 15 years 10 years 5 years 1 year

Oral administration (f1 ¼ 0)

Adrenals 2.0E3 2.8E3 4.6E3 7.8E3 1.4E2
Bone surfaces 3.5E3 4.3E3 5.9E3 8.6E3 1.7E2
Brain 4.4E6 8.1E6 2.7E5 7.1E5 1.7E4
Breast 3.1E4 4.2E4 1.1E3 2.0E3 3.9E3
Gallbladder wall 1.1E2 1.4E2 2.4E2 3.4E2 5.8E2
Gastrointestinal tract
Stomach wall 1.5E2 1.9E2 2.8E2 4.6E2 8.5E2
Small intestine wall 4.4E2 5.5E2 8.8E2 1.4E1 2.4E1
Colon wall 2.0E1 2.5E1 4.3E1 7.0E1 1.3Eþ0
(Upper large intestine wall 1.2E1 1.5E1 2.6E1 4.2E1 8.0E1)
(Lower large intestine wall 3.0E1 3.9E1 6.5E1 1.1Eþ0 2.1Eþ0)
Heart wall 8.1E4 1.2E3 2.0E3 3.7E3 7.6E3
Kidneys 4.7E3 5.6E3 8.8E3 1.4E2 2.1E2
Liver 2.9E3 3.9E3 7.3E3 1.3E2 2.3E2
Lungs 5.1E4 7.9E4 1.4E3 2.5E3 5.5E3
Muscles 4.0E3 5.0E3 7.6E3 1.1E2 2.0E2
Oesophagus 2.3E4 3.3E4 5.9E4 1.3E3 2.5E3
Ovaries 3.5E2 4.7E2 7.0E2 9.8E2 1.7E1
Pancreas 4.1E3 5.6E3 9.0E3 1.4E2 2.5E2
Red marrow 6.5E3 7.7E3 1.0E2 1.3E2 1.5E2
Skin 1.3E3 1.6E3 2.5E3 4.0E3 7.3E3
Spleen 3.3E3 4.0E3 6.9E3 1.1E2 1.9E2
Testes 3.4E3 4.2E3 8.2E3 1.2E2 2.4E2
Thymus 2.3E4 3.3E4 5.9E4 1.3E3 2.5E3
Thyroid 4.0E5 7.6E5 2.3E4 4.8E4 1.4E3
Urinary bladder wall 1.2E2 1.4E2 2.3E2 3.3E2 5.5E2
Uterus 1.6E2 2.1E2 3.4E2 5.1E2 8.3E2
Remaining organs 5.3E3 7.0E3 1.1E2 1.7E2 2.5E2

Effective dose (mSv MBq1) 3.1E2 4.0E2 6.6E2 1.1E1 2.0E1

51
The physical half-life of Cr is 27.7 days.
The urinary bladder wall contributes up to 60% of the effective dose.

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C.21. Ga-citrate
C.21.1. Biokinetic model

(C75) The biokinetic model given in MIRD Dose Estimate Report No. 2 (MIRD,
1973), which is based on human data, is adopted here without change. In children,
the bone uptake is predominantly in the metaphyseal growth zones; this is discussed
in Section A.6, Paragraph A25.
(C76) 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 gastrointestinal tract model [see Section A.3 in Publication 53 (ICRP,
1987)].

67
C.21.2. References for Ga-citrate
ICRP, 1987. Radiation dose to patients from radiopharmaceuticals. ICRP Publication 53.
Ann. ICRP 18(1–4).
MIRD, 1973. Summary of current radiation dose estimates to humans from 66Ga-, 67Ga-,
68
Ga- and 72Ga-citrate. MIRD Dose Estimate Report No. 2. J. Nucl. Med. 14, 755–756.

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Table C.42. Biokinetic data for Ga-citrate.

Organ (S) Fs T (h) a Ãs/A0 (h)

Total body (excluding gastrointestinal 1.0 30 0.17 89

tract and urinary bladder contents) 610 0.83
Adrenals 0.00053 30 0.17 0.047
610 0.83
Bone 0.13 30 0.17 12
610 0.83
Gastrointestinal tract contents
Small intestine 0.09 0.35
Upper large intestine 0.09 1.0
Lower large intestine 0.09 1.5
Kidneys 0.0084 30 0.17 0.74
610 0.83
Liver 0.050 30 0.17 4.4
610 0.83
Red marrow 0.054 30 0.17 4.8
610 0.83
Spleen 0.0074 30 0.17 0.66
610 0.83
Urinary bladder contents 0.91
Adult, 15 years, 10 years 0.35
5 years 0.30
1 year 0.20

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67
Table C.43. Absorbed doses for Ga-citrate.

Absorbed dose per unit activity administered (mGy MBq1)

Organ Adult 15 years 10 years 5 years 1 year

Adrenals 1.3E01 1.8E01 2.6E01 3.6E01 5.7E01

Bone surfaces 6.3E01 8.1E01 1.3Eþ00 2.2Eþ00 5.2Eþ00
Brain 5.7E02 7.2E02 1.2E01 1.9E01 3.4E01
Breast 4.7E02 6.1E02 9.3E02 1.5E01 2.9E01
Gallbladder wall 8.2E02 1.1E01 1.7E01 2.5E01 3.8E01
Gastrointestinal tract
Stomach wall 6.9E02 9.0E02 1.4E01 2.1E01 3.9E01
Small intestine wall 5.9E02 7.4E02 1.1E01 1.6E01 2.8E01
Colon wall 1.6E01 2.0E01 3.3E01 5.4E01 1.0Eþ00
(Upper large intestine wall 1.2E01 1.5E01 2.5E01 4.1E01 7.5E01)
(Lower large intestine wall 2.1E01 2.6E01 4.4E01 7.1E01 1.4Eþ00)
Heart wall 6.9E02 8.9E02 1.4E01 2.1E01 3.8E01
Kidneys 1.2E01 1.4E01 2.0E01 2.9E01 5.1E01
Liver 1.2E01 1.5E01 2.3E01 3.3E01 6.1E01
Lungs 6.3E02 8.3E02 1.3E01 1.9E01 3.6E01
Muscles 6.0E02 7.6E02 1.2E01 1.8E01 3.5E01
Oesophagus 6.1E02 7.9E02 1.2E01 1.9E01 3.5E01
Ovaries 8.2E02 1.1E01 1.6E01 2.4E01 4.5E01
Pancreas 8.1E02 1.0E01 1.6E01 2.4E01 4.3E01
Red marrow 2.1E01 2.3E01 3.8E01 7.1E01 1.5Eþ00
Skin 4.5E02 5.7E02 9.2E02 1.5E01 2.9E01
Spleen 1.4E01 2.0E01 3.1E01 4.8E01 8.6E01
Testes 5.6E02 7.2E02 1.1E01 1.8E01 3.3E01
Thymus 6.1E02 7.9E02 1.2E01 1.9E01 3.5E01
Thyroid 6.2E02 8.0E02 1.3E01 2.0E01 3.8E01
Urinary bladder wall 8.1E02 1.1E01 1.5E01 2.0E01 3.7E01
Uterus 7.6E02 9.7E02 1.5E01 2.3E01 4.2E01
Remaining organs 6.1E02 7.8E02 1.2E01 1.9E01 3.5E01

Effective dose (mSv MBq1) 1.0E01 1.3E01 2.0E01 3.3E01 6.4E01

67
The physical half-life of Ga is 3.26 days.

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 68
C.22. Ga-labelled ethylenediaminetetraacetic acid (EDTA)
C.22.1. Biokinetic model

(C77) This generator-produced positron-emitting substance is used in PET studies.

After intravenous administration and initial distribution in the extracellular fluid, the
substance is excreted exclusively by the renal system according to the model for GFR
substances and the kidney–bladder model [see Sections A.6 and A.5, respectively, in
Publication 53 (ICRP, 1987)]. Assuming normal renal function, total body retention
can be described by a bi-exponential function, with component half-times of 100 min
(0.99) and 7 days (0.01). The fraction excreted by the kidneys is 1.0, and the renal
transit time is 5 min.

68
c.22.2. Reference for Ga-labelled ethylenediaminetetraacetic acid
ICRP, 1987. Radiation dose to patients from radiopharmaceuticals. ICRP Publication 53.
Ann. ICRP 18(1–4).

68
Table C.44. Biokinetic data for Ga-labelled ethylenediaminetetraacetic acid.

Organ (S) Fs T (h) a Ãs/A0 (h)

Total body (excluding urinary 1.0 1.7 0.99 0.98

bladder contents) 170 0.01
Kidneys 1.0 0.033
Urinary bladder contents 1.0
Adult, 15 years 0.51
10 years 0.46
5 years, 1 year 0.35

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Table C.45. Absorbed doses for Ga-labelled ethylenediaminetetraacetic acid.

Absorbed dose per unit activity administered (mGy MBq1)

Organ Adult 15 years 10 years 5 years 1 year

Adrenals 9.4E03 1.2E02 2.0E02 3.2E02 6.2E02

Bone surfaces 9.2E03 1.2E02 1.9E02 3.0E02 6.0E02
Brain 7.7E03 1.0E02 1.7E02 2.8E02 5.5E02
Breast 7.5E03 9.8E03 1.6E02 2.6E02 5.2E02
Gallbladder wall 9.8E03 1.2E02 2.0E02 3.1E02 6.0E02
Gastrointestinal tract
Stomach wall 9.2E03 1.2E02 1.9E02 3.0E02 5.9E02
Small intestine wall 1.2E02 1.5E02 2.4E02 3.7E02 7.0E02
Colon wall 1.3E02 1.6E02 2.5E02 3.8E02 7.0E02
(Upper large intestine wall 1.1E02 1.4E02 2.2E02 3.5E02 6.6E02)
(Lower large intestine wall 1.5E02 1.9E02 2.9E02 4.2E02 7.5E02)
Heart wall 8.7E03 1.1E02 1.9E02 3.0E02 5.8E02
Kidneys 5.4E02 6.5E02 9.2E02 1.4E01 2.5E01
Liver 8.9E03 1.2E02 1.9E02 3.1E02 6.0E02
Lungs 8.2E03 1.1E02 1.8E02 2.8E02 5.6E02
Muscles 9.7E03 1.3E02 2.0E02 3.1E02 6.1E02
Oesophagus 8.3E03 1.1E02 1.8E02 2.9E02 5.7E02
Ovaries 1.5E02 2.0E02 2.9E02 4.2E02 7.8E02
Pancreas 9.6E03 1.2E02 2.0E02 3.2E02 6.3E02
Red marrow 9.5E03 1.2E02 1.9E02 3.0E02 5.7E02
Skin 7.8E03 1.0E02 1.6E02 2.7E02 5.3E02
Spleen 9.2E03 1.2E02 1.9E02 3.1E02 6.1E02
Testes 1.2E02 1.7E02 2.8E02 4.0E02 7.7E02
Thymus 8.3E03 1.1E02 1.8E02 2.9E02 5.7E02
Thyroid 8.2E03 1.1E02 1.8E02 3.0E02 5.8E02
Urinary bladder wall 5.9E01 7.7E01 1.1Eþ00 1.3Eþ00 2.4Eþ00
Uterus 2.3E02 2.8E02 4.4E02 5.9E02 1.1E01
Remaining organs 9.6E03 1.2E02 2.0E02 3.1E02 6.0E02

Effective dose (mSv MBq1) 4.0E02 5.2E02 7.5E02 9.5E02 1.8E01

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The physical half-life of Ga is 68.06 min.

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 75
C.23. Se-labelled amino acids (generic model)
C.23.1. Biokinetic model

(C78) The generic biokinetic model for 75Se-labelled amino acids is the same as the
generic biokinetic model for 11C-labelled amino acids (see Section C.3.1). For details,
please see Bergmann et al. (1995), Coenen et al. (1989), Cottrall et al. (1973), Deloar
et al. (1998), ICRP (1987, 2008), Inoue et al. (1998), Schmidt et al. (1997), Shoup
et al. (1999), Stenhouse and Baxter (1977), Stenstrüm et al. (1996), Taylor (2000),
and Taylor et al. (1973).

75
C.23.2. References for Se-labelled amino acids (generic model)
Bergmann, R., Brust, P., Kampf, G., Coenen, H.H., Stöcklin, G., 1995. Evaluation of radio-
selenium labeled selenomethionine, a potential tracer for brain protein synthesis by PET.
Nucl. Med. Biol. 22, 475–481.
Coenen, H.H., Kling, P., Stöcklin, G., 1989. Cerebral metabolism of l-[2-18F]fluorotyrosine, a
new PET tracer of protein synthesis. J. Nucl. Med. 30, 1367–1372.
Cottrall, M.F., Taylor, D.M., McElwain, T.J., 1973. Investigations of 18F-p-fluorophenylala-
nine for pancreas scanning. Br. J. Radiol. 46, 277–288.
Deloar, H.M., Fujiwara, T., Nakamura, T., et al., 1998. Estimation of internal absorbed dose
of l-[methyl-11C] methionine using whole body positron emission tomography. Eur. J.
Nucl. Med. 25, 629–633.
ICRP, 1987. Radiation dose to patients from radiopharmaceuticals. ICRP Publication 53.
Ann. ICRP 18(1–4).
ICRP, 2008. Radiation dose to patients from radiopharmaceuticals. Addendum 3 to ICRP
Publication 53. Ann. ICRP 38(1/2).
Inoue, T., Tomiyoshi, K., Higuichi, T., et al., 1998. Biodistribution studies on l-3-[fluorine-
18]fluoro-a-methyl tyrosine: a potential tumor-detecting agent. J. Nucl. Med. 39, 663–667.
Schmidt, D., Langen, K-J., Herzog, H., et al., 1997. Whole-body kinetics and dosimetry of l-3-
[123I]iodo-a-methyltyrosine. Eur. J. Nucl. Med. 24, 1162–1166.
Shoup, T.M., Olson, J., Hoffman, J.M., et al., 1999. Synthesis and evaluation of [18F]1-amino-
3-fluorocyclobutane-1-carboxylic acid to image brain tumours. J. Nucl. Med. 40, 331–338.
Stenhouse, M.J., Baxter, M.S., 1977. Bomb 14C as a biological tracer. Nature (Lond.) 267,
828–832.
Stenström, K., Leide-Svegborn, S., Erlandsson, B., et al., 1996. Application of accelerator
mass spectrometry (AMS) for high-sensitivity measurements of 14CO2 in long-term studies
of fat metabolism. Appl. Radiat. Isot. 47, 417–422.
Taylor, D.M., 2000. Generic models for radionuclide dosimetry: 11C, 18F or 75Se-labelled
amino acids. Appl. Radiat. Isot. 52, 911–922.
Taylor, D.M., Cottrall, M.F., 1973. Evaluation of amino acids labelled with 18F for pancreas
scanning. In: Radiopharmaceuticals and Labelled Compounds. Vol. I. IAEA, Vienna, pp.
443–441.
Wester, H.J., Herz, M., Senkowitsch-Schmidtke, R., Schwaiger, M., Stöcklin, G., Hamacher,
K., 1999a. Preclinical evaluation of 4-[18F]fluoroprolines: diasteromeric effect on metabo-
lism and uptake in mice. Nucl. Med. Biol. 26, 259–265.
Wester, H.J., Herz, M., Weber, W., et al., 1999b. Synthesis and radiopharmacology of O-(2-
[18F]fluoroethyl)-L-tyrosine for tumor imaging. J. Nucl. Med. 40, 205–212.

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75
Table C.46. Biokinetic data for Se-labelled amino acids (generic model).

Organ (S) Fs T (h) a Ãs/A0 (h)

Blood 0.20 0.20 0.25 1.3

6.0 0.75
Brain 0.015 1200 0.70 31
1 0.30
Thyroid 0.0007 1200 0.70 1.4
1 0.30
Lungs 0.02 12 0.10 25
1200 0.85
1 0.05
Kidneys 0.02 12 0.15 24
1200 0.80
1 0.05
Kidney excretion 0.20 0.017
Liver 0.08 12 0.40 70
1200 0.55
1 0.05
Spleen 0.004 12 0.33 3.3
1200 0.67
Pancreas 0.03 12 0.85 5.9
1200 0.15
Small intestine wall 0.03 6.0 0.50 0.39
12 0.50
Ovaries 0.0002 1200 0.70 0.41
1 0.30
Testes 0.00092 1200 0.70 1.9
1 0.30
Muscles 0.24 12 0.15 520
1200 0.45
1 0.40
Other organs and tissues 0.359 12 0.15 780
1200 0.45
1 0.40
Urinary bladder contents 0.20
Adult, 15 years, 10 years 0.44
5 years 0.37
1 year 0.24
For [75Se]-selenomethionine, the compound-specific data (ICRP, 1987) should be used.

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75
Table C.47. Absorbed doses for Se-labelled amino acids (generic model).

Absorbed dose per unit activity administered (mGy MBq1)

Organ Adult 15 years 10 years 5 years 1 year

Adrenals 2.6Eþ00 3.1Eþ00 4.6Eþ00 6.7Eþ00 1.2Eþ01

Bone surfaces 2.9Eþ00 3.3Eþ00 4.7Eþ00 6.8Eþ00 1.2Eþ01
Brain 1.7Eþ00 1.7Eþ00 2.0Eþ00 2.7Eþ00 3.9Eþ00
Breast 1.3Eþ00 1.6Eþ00 2.2Eþ00 3.4Eþ00 6.4Eþ00
Gallbladder wall 2.7Eþ00 3.3Eþ00 5.2Eþ00 7.4Eþ00 1.0Eþ01
Gastrointestinal tract
Stomach wall 2.3Eþ00 2.8Eþ00 4.2Eþ00 5.9Eþ00 1.0Eþ01
Small intestine wall 2.0Eþ00 2.4Eþ00 3.6Eþ00 5.5Eþ00 9.5Eþ00
Colon wall 2.1Eþ00 2.6Eþ00 3.9Eþ00 6.0Eþ00 1.0Eþ01
(Upper large intestine wall 2.1Eþ00 2.6Eþ00 3.7Eþ00 6.1Eþ00 9.8Eþ00)
(Lower large intestine wall 2.2Eþ00 2.6Eþ00 4.1Eþ00 5.9Eþ00 1.1Eþ01)
Heart wall 2.3Eþ00 2.8Eþ00 4.0Eþ00 5.7Eþ00 1.0Eþ01
Kidneys 3.8Eþ00 4.6Eþ00 6.3Eþ00 9.2Eþ00 1.6Eþ01
Liver 3.0Eþ00 3.8Eþ00 5.6Eþ00 7.7Eþ00 1.4Eþ01
Lungs 2.1Eþ00 2.8Eþ00 3.9Eþ00 5.7Eþ00 1.0Eþ01
Muscles 1.7Eþ00 2.3Eþ00 3.6Eþ00 6.6Eþ00 1.2Eþ01
Oesophagus 2.0Eþ00 2.4Eþ00 3.5Eþ00 5.2Eþ00 9.4Eþ00
Ovaries 2.7Eþ00 3.0Eþ00 5.4Eþ00 8.8Eþ00 1.7Eþ01
Pancreas 3.6Eþ00 4.7Eþ00 7.8Eþ00 1.1Eþ01 2.0Eþ01
Red marrow 1.9Eþ00 2.2Eþ00 3.2Eþ00 4.5Eþ00 7.6Eþ00
Skin 1.2Eþ00 1.3Eþ00 2.0Eþ00 3.1Eþ00 5.7Eþ00
Spleen 2.2Eþ00 2.9Eþ00 4.3Eþ00 6.4Eþ00 1.1Eþ01
Testes 2.3Eþ00 3.9Eþ00 1.7Eþ01 2.0Eþ01 2.8Eþ01
Thymus 2.0Eþ00 2.4Eþ00 3.5Eþ00 5.2Eþ00 9.4Eþ00
Thyroid 2.8Eþ00 4.0Eþ00 6.1Eþ00 1.1Eþ01 2.1Eþ01
Urinary bladder wall 2.0Eþ00 2.6Eþ00 3.6Eþ00 5.3Eþ00 9.0Eþ00
Uterus 2.3Eþ00 2.7Eþ00 4.2Eþ00 6.5Eþ00 1.1Eþ01
Remaining organs 1.8Eþ00 2.3Eþ00 3.4Eþ00 5.3Eþ00 8.8Eþ00

Effective dose (mSv MBq1) 2.2Eþ00 2.9Eþ00 5.3Eþ00 7.6Eþ00 1.3Eþ01

75
The physical half-life of Se is 119.8 days.
For [75Se]-selenomethionine, the compound-specific data (ICRP, 1987) should be used.

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 75
C.24. Se-labelled bile acid
C.24.1. Biokinetic model

(C79) Tauroselcholic acid (SeHCAT) is a bile acid analogue used to study various
aspects of the enterohepatic circulation. Following oral administration, approxi-
mately 95% of the bile acid is absorbed in normal humans (Heaton, 1976), mainly
by the terminal ileum, during each enterohepatic cycle, and is almost entirely con-
fined to the lumen of the biliary ducts, gut, and liver (Nyhlin et al., 1983). SeHCAT
first appears in the gallbladder, on average, 73 min after oral administration (Jazrawi
et al., 1984), and the substance undergoes enterohepatic circulation approximately
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 was 30%,
62%, and 8%, on average, in gallbladder, small intestine, and liver, respectively.
Whole-body retention data from normal subjects (Nyhlin et al., 1983) showed that
97–100% of the bile acid was excreted with a half-time of 2.6 days and that, in most
cases, a small component of approximately 3% was slowly eliminated with a mean
half-time of 62 days.
(C80) Based on the above data, the biokinetic model for the normal case assumes
that a fraction (0.97) of orally administered 75SeHCAT circulates within the enter-
ohepatic 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 absorp-
tion is assumed to be 3 h and, on the basis of bile acid pool distribution, the transit
times through liver and gallbladder are 0.4 and 1.4 h, respectively. These conditions
lead to a total body retention half-time of 2.7 days. The small fraction of the sub-
stance transferred to the large intestine on each cycle is excreted according to the
gastrointestinal tract model. The residual fraction (0.03) of the administered sub-
stance is assumed to be distributed uniformly in the total body and retained with a
half-time of 62 days.
(C81) In most clinical investigations for which this substance is used (e.g.
Crohn’s disease), the effects of impaired ileal absorption and shorter gastrointest-
inal 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 approximately 100 times the normal value (Soundy et al., 1982).

75
C.24.2. References for Se-labelled bile acid
Heaton, K.W., 1976. Clinical aspects of bile acid metabolism. Rec. Adv. Gastroenterol. 3,
199–230.
Jazrawi, R.P., Lanzini, A., Britten, A., Meller, S.T., Northfield, T.C., 1984. Dynamics of
gallbladder function and of the enterohepatic circulation studied by g labelled bile acid.
Clin. Sci. 66, 10P.
Merrick, M.V., Eastwood, M.A., Ford, J.J., 1985. Is bile acid malabsorption underdiagnosed?
An evaluation of accuracy of diagnosis by measurement of SeHCAT retention. BMJ 290,
665–668.

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 ICRP Publication 128

Nyhlin, H., Merrick, M.V., Eastwood, M.A., Brydon, W.G., 1983. Evaluation of ileal func-
tion using 23-selena-25-homotaurocholate, a g-labeled conjugated bile acid.
Gastroenterology 84, 63–68.
Soundy, R.G., Simpson, J.D., Ross, H.M., Merrick, M.V., 1982. Absorbed dose to man from
the Se-75 labeled conjugated bile salt SeHCAT. J. Nucl. Med. 23, 157–161.

75
Table C.48. Biokinetic data for Se-labelled bile acid.

Organ (S) Fs T (h) a Ãs/A0 (h)

Total body (excluding contents 1.0 65 0.97 130

of gastrointestinal tract) 1500 0.03
Gallbladder 0.92 27
Liver 0.92 7.8
Gastrointestinal tract contents
Stomach 1.0 1.0
Small intestine 1.0 150
Upper large intestine 0.97 13
Lower large intestine 0.97 23

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75
Table C.49. Absorbed doses for Se-labelled bile acid.

Absorbed dose per unit activity administered (mGy MBq1)

Organ Adult 15 years 10 years 5 years 1 year

Adrenals 3.2E01 4.1E01 6.2E01 9.4E01 1.5Eþ00

Bone surfaces 2.3E01 3.0E01 4.3E01 6.4E01 1.2Eþ00
Brain 4.8E02 5.6E02 7.9E02 1.2E01 2.0E01
Breast 7.7E02 9.6E02 1.8E01 2.8E01 5.2E01
Gallbladder wall 6.4Eþ00 7.1Eþ00 9.0Eþ00 1.5Eþ01 4.8Eþ01
Gastrointestinal tract
Stomach wall 4.2E01 5.5E01 9.3E01 1.5Eþ00 2.5Eþ00
Small intestine wall 1.9Eþ00 2.4Eþ00 3.8Eþ00 5.9Eþ00 1.0Eþ01
Colon wall 2.0Eþ00 2.4Eþ00 3.8Eþ00 5.8Eþ00 1.0Eþ01
(Upper large intestine wall 1.9Eþ00 2.3Eþ00 3.5Eþ00 5.3Eþ00 9.1Eþ00)
(Lower large intestine wall 2.1Eþ00 2.6Eþ00 4.2Eþ00 6.5Eþ00 1.2Eþ01)
Heart wall 3.3E01 4.3E01 6.4E01 9.6E01 1.6Eþ00
Kidneys 5.0E01 6.1E01 8.9E01 1.3Eþ00 2.0Eþ00
Liver 6.9E01 8.7E01 1.3Eþ00 1.8Eþ00 3.2Eþ00
Lungs 2.4E01 3.3E01 4.7E01 7.2E01 1.3Eþ00
Muscles 2.0E01 2.5E01 3.7E01 5.5E01 9.8E01
Oesophagus 1.1E01 1.4E01 1.9E01 2.9E01 4.8E01
Ovaries 1.0Eþ00 1.3Eþ00 2.0Eþ00 2.9Eþ00 4.9Eþ00
Pancreas 4.5E01 5.8E01 1.1Eþ00 1.7Eþ00 2.6Eþ00
Red marrow 2.9E01 3.4E01 4.6E01 6.0E01 8.3E01
Skin 7.5E02 9.1E02 1.4E01 2.2E01 4.2E01
Spleen 3.0E01 4.1E01 6.6E01 1.0Eþ00 1.7Eþ00
Testes 9.2E02 1.3E01 2.2E01 3.7E01 7.0E01
Thymus 1.1E01 1.4E01 1.9E01 2.9E01 4.8E01
Thyroid 6.9E02 9.6E02 1.5E01 2.7E01 5.2E01
Urinary bladder wall 3.3E01 4.2E01 6.7E01 1.0Eþ00 1.7Eþ00
Uterus 7.5E01 9.4E01 1.5Eþ00 2.3Eþ00 3.8Eþ00
Remaining organs 2.6E01 3.4E01 5.3E01 8.3E01 1.3Eþ00

Effective dose (mSv MBq1) 6.9E01 8.6E01 1.3Eþ00 2.0Eþ00 3.9Eþ00

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The physical half-life of Se is 119.8 days.

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 82
C.25. Rb-chloride
C.25.1. Biokinetic model

(C82) 82Rb-chloride is a clinical PET perfusion tracer. Myocardial perfusion ima-

ging with 82Rb may be performed under both rest and stress conditions. The bioki-
netics and absorbed doses of organs have been reported to differ between stress and
rest studies. The differences between stress and rest are, in almost all cases, so small
that, considering the overall uncertainties, only one set of biokinetic model and dose
coefficients is discussed here. ICRP (1998) developed dosimetry for this agent, assum-
ing a model based on relative blood flow to various tissues as a proportion of cardiac
output. It was noted that this model might be conservative for some organs. The
effective dose equivalent (He) [using weighting factors from Publication 26 (ICRP,
1977)] was 4.8  103 mSv MBq1 in adults.
(C83) The radiation dosimetry for this agent has also been evaluated by several
authors, with considerable variation in the results. Ryan et al. (1986) collected data
in two human subjects over approximately 10 min post injection using an Anger
camera configured to image the 511-keV photons; they presented cumulated activity
values for a limited number of organs. The data of Ryan et al. (1986) were used as
the basis for the dose estimates presented in NUREG/CR-6345 (Stabin et al., 1996),
which suggested an He of 1.2  103 mSv MBq1 (for adults).
(C84) There was concern in the nuclear medicine community about the signifi-
cant difference between these two dose estimates. Stabin (2010) performed an
analysis of the two models, and introduced a third model, by Leggett et al.
(1996), which proposed cumulated activity values for most organs of the body
based on a blood flow model. The results of this model were in good agreement
with those of Ryan et al. (1986) for organs that they presented. The effective dose
for this model was 1.7  103 mSv MBq1 using tissue weighting factors from
Publication 60 (ICRP, 1991).
(C85) In 2011, cumulated activity values were measured in patients under rest and
stress conditions (Senthamizhchelvan et al., 2011) and reported for many organs.
The measured values varied from approximately 0.2 to 1.5 times the values suggested
by Leggett et al.’s (1996) model. After evaluation of these publications, the Task
Group decided to use the data of Senthamizhchelvan et al. (2011) for organs for
which contours were well defined and activity content could be quantified experi-
mentally at various time points, and where there were large differences in the esti-
mates between the two publications (e.g. for thyroid, heart contents, and heart wall).
For bone and kidneys (accumulated and moving through to the urinary bladder),
Leggett et al.’s (1996) cumulated activity data were used. The average between
Senthamizhchelvan et al. (2011) and Leggett et al. (1996) was used for red
marrow, stomach wall, intestine, spleen, adrenals, and other organs. The final
value of effective dose using these combined values was 1.1  103 mSv MBq1 (for
adults, rest or stress).

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 82
C.25.2. References for Rb-chloride
ICRP, 1977. Recommendations of the International Commission on Radiological Protection.
ICRP Publication 26. Pergamon Press, Oxford.
ICRP, 1991. 1990 Recommendations of the International Commission on Radiological
Protection. ICRP Publication 60. Ann. ICRP 21(1–3).
ICRP, 1998. Radiation dose to patients from radiopharmaceuticals. Addendum to ICRP
Publication 53. ICRP Publication 80. Ann. ICRP 28(3).
Leggett, R.W., Williams, L.R., Eckerman, K.F., 1996. A blood circulation model for reference
man. In: Proceedings of the Sixth International Radiopharmaceutical Dosimetry
Symposium, May 7–10, 1976, ORISE 00-0164. Oak Ridge Associated Universities, Oak
Ridge, TN, USA, pp. 487–499.
Ryan, J.W., Harper, P.V., Stark, V.S., et al., 1986. Radiation absorbed dose estimate for
rubidium-82 determined from in-vivo measurements in human subjects. In: Fourth
International Radiopharmaceutical Dosimetry Symposium. Oak Ridge Associated
Universities, Oak Ridge, TN, USA, pp. 346–358.
Senthamizhchelvan, S., Bravo, P.E., Lodge, M.A., et al., 2011. Radiation dosimetry of 82Rb in
humans under pharmacologic stress. J. Nucl. Med. 52, 485–491.
Stabin, M.G., 2010. Proposed revision to the radiation dosimetry of 82Rb. Health Phys. 99,
811–813.
Stabin, M.G., Stubbs, J.B., Toohey, R.E., 1996. Radiation dose estimates for radiopharma-
ceuticals. NUREG/CR-6345. Prepared for US Nuclear Regulatory Commission, US
Department of Energy, US Department of Health & Human Services, Washington, DC,
USA. 81 pages.

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82
Table C.50. Biokinetic data for Rb-chloride.

Organ (S) Ãs/A0 (h)

Adrenals 4.6E05
Brain 1.8E04
Breast 4.9E05
Gallbladder wall 5.9E05
Gastrointestinal tract
Stomach wall 3.5E04
Small intestine wall 1.8E03
Upper large intestine wall 4.5E04
Lower large intestine wall 2.9E04
Heart contents 1.3E03
Heart wall 9.4E04
Kidneys 3.3E03
Liver 1.8E03
Lungs 2.9E03
Muscles 4.7E03
Ovaries 4.1E06
Pancreas 2.8E04
Bone (cortical) 1.5E04
Bone (trabecular) 2.2E04
Red marrow 4.3E04
Spleen 6.2E04
Testes 6.4E06
Thyroid 3.8E05
Urinary bladder contents 4.4E05
Uterus 8.7E05
Other organs and tissues 1.1E02

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82
Table C.51. Absorbed doses for Rb-chloride.

Absorbed dose per unit activity administered (mGy MBq1)

Organ Adult 15 years 10 years 5 years 1 year

Adrenals 2.4E03 3.6E03 5.1E03 7.0E03 1.0E02

Bone surfaces 4.2E04 5.6E04 8.5E04 1.4E03 3.1E03
Brain 1.4E04 1.4E04 1.6E04 1.9E04 2.8E04
Breast 1.9E04 2.0E04 1.3E02 2.2E02 4.3E02
Gallbladder wall 7.2E04 8.5E04 1.2E03 2.0E03 5.7E03
Gastrointestinal tract
Stomach wall 8.3E04 1.1E03 1.6E03 2.7E03 5.4E03
Small intestine wall 2.0E03 2.6E03 4.6E03 7.7E03 1.5E02
Colon wall 1.1E03 1.4E03 2.5E03 4.1E03 7.8E03
(Upper large intestine wall 1.1E03 1.4E03 2.5E03 4.1E03 7.9E03)
(Lower large intestine wall 1.1E03 1.4E03 2.4E03 3.9E03 7.6E03)
Heart wall 4.0E03 5.2E03 8.2E03 1.3E02 2.4E02
Kidneys 9.3E03 1.1E02 1.6E02 2.4E02 4.3E02
Liver 9.8E04 1.3E03 2.0E03 3.0E03 5.8E03
Lungs 2.6E03 3.8E03 5.5E03 8.5E03 1.7E02
Muscles 2.3E04 3.6E04 7.2E04 2.2E03 4.3E03
Oesophagus 1.5E03 2.4E03 3.7E03 8.1E03 1.5E02
Ovaries 5.0E04 4.9E04 1.2E03 2.0E03 4.4E03
Pancreas 2.6E03 3.7E03 7.6E03 9.7E03 2.1E02
Red marrow 3.8E04 4.6E04 7.8E04 1.5E03 3.8E03
Skin 1.8E04 2.3E04 3.7E04 6.1E04 1.2E03
Spleen 1.8E04 3.9E04 2.4E03 2.8E03 3.8E03
Testes 2.6E04 3.3E04 5.0E04 7.9E04 1.5E03
Thymus 1.5E03 2.4E03 3.7E03 8.1E03 1.5E02
Thyroid 3.1E04 3.8E04 6.2E04 1.0E03 1.9E03
Urinary bladder wall 1.8E04 3.9E04 2.4E03 2.8E03 3.8E03
Uterus 1.0E03 1.1E03 1.5E02 2.3E02 4.1E02
Remaining organs 3.1E04 5.0E04 9.3E04 2.1E03 4.7E03

Effective dose (mSv MBq1) 1.1E03 1.4E03 3.0E03 4.9E03 8.5E03

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 99m
C.26. Tc-apcitide
C.26.1. Biokinetic model

(C86) Apcitide is a peptide that binds to the glycoprotein IIb/IIIa receptor on the
surface of activated platelets; a major component of active thrombus formation.
Apcitide is used for the detection and localisation of acute venous thrombosis in
the lower extremities (Taillefer et al., 2000). A biokinetic model with distribution in
circulating blood and an effective half-life equal to the physical half-life is assumed.

99m
C.26.2. Reference for Tc-apcitide
Taillefer, R., Edell, S., Innes, G., Lister-James, J.; Multicenter Trial Investigators, 2000. Acute
thromboscintigraphy with 99mTc-apcitide: results of the phase 3 multicenter clinical trial
comparing 99mTc-apcitide scintigraphy with contrast venography for imaging acute DVT.
J. Nucl. Med. 41, 1214–1223.

99m
Table C.52. Biokinetic data for Tc-apcitide.

Organ (S) Fs T (h) a Ãs/A0 (h)

Blood 1.0 1 1.0 8.7

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99m
Table C.53. Absorbed doses for Tc-apcitide.

Absorbed dose per unit activity administered (mGy MBq1)

Organ Adult 15 years 10 years 5 years 1 year

Adrenals 5.3E03 6.6E03 9.8E03 1.5E02 2.7E02

Bone surfaces 8.0E03 9.4E03 1.4E02 2.1E02 3.7E02
Brain 3.8E03 4.8E03 7.8E03 1.2E02 2.2E02
Breast 3.2E03 4.0E03 5.8E03 9.2E03 1.8E02
Gallbladder 5.6E03 7.5E03 1.2E02 1.8E02 2.2E02
Gastrointestinal tract
Stomach wall 5.0E03 6.6E03 1.1E02 1.5E02 2.6E02
Small intestine wall 5.6E03 7.0E03 1.0E02 1.6E02 2.8E02
Colon wall 5.4E03 7.0E03 1.0E02 1.6E02 2.8E02
(Upper large intestine wall 5.4E03 7.1E03 1.0E02 1.6E02 2.7E02)
(Lower large intestine wall 5.4E03 6.9E03 1.1E02 1.6E02 2.9E02)
Heart 5.1E03 6.4E03 9.5E03 1.4E02 2.5E02
Kidneys 4.9E03 6.0E03 9.2E03 1.4E02 2.5E02
Liver 4.9E03 6.1E03 9.5E03 1.4E02 2.5E02
Lungs 4.5E03 5.7E03 8.5E03 1.3E02 2.3E02
Muscles 4.1E03 5.1E03 7.8E03 1.2E02 2.2E02
Oesophagus 4.5E03 5.7E03 8.5E03 1.3E02 2.4E02
Ovaries 5.7E03 7.1E03 1.0E02 1.6E02 2.9E02
Pancreas 5.6E03 7.1E03 1.0E02 1.6E02 2.8E02
Red marrow 4.4E03 5.4E03 8.3E03 1.2E02 2.2E02
Skin 2.9E03 3.5E03 5.5E03 8.9E03 1.7E02
Spleen 4.9E03 6.1E03 9.5E03 1.4E02 2.5E02
Testes 4.1E03 5.0E03 7.4E03 1.2E02 2.1E02
Thymus 4.5E03 5.7E03 8.5E03 1.3E02 2.4E02
Thyroid 4.6E03 5.8E03 9.2E03 1.5E02 2.6E02
Urinary bladder wall 5.3E03 7.3E03 1.0E02 1.5E02 2.7E02
Uterus 5.8E03 7.1E03 1.1E02 1.6E02 2.9E02
Remaining organs 4.2E03 5.2E03 8.0E03 1.2E02 2.3E02

Effective dose (mSv MBq1) 4.7E03 6.0E03 9.1E03 1.4E02 2.5E02

99m
The physical half-life of Tc is 6.01 h.

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 99m
C.27. Tc-labelled large colloids
C.27.1. Biokinetic model

(C87) These are defined in Section A.8 in Publication 53 (ICRP, 1987) for two
types of 99mTc-labelled colloids:
. large colloids (100–1000 nm) – sulphur colloid, tin colloid, micro-aggregated
albumin, and phytate; and
. small colloids (<100 nm) – mini-/micro-aggregated albumin and antimony sul-
phide colloid.
99m
Due to the short physical half-life of Tc, it is assumed that no redistribution or
excretion occurs.
99m
C.27.2. Reference for Tc-labelled large colloids
ICRP, 1987. Radiation dose to patients from radiopharmaceuticals. ICRP Publication 53.
Ann. ICRP 18(1–4).

99m
Table C.54. Biokinetic data for Tc-labelled large colloids.

Organ (S) Fs T (h) a Ãs/A0 (h)

Normal liver condition

Liver 0.70 1 1.0 6.1
Spleen 0.10 1 1.0 0.87
Red marrow 0.10 1 1.0 0.87
Other organs and tissues 0.10 1 1.0 0.87
Early to intermediate diffuse parenchymal liver disease
Liver 0.50 1 1.0 4.3
Spleen 0.20 1 1.0 1.7
Red marrow 0.15 1 1.0 1.3
Other organs and tissues 0.15 1 1.0 1.3
Intermediate to advanced diffuse parenchymal liver disease
Liver 0.30 1 1.0 2.6
Spleen 0.30 1 1.0 2.6
Red marrow 0.25 1 1.0 2.2
Other organs and tissues 0.15 1 1.0 1.3

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99m
Table C.55. Absorbed doses for Tc-labelled large colloids.

Absorbed dose per unit activity administered (mGy MBq1)

Organ Adult 15 years 10 years 5 years 1 year

Normal liver condition

Adrenals 1.2E–2 1.5E–2 2.1E–2 2.8E–2 4.2E–2
Bone surfaces 7.0E–3 9.0E–3 1.3E–2 2.1E–2 4.4E–2
Brain 6.7E–4 8.6E–4 1.3E–3 2.1E–3 4.0E–3
Breast 2.1E–3 2.7E–3 4.6E–3 7.1E–3 1.3E–2
Gallbladder wall 2.0E–2 2.3E–2 3.1E–2 5.0E–2 8.4E–2
Gastrointestinal tract
Stomach wall 6.4E–3 8.2E–3 1.3E–2 2.1E–2 3.5E–2
Small intestine wall 4.0E–3 5.1E–3 8.9E–3 1.4E–2 2.4E–2
Colon wall 3.8E–3 4.8E–3 8.6E–3 1.4E–2 2.4E–2
(Upper large intestine wall5.5E–3 6.8E–3 1.2E–2 2.0E–2 3.4E–2)
(Lower large intestine wall1.6E–3 2.2E–3 3.8E–3 6.1E–3 1.1E–2)
Heart wall 6.5E–3 8.3E–3 1.2E–2 1.7E–2 3.0E–2
Kidneys 9.5E–3 1.1E–2 1.7E–2 2.4E–2 3.5E–2
Liver 7.1E–2 9.1E–2 1.3E–1 1.9E–1 3.4E–1
Lungs 5.9E–3 7.5E–3 1.0E–2 1.5E–2 2.5E–2
Muscles 2.7E–3 3.4E–3 4.9E–3 7.2E–3 1.3E–2
Oesophagus 2.1E–3 2.7E–3 3.7E–3 5.7E–3 9.7E–3
Ovaries 2.2E–3 2.9E–3 4.9E–3 7.8E–3 1.4E–2
Pancreas 1.3E–2 1.7E–2 2.5E–2 3.7E–2 5.9E–2
Red marrow 8.0E–3 8.9E–3 1.4E–2 2.4E–2 5.2E–2
Skin 1.3E–3 1.6E–3 2.5E–3 3.9E–3 7.5E–3
Spleen 7.4E–2 1.1E–1 1.6E–1 2.4E–1 4.3E–1
Testes 5.6E–4 7.6E–4 1.3E–3 2.3E–3 4.5E–3
Thymus 2.1E–3 2.7E–3 3.7E–3 5.7E–3 9.7E–3
Thyroid 9.2E–4 1.2E–3 2.0E–3 3.5E–3 6.4E–3
Urinary bladder wall 1.9E–3 2.5E–3 4.4E–3 7.3E–3 1.4E–2
Uterus 1.1E–3 1.6E–3 2.7E–3 5.7E–3 9.4E–3
Remaining organs 2.7E–3 3.4E–3 4.9E–3 6.7E–3 1.1E–2

Effective dose (mSv MBq1) 9.1E–3 1.2E–2 1.8E–2 2.7E–2 4.9E–2

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 ICRP Publication 128

Table C.55. (continued)

Absorbed dose per unit activity administered (mGy MBq1)

Organ Adult 15 years 10 years 5 years 1 year

Early to intermediate diffuse parenchymal liver disease

Adrenals 1.2E–2 1.4E–2 2.1E–2 2.7E–2 4.2E–2
Bone surfaces 8.6E–3 1.1E–2 1.7E–2 2.6E–2 5.6E–2
Brain 9.9E–4 1.3E–3 1.9E–3 3.0E–3 5.8E–3
Breast 2.1E–3 2.6E–3 4.4E–3 6.9E–3 1.2E–2
Gallbladder wall 1.6E–2 1.8E–2 2.5E–2 4.1E–2 6.6E–2
Gastrointestinal tract
Stomach wall 8.3E–3 1.0E–2 1.5E–2 2.3E–2 3.7E–2
Small intestine wall 4.2E–3 5.3E–3 8.8E–3 1.4E–2 2.3E–2
Colon wall 3.9E–3 5.0E–3 8.4E–3 1.3E–2 2.3E–2
(Upper large intestine wall5.1E–3 6.4E–3 1.1E–2 1.8E–2 3.0E–2)
(Lower large intestine wall2.3E–3 3.0E–3 4.9E–3 7.4E–3 1.3E–2)
Heart wall 6.0E–3 7.5E–3 1.1E–2 1.6E–2 2.7E–2
Kidneys 1.0E–2 1.2E–2 1.8E–2 2.6E–2 3.9E–2
Liver 5.2E–2 6.6E–2 9.7E–2 1.4E–1 2.4E–1
Lungs 5.5E–3 7.0E–3 9.7E–3 1.4E–2 2.4E–2
Muscles 2.9E–3 3.6E–3 5.3E–3 7.8E–3 1.4E–2
Oesophagus 2.3E–3 2.8E–3 3.9E–3 5.9E–3 1.0E–2
Ovaries 2.7E–3 3.5E–3 5.5E–3 8.6E–3 1.5E–2
Pancreas 1.6E–2 1.9E–2 2.8E–2 4.1E–2 6.4E–2
Red marrow 1.1E–2 1.2E–2 1.9E–2 3.3E–2 7.4E–2
Skin 1.4E–3 1.7E–3 2.7E–3 4.3E–3 8.2E–3
Spleen 1.5E–1 2.1E–1 3.1E–1 4.8E–1 8.5E–1
Testes 8.2E–4 1.1E–3 1.7E–3 2.9E–3 5.6E–3
Thymus 2.3E–3 2.8E–3 3.9E–3 5.9E–3 1.0E–2
Thyroid 1.3E–3 1.6E–3 2.5E–3 4.2E–3 7.8E–3
Urinary bladder wall 1.5E–3 2.1E–3 3.4E–3 6.0E–3 1.0E–2
Uterus 2.3E–3 3.0E–3 4.9E–3 7.8E–3 1.4E–2
Remaining organs 2.9E–3 3.7E–3 5.3E–3 7.4E–3 1.2E–2

Effective dose (mSv MBq1) 1.1E–2 1.4E–2 2.1E–2 3.2E–2 5.7E–2

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 Radiation dose to patients from radiopharmaceuticals

Table C.55. (continued)

Absorbed dose per unit activity administered (mGy MBq1)

Organ Adult 15 years 10 years 5 years 1 year

Intermediate to advanced diffuse parenchymal liver disease

Adrenals 1.1E–2 1.4E–2 2.0E–2 2.7E–2 4.3E–2
Bone surfaces 1.1E–2 1.5E–2 2.2E–2 3.6E–2 7.9E–2
Brain 1.2E–3 1.6E–3 2.3E–3 3.6E–3 7.1E–3
Breast 1.9E–3 2.4E–3 4.1E–3 6.3E–3 1.1E–2
Gallbladder wall 1.1E–2 1.3E–2 1.9E–2 3.2E–2 4.8E–2
Gastrointestinal tract
Stomach wall 1.0E–2 1.2E–2 1.7E–2 2.4E–2 3.7E–2
Small intestine wall 4.3E–3 5.4E–3 8.6E–3 1.3E–2 2.1E–2
Colon wall 4.0E–3 5.1E–3 8.2E–3 1.2E–2 2.0E–2
(Upper large intestine wall4.8E–3 6.0E–3 9.8E–3 1.5E–2 2.5E–2)
(Lower large intestine wall3.0E–3 3.9E–3 6.0E–3 8.5E–3 1.4E–2)
Heart wall 5.4E–3 6.6E–3 9.5E–3 1.3E–2 2.3E–2
Kidneys 1.1E–2 1.3E–2 2.0E–2 2.8E–2 4.2E–2
Liver 3.2E–2 4.1E–2 6.0E–2 8.4E–2 1.5E–1
Lungs 5.0E–3 6.5E–3 9.0E–3 1.3E–2 2.2E–2
Muscles 3.0E–3 3.8E–3 5.5E–3 8.1E–3 1.4E–2
Oesophagus 2.3E–3 2.8E–3 3.8E–3 5.7E–3 9.8E–3
Ovaries 3.3E–3 4.2E–3 6.1E–3 9.1E–3 1.5E–2
Pancreas 1.8E–2 2.1E–2 3.1E–2 4.4E–2 6.7E–2
Red marrow 1.6E–2 1.8E–2 2.8E–2 5.1E–2 1.2E–1
Skin 1.4E–3 1.7E–3 2.8E–3 4.4E–3 8.3E–3
Spleen 2.2E–1 3.1E–1 4.7E–1 7.1E–1 1.3Eþ0
Testes 9.1E–4 1.2E–3 2.0E–3 3.2E–3 5.8E–3
Thymus 2.3E–3 2.8E–3 3.8E–3 5.7E–3 9.8E–3
Thyroid 1.5E–3 1.8E–3 2.8E–3 4.5E–3 8.1E–3
Urinary bladder wall 1.7E–3 2.3E–3 3.7E–3 6.0E–3 9.9E–3
Uterus 2.6E–3 3.4E–3 5.3E–3 7.9E–3 1.3E–2
Remaining organs 3.1E–3 3.9E–3 5.5E–3 7.8E–3 1.3E–2

Effective dose (mSv MBq1) 1.2E–2 1.6E–2 2.4E–2 3.7E–2 6.8E–2

99m
The physical half-life of Tc is 6.01 h.

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 99m
C.28. Tc-labelled small colloids (intratumoural injection)
C.28.1. Biokinetic model

(C88) The typical procedure is to inject approximately 20 MBq 99mTc-colloid

immediately adjacent to the breast tumour that is later to be removed. The patient
is investigated with a gamma camera 4 h after injection and then operated on for the
removal of the tumour very shortly afterwards. If no uptake of 99mTc in the lymph
nodes is seen on the scan, the tumour and the site(s) of injection of the radioactivity
are removed surgically. If lymph node uptake of activity is found, a more radical
operation is performed. For more detailed information, the reader is referred to
Bronskill (1983), Eshima et al. (2000), and Wilhelm et al. (1999).
(C89) In either situation, the injected 99mTc-colloid is removed in its entirety by
approximately 6 h after injection (this may be extended to 18 h in some circum-
stances). The only significant absorbed dose of radiation is that to surrounding
tissues, mainly lung, as a result of irradiation from the local deposit of radionuclide
in the breast during the few hours of exposure. This dose is generally considered to be
very small.
(C90) Current ICRP dosimetric models do not permit calculations of dose from
breast as a source organ, and because the doses are likely to be very small, the Task
Group does not consider it necessary to develop a new dosimetric model in which
breast is treated as a source organ.
(C91) Leakage of radionuclide from the injection site into the systemic circulation
is not considered likely; should it happen, such leakage would be covered by the
existing 99mTc-colloid model.

99m
C.28.2. References for Tc-labelled small colloids (intratumoural injection)
Bronskill, M.J., 1983. Radiation dose estimates for interstitial radiocolloid lymphoscintigra-
phy. Small colloids. Semin. Nucl. Med. 13, 20–25.
Eshima, D., Fauconnier, T., Eshima, L., et al., 2000. Radiopharmaceuticals for lymphoscinti-
graphy; including dosimetry and radiation considerations. Semin. Nucl. Med. 30, 25–32.
Wilhelm, A.J., Mijnhout, G.S., Franssen, J., 1999. Radiopharmaceuticals in sentinel lymph-
node detection – an overview. Eur. J. Nucl. Med. 26(Suppl.), S36–S42.

99m
Table C.56. Biokinetic data for Tc-labelled small colloids (intratumoural injection).

Organ (S) Fs T (h) a Ãs/A0 (h)

Time to removal: 6 h
Breast 1.0 4.3
Time to removal: 18 h
Breast 1.0 7.6

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99m
Table C.57. Absorbed doses for Tc-labelled small colloids (intratumoural injection).

Absorbed dose per unit activity administered (mGy MBq1)

6 h to removal 18 h to removal

Organ Adult 15 years Adult 15 years

Adrenals 7.9E04 9.3E04 1.4E03 1.6E03

Bone surfaces 1.2E03 1.5E03 2.1E03 2.6E03
Brain 4.9E05 5.8E05 8.7E05 1.0E04
Breast (remaining*) 3.6E03 3.9E03 6.4E03 6.9E03
Gallbladder wall 5.3E04 7.2E04 9.3E04 1.3E03
Gastrointestinal tract
Stomach wall 9.2E04 1.3E03 1.6E03 2.3E03
Small intestine wall 1.1E04 1.5E04 2.0E04 2.7E04
Colon wall 8.3E05 1.9E04 1.4E04 3.3E04
(Upper large intestine wall 1.2E04 2.8E04 2.0E04 4.9E04)
(Lower large intestine wall 3.8E05 7.0E05 6.6E05 1.2E04)
Heart wall 4.1E03 5.2E03 7.1E03 9.1E03
Kidneys 3.1E04 4.2E04 5.4E04 7.3E04
Liver 1.1E03 1.4E03 1.9E03 2.4E03
Lungs 3.6E03 3.9E03 6.4E03 6.9E03
Muscles 6.6E04 8.3E04 1.2E03 1.5E03
Oesophagus 3.6E03 5.0E03 6.2E03 8.7E03
Ovaries 4.1E05 4.8E05 7.1E05 8.3E05
Pancreas 9.7E04 1.1E03 1.7E03 2.0E03
Red marrow 8.6E04 9.2E04 1.5E03 1.6E03
Skin 1.2E03 1.4E03 2.1E03 2.4E03
Spleen 6.8E04 8.3E04 1.2E03 1.5E03
Thymus 3.6E03 5.0E03 6.2E03 8.7E03
Thyroid 4.7E04 6.2E04 8.2E04 1.1E03
Urinary bladder wall 2.1E05 3.9E05 3.6E05 6.8E05
Uterus 4.1E05 6.4E05 7.1E05 1.1E04
Remaining organs 6.6E04 8.3E04 1.2E03 1.5E03

Effective dose (mSv MBq1) 1.2E03 1.4E03 2.0E03 2.4E03

The physical half-life of 99mTc is 6.01 h.
In the model, it is assumed that no leakage occurs.
*Dose to the remaining breast has been assumed to be equal to the dose to the lungs.

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 99m
C.29. Tc-dimercaptosuccinic acid (DMSA)
C.29.1. Biokinetic model

(C92) Intravenous injection of 99mTc-dimercaptosuccinic acid (DMSA) gives rise

to an initial distribution in the extracellular fluid. Of material entering the extracel-
lular 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. For details, the reader is referred to Arnold et al. (1975), Elliott et al.
(1976), Enlander et al. (1974), and Handmaker et al. (1975).
(C93) Total body retention is described by tri-exponential functions. A fraction of
0.5 is taken up in the renal cortex, with an uptake half-time of 1 h, 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 h, and eliminated with half-times of 2 h (0.5) and
1.8 days (0.5).

99m
C.29.2. References for Tc-dimercaptosuccinic acid
Arnold, R.W., Subramanian, G., McAfee, J.G., Blair, R.J., Thomas, F.D., 1975. Comparison
of 99mTc complexes 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., Barnasconi, E.W.,
1976. Dosimetry of current radiopharmaceuticals used in renal investigation. In:
Proceedings of the Radiopharmaceutical Dosimetry Symposium, 26–29 April 1976, Oak
Ridge, TN, USA. HEW Publication (FDA) 768044. US Department of Health and
Welfare, Washington, DC, pp. 293–304.
Enlander, D., Weber, P.M., 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., Lowenstein, J.M., 1975. Clinical experience with 99mTc-DMSA
[dimercaptosuccinic acid], a new renal imaging agent. J. Nucl. Med. 16, 28–32.

99m
Table C.58. Biokinetic data for Tc-dimercaptosuccinic acid.

Organ (S) Fs T (h) a Ãs/A0 (h)

Total body (excluding urinary 1.0 2.0 0.25 6.8

bladder contents) 43 0.25
1 0.50
Kidneys (cortex) 0.50 1.0 1.0 3.7
1 1.0
Liver 0.10 1.0 1.0 0.42
2.0 0.50
43 0.50
Spleen 0.01 1.0 1.0 0.042
2.0 0.50
43 0.50
Urinary bladder contents 0.50 0.40

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99m
Table C.59. Absorbed doses for Tc-dimercaptosuccinic acid.

Absorbed dose per unit activity administered (mGy MBq1)

Organ Adult 15 years 10 years 5 years 1 year

Adrenals 1.2E02 1.6E02 2.4E02 3.5E02 6.0E02

Bone surfaces 5.0E03 6.2E03 9.2E03 1.4E02 2.6E02
Brain 1.2E03 1.5E03 2.5E03 4.0E03 7.2E03
Breast 1.3E03 1.8E03 2.8E03 4.5E03 8.4E03
Gallbladder wall 8.3E03 1.0E02 1.4E02 2.2E02 3.1E02
Gastrointestinal tract
Stomach wall 5.2E03 6.3E03 1.0E02 1.4E02 2.0E02
Small intestine wall 5.0E03 6.4E03 1.0E02 1.4E02 2.4E02
Colon wall 4.3E03 5.5E03 8.2E03 1.2E02 2.0E02
(Upper large intestine wall 5.0E03 6.4E03 9.5E03 1.4E02 2.3E02)
(Lower large intestine wall 3.3E03 4.3E03 6.5E03 9.6E03 1.6E02)
Heart wall 3.0E03 3.8E03 5.8E03 8.6E03 1.4E02
Kidneys 1.8E01 2.2E01 3.0E01 4.3E01 7.6E01
Liver 9.5E03 1.2E02 1.8E02 2.5E02 4.1E02
Lungs 2.5E03 3.5E03 5.2E03 8.0E03 1.5E02
Muscles 2.9E03 3.6E03 5.2E03 7.7E03 1.4E02
Oesophagus 1.7E03 2.3E03 3.4E03 5.4E03 9.4E03
Ovaries 3.5E03 4.7E03 7.0E03 1.1E02 1.9E02
Pancreas 9.0E03 1.1E02 1.6E02 2.3E02 3.7E02
Red marrow 3.9E03 4.7E03 6.8E03 9.0E03 1.4E02
Skin 1.5E03 1.8E03 2.9E03 4.5E03 8.5E03
Spleen 1.3E02 1.7E02 2.6E02 3.8E02 6.1E02
Testes 1.8E03 2.4E03 3.7E03 5.3E03 1.0E02
Thymus 1.7E03 2.3E03 3.4E03 5.4E03 9.4E03
Thyroid 1.5E03 1.9E03 3.1E03 5.2E03 9.4E03
Urinary bladder wall 1.8E02 2.3E02 2.9E02 3.1E02 5.7E02
Uterus 4.5E03 5.6E03 8.3E03 1.1E02 1.9E02
Remaining organs 2.9E03 3.7E03 5.2E03 7.7E03 1.4E02

Effective dose (mSv MBq1) 8.8E03 1.1E02 1.5E02 2.1E02 3.7E02

99m
The physical half-life of Tc is 6.01 h.

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 99m
C.30. Tc-diethylenetriaminepentaacetic acid (DTPA)
C.30.1. Biokinetic model

(C94) 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 Sections A.6 and A.5, respectively, in Publication 53 (ICRP, 1987)] (Klopper
et al., 1972; McAfee et al., 1979; O’Reilly et al., 1979).
(C95) In the normal case, total body retention is described by a bi-exponential
function with component half-times of 100 min (0.99) and 7 days (0.01). The fraction
excreted by the kidneys is 1.0 (1.0), and the renal transit time is 5 min.
(C96) For the abnormal case, it is assumed that the retention half-time of the
major component is 1000 min, and the renal transit time is increased to 20 min.

99m
C.30.2. References for Tc-diethylenetriaminepentaacetic acid
ICRP, 1987. Radiation dose to patients from radiopharmaceuticals. ICRP Publication 53.
Ann. ICRP 18(1–4).
Klopper, J.F., Hauser, W., Atkins, H.L., Eckelman, W.C., Richards, P., 1972. Evaluation of
99m
T-DTPA for the measurement of glomerular filtration rate. J. Nucl. Med. 13, 107–110.
McAfee, J.G., Gagne, G., Atkins, H.L., et al., 1979. Biological distribution and excretion of
DTPA labelled with Tc-99m and In-111. J. Nucl. Med. 20, 1273–1278.
O’Reilly, P.H., Shields, R.A., Testa, H.J., 1979. Nuclear Medicine in Urology and
Nephrology. Butterworths, London.

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99m
Table C.60. Biokinetic data for Tc-diethylenetriaminepentaacetic acid.

Organ (S) Fs T (h) a Ãs/A0 (h)

Normal renal function

Total body (excluding urinary bladder contents) 1.0 1.7 0.99 2.0
Kidneys 1.0 170 0.01 0.073
Urinary bladder contents 1.0
Adult, 15 years, 10 years 1.5
5 years 1.3
1 year 0.83
Abnormal renal function
Total body (excluding urinary bladder contents) 1.0 17 0.99 6.4
Kidneys 1.0 170 0.01 0.11
Urinary bladder contents 1.0
Adult, 15 years, 10 years 0.44
5 years 0.37
1 year 0.25

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 ICRP Publication 128

99m
Table C.61. Absorbed doses for Tc-diethylenetriaminepentaacetic acid.

Absorbed dose per unit activity administered (mGy MBq1)

Organ Adult 15 years 10 years 5 years 1 year

Normal renal function

Adrenals 1.4E03 1.8E03 2.7E03 4.0E03 7.2E03
Bone surfaces 2.4E03 2.9E03 4.3E03 6.1E03 1.0E02
Brain 8.6E04 1.1E03 1.7E03 2.8E03 4.9E03
Breast 7.2E04 9.2E04 1.3E03 2.2E03 4.1E03
Gallbladder wall 1.5E03 2.1E03 3.8E03 5.0E03 6.1E03
Gastrointestinal tract
Stomach wall 1.3E03 1.7E03 2.8E03 4.0E03 6.8E03
Small intestine wall 2.5E03 3.1E03 4.9E03 7.0E03 1.0E02
Colon wall 3.1E03 3.9E03 6.0E03 8.1E03 1.1E02
(Upper large intestine wall 2.1E03 2.8E03 4.3E03 6.5E03 9.2E03)
(Lower large intestine wall 4.3E03 5.4E03 8.2E03 1.0E02 1.3E02)
Heart wall 1.2E03 1.5E03 2.2E03 3.3E03 5.9E03
Kidneys 4.4E03 5.3E03 7.5E03 1.1E02 1.8E02
Liver 1.2E03 1.6E03 2.5E03 3.8E03 6.4E03
Lungs 1.0E03 1.3E03 2.0E03 3.0E03 5.5E03
Muscles 1.6E03 2.0E03 3.0E03 4.3E03 6.8E03
Oesophagus 1.0E03 1.3E03 1.9E03 3.0E03 5.4E03
Ovaries 4.2E03 5.3E03 7.7E03 1.0E02 1.3E02
Pancreas 1.4E03 1.8E03 2.8E03 4.3E03 7.4E03
Red marrow 1.5E03 1.8E03 2.7E03 3.7E03 5.7E03
Skin 8.7E04 1.0E03 1.7E03 2.6E03 4.4E03
Spleen 1.3E03 1.6E03 2.6E03 3.9E03 6.8E03
Testes 2.9E03 4.0E03 6.8E03 9.4E03 1.3E02
Thymus 1.0E03 1.3E03 1.9E03 3.0E03 5.4E03
Thyroid 1.0E03 1.3E03 2.1E03 3.3E03 6.0E03
Urinary bladder wall 6.2E02 7.8E02 1.1E01 1.5E01 1.7E01
Uterus 7.9E03 9.6E03 1.5E02 1.8E02 2.2E02
Remaining organs 1.7E03 2.1E03 3.0E03 4.2E03 6.6E03

Effective dose (mSv MBq1) 4.9E03 6.3E03 9.4E03 1.2E02 1.6E02

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 Radiation dose to patients from radiopharmaceuticals

Table C.61. (continued)

Absorbed dose per unit activity administered (mGy MBq1)

Organ Adult 15 years 10 years 5 years 1 year

Abnormal renal function

Adrenals 4.1E03 5.1E03 7.6E03 1.1E02 2.1E02
Bone surfaces 6.0E03 7.1E03 1.1E02 1.5E02 2.8E02
Brain 2.8E03 3.5E03 5.7E03 9.1E03 1.6E02
Breast 2.3E03 3.0E03 4.2E03 6.8E03 1.3E02
Gallbladder wall 4.2E03 5.7E03 9.2E03 1.3E02 1.6E02
Gastrointestinal tract
Stomach wall 3.8E03 5.0E03 7.9E03 1.1E02 1.9E02
Small intestine wall 4.5E03 5.6E03 8.5E03 1.3E02 2.2E02
Colon wall 4.5E03 5.8E03 8.7E03 1.3E02 2.2E02
(Upper large intestine wall 4.3E03 5.6E03 8.1E03 1.3E02 2.1E02)
(Lower large intestine wall 4.9E03 6.1E03 9.5E03 1.3E02 2.3E02)
Heart wall 3.7E03 4.7E03 7.0E03 1.0E02 1.8E02
Kidneys 7.7E03 9.2E03 1.3E02 1.9E02 3.2E02
Liver 3.7E03 4.6E03 7.1E03 1.1E02 1.9E02
Lungs 3.3E03 4.2E03 6.2E03 9.5E03 1.7E02
Muscles 3.2E03 4.0E03 6.1E03 9.1E03 1.7E02
Oesophagus 3.3E03 4.2E03 6.2E03 9.6E03 1.7E02
Ovaries 5.0E03 6.2E03 9.2E03 1.4E02 2.3E02
Pancreas 4.3E03 5.3E03 8.0E03 1.2E02 2.1E02
Red marrow 3.4E03 4.2E03 6.4E03 9.3E03 1.6E02
Skin 2.2E03 2.6E03 4.2E03 6.7E03 1.2E02
Spleen 3.8E03 4.7E03 7.3E03 1.1E02 1.9E02
Testes 3.5E03 4.5E03 6.9E03 1.0E02 1.8E02
Thymus 3.3E03 4.2E03 6.2E03 9.6E03 1.7E02
Thyroid 3.4E03 4.2E03 6.7E03 1.1E02 1.9E02
Urinary bladder wall 2.1E02 2.7E02 3.9E02 5.0E02 6.6E02
Uterus 6.1E03 7.4E03 1.1E02 1.6E02 2.5E02
Remaining organs 3.3E03 4.1E03 6.3E03 9.7E03 1.7E02

Effective dose (mSv MBq1) 4.6E03 5.8E03 8.7E03 1.3E02 2.1E02

99m
The physical half-life of Tc is 6.01 h.
The urinary bladder wall contributes up to 57% of the effective dose.

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 99m
C.31. Tc-ethylenedicysteine (EC)
C.31.1. Biokinetic model

(C97) 99mTc-ethylenedicysteine (EC) is used for renal studies. The biokinetic beha-
viour of the substance is very similar to that of Hippuran (sodium orthoiodohippu-
rate) with a half-time in the total body of 25 min (ICRP, 1987). The cumulated
amount found in urine at different times is as follows: 40 min, 70%; 60 min, 80%;
and 90 min, 95% (Surma et al., 1994; Surma, 1998a, 1998b; Liniecki, 1998). The
clearance is approximately 70% of that of Hippuran.

99m
C.31.2. References for Tc-ethylenedicysteine
ICRP, 1987. Radiation dose to patients from radiopharmaceuticals. ICRP Publication 53.
Ann. ICRP 18(1–4).
Liniecki, J., 1998. Private communication. Department of Nuclear Medicine, Medical
University of Lodz, Lodz.
Surma, M.J., 1998a. Verification of 99mTc-ethylenedicysteine (99mTc-EC) distribution model in
the organism. Nucl. Med. Rev. 1, 29–32.
Surma, M.J., 1998b. 99mTc-Ethylenedicysteine (99mTc-EC) renal clearance determination error
for the multiple- and single-sample methods. Nucl. Med. Rev. 1, 33–40.
Surma, M.J., Wiewiora, J., Liniecki, J., 1994. Usefulness of 99mTc-N,N0 -ethylene-1-dicysteine
complex for dynamic kidney investigations. Nucl. Med. Comm. 15, 628–635.

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99m
Table C.62. Biokinetic data for Tc-ethylenedicysteine.

Organ (S) Fs T (h) a Ãs/A0 (h)

Normal renal function

Total body (excluding urinary bladder contents) 1.0 0.42 1.0 0.56
Kidney excretion 1.0 0.062
Urinary bladder contents 1.0
Adult, 15 years, 10 years 2.3
5 years 2.0
1 year 1.3
Abnormal renal function
Total body (excluding urinary bladder contents) 1.0 4.2 1.0 3.6
Kidney excretion 1.0 0.20
Liver 0.04 4.2 1.0 0.14
Urinary bladder contents 1.0
Adult, 15 years, 10 years 1.0
5 years 0.86
1 year 0.58
Acute unilateral renal blockage
Total body (excluding urinary bladder contents) 1.0 0.42 0.5 4.4
Abnormal kidney 0.5 120 0.5 4.1
Normal kidney excretion 1.0 120 1.0 0.033
Urinary bladder contents 1.0
Adult, 15 years, 10 years 1.2
5 years 1.0
1 year 0.66

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99m
Table C.63. Absorbed doses for Tc-ethylenedicysteine.

Absorbed dose per unit activity administered (mGy MBq1)

Organ Adult 15 years 10 years 5 years 1 year

Normal renal function

Adrenals 5.3E04 6.8E04 1.1E03 1.7E03 3.0E03
Bone surfaces 1.4E03 1.7E03 2.5E03 3.4E03 4.8E03
Brain 2.2E04 2.8E04 4.5E04 7.3E04 1.3E03
Breast 2.0E04 2.6E04 4.1E04 7.0E04 1.3E03
Gallbladder wall 7.0E04 1.0E03 2.4E03 2.4E03 3.1E03
Gastrointestinal tract
Stomach wall 5.2E04 6.5E04 1.3E03 1.9E03 2.9E03
Small intestine wall 2.2E03 2.8E03 4.5E03 6.0E03 7.2E03
Colon wall 3.2E03 4.0E03 6.2E03 7.8E03 8.8E03
(Upper large intestine wall 1.7E03 2.2E03 3.7E03 5.3E03 6.3E03)
(Lower large intestine wall 5.2E03 6.3E03 9.6E03 1.1E02 1.2E02)
Heart wall 3.3E04 4.3E04 6.6E04 1.0E03 1.9E03
Kidneys 3.4E03 4.1E03 5.9E03 8.5E03 1.4E02
Liver 4.5E04 5.9E04 1.0E03 1.7E03 2.6E03
Lungs 2.8E04 3.8E04 5.8E04 9.1E04 1.7E03
Muscles 1.4E03 1.6E03 2.4E03 3.2E03 4.1E03
Oesophagus 2.7E04 3.5E04 5.4E04 8.6E04 1.5E03
Ovaries 4.9E03 6.2E03 9.0E03 1.1E02 1.2E02
Pancreas 5.5E04 6.8E04 1.2E03 1.9E03 3.1E03
Red marrow 9.6E04 1.2E03 1.8E03 2.1E03 2.4E03
Skin 5.0E04 6.1E04 1.0E03 1.4E03 2.0E03
Spleen 5.0E04 6.5E04 1.1E03 1.7E03 2.8E03
Testes 3.4E03 4.8E03 8.4E03 1.1E02 1.3E02
Thymus 2.7E04 3.5E04 5.4E04 8.6E04 1.5E03
Thyroid 2.7E04 3.4E04 5.5E04 8.9E04 1.6E03
Urinary bladder wall 9.5E02 1.2E01 1.7E01 2.2E01 2.6E01
Uterus 1.1E02 1.3E02 2.0E02 2.4E02 2.6E02
Remaining organs 1.4E03 1.7E03 2.3E03 2.7E03 3.4E03

Effective dose (mSv MBq1) 6.3E03 8.0E03 1.2E02 1.5E02 1.8E02

(continued on next page)

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 Radiation dose to patients from radiopharmaceuticals

Table C.63. (continued)

Absorbed dose per unit activity administered (mGy MBq1)

Organ Adult 15 years 10 years 5 years 1 year

Abnormal renal function

Adrenals 2.6E03 3.3E03 5.0E03 7.4E03 1.3E02
Bone surfaces 3.6E03 4.3E03 6.4E03 9.2E03 1.6E02
Brain 1.5E03 1.8E03 3.0E03 4.8E03 8.5E03
Breast 1.3E03 1.6E03 2.3E03 3.7E03 7.0E03
Gallbladder wall 2.7E03 3.6E03 5.9E03 8.3E03 1.0E02
Gastrointestinal tract
Stomach wall 2.2E03 2.9E03 4.7E03 6.5E03 1.1E02
Small intestine wall 3.1E03 3.9E03 6.0E03 8.8E03 1.4E02
Colon wall 3.4E03 4.4E03 6.7E03 9.6E03 1.4E02
(Upper large intestine wall 2.8E03 3.7E03 5.6E03 8.6E03 1.3E02)
(Lower large intestine wall 4.3E03 5.3E03 8.2E03 1.1E02 1.6E02)
Heart wall 2.1E03 2.6E03 3.9E03 5.8E03 1.0E02
Kidneys 1.1E02 1.3E02 1.8E02 2.6E02 4.5E02
Liver 2.8E03 3.5E03 5.3E03 7.5E03 1.3E02
Lungs 1.8E03 2.3E03 3.4E03 5.2E03 9.5E03
Muscles 2.1E03 2.6E03 4.0E03 5.8E03 1.0E02
Oesophagus 1.8E03 2.2E03 3.3E03 5.2E03 9.3E03
Ovaries 4.3E03 5.4E03 7.9E03 1.1E02 1.6E02
Pancreas 2.6E03 3.3E03 4.9E03 7.4E03 1.3E02
Red marrow 2.1E03 2.6E03 4.0E03 5.6E03 9.3E03
Skin 1.3E03 1.6E03 2.5E03 3.9E03 7.0E03
Spleen 2.3E03 3.0E03 4.6E03 6.8E03 1.2E02
Testes 2.9E03 3.9E03 6.4E03 9.2E03 1.4E02
Thymus 1.8E03 2.2E03 3.3E03 5.2E03 9.3E03
Thyroid 1.8E03 2.2E03 3.6E03 5.7E03 1.0E02
Urinary bladder wall 4.4E02 5.6E02 8.1E02 1.0E01 1.3E01
Uterus 6.9E03 8.3E03 1.3E02 1.7E02 2.2E02
Remaining organs 2.2E03 2.8E03 4.2E03 6.4E03 1.1E02

Effective dose (mSv MBq1) 4.6E03 5.9E03 8.8E03 1.2E02 1.8E02

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 ICRP Publication 128

Table C.63. (continued)

Absorbed dose per unit activity administered (mGy MBq1)

Organ Adult 15 years 10 years 5 years 1 year

Acute unilateral renal function

Adrenals 1.1E02 1.5E02 2.3E02 3.3E02 5.7E02
Bone surfaces 3.1E03 4.1E03 6.0E03 8.9E03 1.7E02
Brain 1.1E04 1.4E04 2.4E04 4.0E04 7.9E04
Breast 4.0E04 5.3E04 1.1E03 1.7E03 3.1E03
Gallbladder wall 6.4E03 7.5E03 1.1E02 1.6E02 2.3E02
Gastrointestinal tract
Stomach wall 4.0E03 4.6E03 7.3E03 9.7E03 1.3E02
Small intestine wall 4.3E03 5.5E03 8.8E03 1.2E02 1.9E02
Colon wall 3.8E03 4.8E03 7.4E03 1.0E02 1.4E02
(Upper large intestine wall 4.0E03 5.1E03 7.8E03 1.1E02 1.6E02)
(Lower large intestine wall 3.5E03 4.4E03 6.8E03 9.4E03 1.2E02)
Heart wall 1.4E03 1.7E03 2.8E03 4.2E03 6.3E03
Kidneys 2.0E01 2.4E01 3.4E01 4.8E01 8.4E01
Liver 4.6E03 5.6E03 8.4E03 1.2E02 1.7E02
Lungs 1.1E03 1.7E03 2.6E03 4.0E03 7.4E03
Muscles 2.2E03 2.7E03 3.8E03 5.5E03 8.8E03
Oesophagus 3.9E04 5.6E04 8.8E04 1.6E03 2.3E03
Ovaries 3.6E03 4.7E03 7.2E03 1.0E02 1.4E02
Pancreas 7.7E03 9.3E03 1.4E02 1.9E02 2.9E02
Red marrow 3.0E03 3.6E03 5.1E03 6.4E03 8.4E03
Skin 8.2E04 1.0E03 1.6E03 2.3E03 4.2E03
Spleen 1.0E02 1.3E02 1.9E02 2.7E02 4.1E02
Testes 1.8E03 2.5E03 4.5E03 6.1E03 8.4E03
Thymus 3.9E04 5.6E04 8.8E04 1.6E03 2.3E03
Thyroid 1.8E04 2.4E04 4.7E04 9.6E04 1.7E03
Urinary bladder wall 4.9E02 6.2E02 9.1E02 1.2E01 1.4E01
Uterus 6.5E03 7.9E03 1.2E02 1.6E02 2.0E02
Remaining organs 2.2E03 2.7E03 3.7E03 4.6E03 6.8E03

Effective dose (mSv MBq1) 9.9E03 1.2E02 1.8E02 2.4E02 3.7E02

99m
The physical half-life of Tc is 6.01 h.
The urinary bladder wall contributes 76% of the effective dose.

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 99m
C.32. Tc-ethylenedicysteine diester (ECD, Neurolite)
C.32.1. Biokinetic model

(C98) N,N’-1,2-ethylenediylbis-L-cysteinediethylester, (ECD) (Neurolite), labelled

with 99mTc, is a neutral lipophilic complex that crosses the intact blood–brain barrier
rapidly and is retained in the brain for a long time, making it possible to perform
detailed tomographic studies of regional cerebral blood flow.
(C99) Kinetic data from humans (Holman et al., 1989; Vallabhajosula et al., 1989;
Léveillé et al., 1992) have shown that the substance is cleared rapidly from the blood
after intravenous injection. Uptake in the brain reaches a maximum of 4.9–6.5%
within 1 min, and remains relatively constant over several hours. Early whole-body
imaging also shows uptake in lungs, liver, kidneys, and thyroid.
(C100) In the model, it is assumed that there is immediate cellular uptake of the
substance in the brain (0.06), lungs (0.06), liver (0.20), kidneys (0.10), and thyroid
(0.003). The activity in the brain is cleared bi-exponentially with half-times of 1 h
(0.40) and 1.5 days (0.60). At 48 h, approximately 80% has been excreted in urine
and 20% in faeces. Activity in the liver is assumed to be excreted through the
intestines, partly via the gallbladder, according to the model described in Section
A.9 in Publication 53 (ICRP, 1987). The rest of the activity is assumed to be excreted
via the kidneys and urinary bladder.
(C101) For children, the fractional uptake in the brain is higher due to the relative
weight of the brain (Barthel et al., 1997).

99m
C.32.2. References for Tc-ethylenedicysteine diester
Barthel, H., Wiener, M., Dannenberg, C., Bettin, S., Sattler, B., Knapp, W.H., 1997. Age-
specific cerebral perfusion in 4- to 15-year-old children: a high-resolution brain SPET study
using 99mTc-ECD. Eur. J. Nucl. Med. 24, 1245–1252.
Holman, B.L., Hellman, R.S., Goldsmith, S.J., et al., 1989. Biodistribution, dosimetry and
clinical evaluation of technetium-99m ethyl cysteinate dimer in normal subjects and in
patients with chronic cerebral infarction. J. Nucl. Med. 30, 1018–1024.
ICRP, 1987. Radiation dose to patients from radiopharmaceuticals. ICRP Publication 53.
Ann. ICRP 18(1–4).
Léveillé, J., Demonceau, G., Walovitch, R.C., 1992. Intrasubject comparison between tech-
netium-99m-ECD and technetium-99m-HMPAO in healthy human subjects. J. Nucl. Med.
33, 480–484.
Vallabhajosula, S., Zimmerman, R.E., Picard, M., et al., 1989. Technetium-99m ECD: a new
brain imaging agent. In vivo kinetics and biodistribution studies in normal human subjects.
J. Nucl. Med. 30, 599–604.

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99m
Table C.64. Biokinetic data for Tc-ethylenedicysteine diester.

Organ (S) Fs T (h) a Ãs/A0 (h)

Brain 1.0 0.4

36 0.6
Adult 0.06 0.30
15 years 0.10 0.50
10 years 0.17 0.84
5 years 0.23 1.1
1 year 0.28 1.4

Thyroid 0.003 1.0 0.7 0.0093

36 0.3
Lungs 0.06 0.25 0.8 0.082
10 0.2
Kidneys 0.10 0.50 0.9 0.13
36 0.1
Liver 0.20 0.50 0.9 0.27
36 0.1
Other organs and tissues 1.0 0.7
36 0.3
Adult 0.577 1.8
15 years 0.537 1.7
10 years 0.467 1.5
5 years 0.407 1.3
1 year 0.357 1.1

Gallbladder contents 0.07 0.19

Gastrointestinal tract contents
Small intestine 0.20 0.44
Upper large intestine 0.20 0.58
Lower large intestine 0.20 0.28
Urinary bladder contents 0.80
Adult 1.2
15 years 1.2
10 years 1.1
5 years 0.92
1 year 0.58

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99m
Table C.65. Absorbed doses for Tc-ethylenedicysteine diester.

Absorbed dose per unit activity administered (mGy MBq1)

Organ Adult 15 years 10 years 5 years 1 year

Adrenals 2.5E03 3.1E03 4.5E03 6.5E03 1.1E02

Bone surfaces 3.5E03 4.3E03 6.4E03 9.4E03 1.5E02
Brain 4.9E03 8.0E03 1.4E02 1.9E02 3.1E02
Breast 8.9E04 1.1E03 1.6E03 2.4E03 4.3E03
Gallbladder wall 2.8E02 3.2E02 4.2E02 7.3E02 2.4E01
Gastrointestinal tract
Stomach wall 2.7E03 3.5E03 5.6E03 8.3E03 1.3E02
Small intestine wall 1.2E02 1.6E02 2.5E02 3.8E02 6.8E02
Colon wall 2.1E02 2.6E02 4.3E02 6.7E02 1.2E01
(Upper large intestine wall 2.3E02 2.9E02 4.8E02 7.5E02 1.4E01)
(Lower large intestine wall 1.8E02 2.2E02 3.6E02 5.6E02 1.0E01)
Heart wall 1.6E03 2.0E03 2.9E03 4.2E03 7.2E03
Kidneys 8.7E03 1.0E02 1.5E02 2.1E02 3.5E02
Liver 5.0E03 6.3E03 9.5E03 1.4E02 2.4E02
Lungs 2.1E03 2.9E03 4.0E03 5.9E03 1.1E02
Muscles 2.2E03 2.7E03 3.8E03 5.4E03 8.7E03
Oesophagus 1.2E03 1.5E03 2.0E03 3.0E03 5.1E03
Ovaries 7.9E03 9.9E03 1.4E02 1.9E02 2.9E02
Pancreas 2.9E03 3.7E03 6.0E03 9.0E03 1.4E02
Red marrow 2.4E03 3.0E03 4.2E03 5.5E03 8.9E03
Skin 1.1E03 1.3E03 2.0E03 3.0E03 5.2E03
Spleen 2.0E03 2.6E03 3.9E03 5.7E03 9.5E03
Testes 2.7E03 3.6E03 5.8E03 7.9E03 1.1E02
Thymus 1.2E03 1.5E03 2.0E03 3.0E03 5.1E03
Thyroid 6.1E03 9.6E03 1.5E02 3.1E02 5.8E02
Urinary bladder wall 5.0E02 6.2E02 8.7E02 1.1E01 1.3E01
Uterus 9.2E03 1.1E02 1.7E02 2.2E02 2.9E02
Remaining organs 2.8E03 3.8E03 6.8E03 1.3E02 2.1E02

Effective dose (mSv MBq1) 7.7E03 9.9E03 1.5E02 2.2E02 4.0E02

99m
The physical half-life of Tc is 6.01 h.

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 99m
C.33. Tc-furifosmin (Q12)
C.33.1. Biokinetic model

(C102) [Trans-1,2-bis(dihydro-2,2,5,5-tetramethyl-3(2H)furanone-4-methylenei-
mino ethane) bis tris(3-methoxy-1propyl)–phosphine] technetium (III)-99 m is a
non-reducible complex of Tc(III). 99mTc-furifosmin is prepared from a freeze-dried
kit (TechneCard) and is used for studies of myocardial perfusion.
(C103) 99mTc-furifosmin accumulates in viable myocardial tissue in proportion to
regional blood flow in a manner similar to thallous chloride. After intravenous injec-
tion, the substance is cleared rapidly from the blood (<5% left by 20 min) and taken
up predominantly in muscular tissues (including heart), liver, and kidneys.
Biodistribution is generally similar to that of 99mTc-methyl oxy-isobutyl-isonitrile
(MIBI, Cardiolite) (ICRP, 1991) and 99mTc-tetrofosmin (Myoview; ICRP, 1998),
but there are some differences which have a bearing on diagnostic technique. 99mTc-
furifosmin shows a heart uptake of 1.2–2.4%. It is cleared rapidly from the liver
(<6.5% left by 1 h), and lung uptake is low (4%). More than 50% of the substance
has entered excretory pathways by 24 h and the faecal:urinary excretion ratio is 60:40.
(C104) It is assumed that the fractions of the substance taken up by the liver
and kidneys are excreted in faeces and urine, respectively. When the substance is
injected in conjunction with an exercise stress test, there is little change in heart
uptake, and biodistribution is similar to that observed at rest. The initial rate of
urinary clearance is lower than at rest, and the same faecal:urinary excretion ratio
is assumed.
(C105) The quantitative figures for uptake and excretion in man, presented in
Table C.66, are based on the rest and exercise studies of Rossetti et al. (1994) with
supplementary information from Gerson et al. (1994). Substance excreted by the
hepatobiliary system is assumed to leave the body via the intestinal tract according
to the ICRP model for the gastrointestinal tract (ICRP, 1979).
(C106) The biodistribution and excretion data used to derive this model were
based on a small number of subjects (seven at rest and three after exercise), with
the result that significant differences between rest and exercise data could not be
established. The difference between the biokinetic data tables presented for rest
and exercise studies is therefore largely based on experience of models for similar
99m
Tc-labelled myocardial perfusion imaging agents such as MIBI and
tetrofosmin.

99m
C.33.2. References for Tc-furifosmin
Gerson, M.C., Lukes, J., Deutsch, E., et al., 1994. Comparison of technetium 99m Q12 and
thallium 201 for detection of angiographically documented coronary artery disease in
humans. J. Nucl. Cardiol. 1, 499–508.
ICRP, 1979. Limits for intakes of radionuclides by workers. ICRP Publication 30, Part 1.
Ann. ICRP 2(3/4).

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ICRP, 1991. Radiation dose to patients from radiopharmaceuticals. Addendum 1 to

Publication 53. ICRP Publication 62. Ann. ICRP 22(3).
ICRP, 1998. Radiation dose to patients from radiopharmaceuticals. Addendum 2 to ICRP
Publication 53. ICRP Publication 80. Ann. ICRP 28(3).
Rossetti, C., Vanoli, G., Paganelli, G., et al., 1994. Human biodistribution, dosimetry and
clinical use of technetium (III)-99m-Q12. J. Nucl. Med. 35, 1571–1580.

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99m
Table C.66. Biokinetic data for Tc-furifosmin.

Organ (S) Fs T (h) a Ãs/A0 (h)

Resting subject
Heart wall 0.024 6.0 0.67 0.13
24 0.33
Lungs 0.04 24 1.0 0.28
Kidneys 0.052 1.0 0.5 0.21
24 0.5
Liver 0.07 6.0 1.0 0.30
Other organs and tissues 0.814 0.42 0.48 3.4
36 0.52
Gallbladder contents 0.20 0.35
Gastrointestinal tract contents
Small intestine 0.60 0.72
Upper large intestine 0.60 0.94
Lower large intestine 0.60 0.46
Urinary bladder contents 0.40
Adult, 15 years, 10 years 0.47
5 years 0.40
1 year 0.26

Exercise
Heart wall 0.027 6.0 0.67 0.14
24 0.33
Lungs 0.04 24 1.0 0.28
Kidneys 0.06 1.3 0.75 0.23
24 0.25
Liver 0.08 6.0 1.0 0.26
Other organs and tissues 0.793 1.0 0.45 4.0
96 0.55
Gallbladder contents 0.20 0.29
Gastrointestinal tract contents
Small intestine 0.60 0.59
Upper large intestine 0.60 0.77
Lower large intestine 0.60 0.38
Urinary bladder contents 0.40
Adult, 15 years, 10 years 0.38
5 years 0.32
1 year 0.21

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99m
Table C.67. Absorbed doses for Tc-furifosmin.

Absorbed dose per unit activity administered (mGy MBq1)

Organ
Adult 15 years 10 years 5 years 1 year

Resting subject
Adrenals 4.3E03 5.5E03 8.4E03 1.2E02 2.1E02
Bone surfaces 5.1E03 6.2E03 9.1E03 1.3E02 2.4E02
Brain 1.6E03 2.0E03 3.3E03 5.3E03 9.3E03
Breast 1.8E03 2.2E03 3.5E03 5.7E03 1.1E02
Gallbladder wall 5.1E02 5.7E02 7.5E02 1.3E01 4.4E01
Gastrointestinal tract
Stomach wall 4.6E03 6.2E03 1.0E02 1.5E02 2.6E02
Small intestine wall 1.9E02 2.4E02 3.9E02 6.1E02 1.1E01
Colon wall 3.2E02 4.1E02 6.8E02 1.1E01 1.9E01
(Upper large intestine wall 3.6E02 4.7E02 7.7E02 1.2E01 2.2E01)
(Lower large intestine wall 2.6E02 3.3E02 5.5E02 8.8E02 1.6E01)
Heart wall 7.8E03 1.0E02 1.5E02 2.3E02 4.0E02
Kidneys 1.4E02 1.7E02 2.3E02 3.4E02 5.8E02
Liver 6.9E03 8.8E03 1.3E02 1.9E02 3.4E02
Lungs 5.5E03 7.8E03 1.1E02 1.7E02 3.1E02
Muscles 3.1E03 3.9E03 5.8E03 8.7E03 1.5E02
Oesophagus 2.5E03 3.2E03 4.6E03 7.1E03 1.3E02
Ovaries 1.0E02 1.3E02 1.9E02 2.8E02 4.6E02
Pancreas 5.1E03 6.6E03 1.1E02 1.7E02 2.7E02
Red marrow 3.7E03 4.4E03 6.4E03 8.7E03 1.4E02
Skin 1.7E03 2.0E03 3.1E03 5.0E03 9.3E03
Spleen 3.6E03 4.7E03 7.4E03 1.1E02 2.0E02
Testes 2.7E03 3.5E03 5.7E03 8.8E03 1.5E02
Thymus 2.5E03 3.2E03 4.6E03 7.1E03 1.3E02
Thyroid 2.0E03 2.6E03 4.2E03 6.7E03 1.2E02
Urinary bladder wall 2.2E02 2.9E02 4.2E02 5.5E02 7.1E02
Uterus 8.8E03 1.1E02 1.7E02 2.5E02 3.9E02
Remaining organs 3.8E03 4.9E03 7.6E03 1.2E02 2.0E02

Effective dose (mSv MBq1) 1.0E02 1.3E02 1.8E02 3.0E02 5.7E02

(continued on next page)

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 ICRP Publication 128

Table C.67. (continued)

Absorbed dose per unit activity administered (mGy MBq1)

Organ
Adult 15 years 10 years 5 years 1 year

Exercise
Adrenals 4.5E03 5.7E03 8.7E03 1.3E02 2.2E02
Bone surfaces 5.5E03 6.6E03 9.7E03 1.4E02 2.6E02
Brain 1.9E03 2.4E03 3.9E03 6.3E03 1.1E02
Breast 2.0E03 2.5E03 3.9E03 6.2E03 1.2E02
Gallbladder wall 4.3E02 4.9E02 6.3E02 1.1E01 3.6E01
Gastrointestinal tract
Stomach wall 4.6E03 6.2E03 1.0E02 1.5E02 2.5E02
Small intestine wall 1.6E02 2.1E02 3.3E02 5.1E02 9.2E02
Colon wall 2.7E02 3.4E02 5.7E02 8.9E02 1.7E01
(Upper large intestine wall 3.0E02 3.9E02 6.4E02 1.0E01 1.9E01)
(Lower large intestine wall 2.2E02 2.8E02 4.7E02 7.4E02 1.4E01)
Heart wall 8.7E03 1.1E02 1.7E02 2.5E02 4.4E02
Kidneys 1.5E02 1.8E02 2.5E02 3.6E02 6.1E02
Liver 6.3E03 7.9E03 1.2E02 1.7E02 3.0E02
Lungs 5.6E03 8.0E03 1.1E02 1.7E02 3.1E02
Muscles 3.2E03 4.0E03 6.0E03 9.0E03 1.6E02
Oesophagus 2.9E03 3.6E03 5.2E03 8.1E03 1.4E02
Ovaries 9.2E03 1.2E02 1.7E02 2.5E02 4.2E02
Pancreas 5.2E03 6.7E03 1.1E02 1.6E02 2.7E02
Red marrow 3.7E03 4.5E03 6.6E03 9.1E03 1.5E02
Skin 1.8E03 2.2E03 3.4E03 5.5E03 1.0E02
Spleen 3.9E03 4.9E03 7.8E03 1.2E02 2.1E02
Testes 2.8E03 3.6E03 5.7E03 8.9E03 1.5E02
Thymus 2.9E03 3.6E03 5.2E03 8.1E03 1.4E02
Thyroid 2.4E03 3.0E03 4.9E03 7.8E03 1.4E02
Urinary bladder wall 1.8E02 2.3E02 3.4E02 4.4E02 5.8E02
Uterus 7.9E03 9.9E03 1.5E02 2.2E02 3.6E02
Remaining organs 3.8E03 4.9E03 7.5E03 1.2E02 2.0E02

Effective dose (mSv MBq1) 8.9E03 1.1E02 1.6E02 2.7E02 5.1E02

99m
The physical half-life of Tc is 6.01 h.

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 99m
C.34. Tc-labelled human immunoglobulin (HIG)
C.34.1. Biokinetic model

(C107) Labelled non-specific (polyclonal) human immunoglobulin of IgG-type

(HIG) is used to localise and image focal sites of infection and inflammation in
the body. Increased vascular permeability and trapping of HIG by inflammatory
cells is believed to play a role in the accumulation of radioactivity in the foci.
(C108) Native IgG has a half-time in the body of approximately 23 days (Solomon
et al., 1963). After labelling with 99mTc or 111In, a much shorter half-time of the
radioactivity in the body is observed, probably due to some alteration of the protein
during the labelling procedure and to partial dissociation of the label from the carrier
protein.
(C109) After intravenous injection, the initial distribution is determined by the
blood content of the organs. The early whole-body image therefore shows the heart,
major blood vessels, lungs, liver, spleen, kidneys, mucosae of the nose and vagina,
and the external genitalia. There is also early activity in the bladder. Blood activity
falls slowly due to the combined effect of distribution of HIG into extravascular
spaces, uptake and excretion via the kidneys of some dissociated label, and some
active uptake in the liver. As a consequence, delayed images (at 24 h) are dominated
by activity in liver and kidneys, while activity in other blood-rich organs has
decreased. There is no visible uptake in the bone marrow, and activity in the intes-
tines is only seen occasionally. The urine contains 27–50% of administered activity
after 24 h. For detailed information, see Buscombe et al. (1990), Corstens and
Claessens (1992), Datz et al. (1995), Hovi et al. (1993), Kinne et al. (1993),
Saptogino et al. (1991), and Sciuk et al. (1991).
(C110) The dosimetric model assumes an initial blood pool distribution, with
organ blood content according to Publication 23 (ICRP, 1975). There is rapid
uptake (T1/2 ¼ 1 h) in the liver (5%) and kidneys (8%); the kidney contents are
excreted in the urine with a half-time of 6 h. The rest of the blood activity falls
with a half-time of 12 h because of distribution into other organs and tissues
(50%) and direct excretion in the urine (37%). In view of the short physical half-
life of the label, infinite half-time is assumed for activity remaining in the body.

99m
C.34.2. References for Tc-labelled human immunoglobulin
Buscombe, J.R., Lui, D., Ensing, G., et al., 1990. 99mTc-human immunoglobulin (HIG) – first
results of a new agent for the localisation of infection and inflammation. Eur. J. Nucl. Med.
16, 649–655.
Corstens, F.H.M., Claessens, R.A.M.J., 1992. Imaging inflammation with polyclonal immu-
noglobulin: not looked for but discovered. Eur. J. Nucl. Med. 19, 155–158.
Datz, F.L., Castronovo, F.P., Christian, P.E., et al., 1995. Biodistribution and dosimetry of
indium-111-polyclonal IgG in normal subjects. J. Nucl. Med. 36, 2372–2379.
Hovi, I., Taavitsainen, M., Lantto, T., et al., 1993. Technetium-99m-HMPAO-labeled leuko-
cytes and technetium-99m-labelled human polyclonal immunoglobulin G in diagnosis of
focal purulent disease. J. Nucl. Med. 9, 1428–1434.

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 ICRP Publication 128

ICRP, 1975. A Report of the Task Group on Reference Man. ICRP Publication 23. Pergamon
Press, Oxford.
Kinne, R.W., Becker, W., Schwab, J., et al., 1993. Comparison of 99Tcm-labelled specific
murine anti-CD4 monoclonal antibodies and non-specific human immunoglobulin for
imaging inflamed joints in rheumatoid arthritis. Nucl. Med. Comm. 14, 667–675.
Saptogino, A., Becker, W., Wolf, F., 1991. Biokinetics and estimation of dose from 99Tcm
labelled polyclonal human immunoglobulin (HIG). Nuklearmedizin 30, 18–23.
Sciuk, J., Brandau, W., Vollet, B., et al., 1991. Comparison of technetium-99m polyclonal
human immunoglobulin and technetium-99m monoclonal antibodies for imaging chronic
osteomyelitis. Eur. J. Nucl. Med. 18, 401–407.
Solomon, A., Waldmann, T.A., Fahey, J.L., 1963. Metabolism of normal 6,6 S g-globulin in
normal subjects and in patients with macroglobulinemia and multiple myeloma. J. Lab.
Clin. Med. 62, 1–17.

99m
Table C.68. Biokinetic data for Tc-labelled human immunoglobulin.

Organ (S) Fs T (h) a Ãs/A0 (h)

Blood 1.00 1.0 0.13 5.2

12 0.87
Liver 0.05 1.0 1.00 0.37
1 1.00
Kidneys 0.08 1.0 1.00 0.30
6.0 1.00
Testes 0.003 1.0 1.00 0.018
24 1.00
Other organs and tissues 0.50 12 1.00 1.5
1 1.00
Urinary bladder contents 0.45
From activity accumulated in kidneys (0.08)
Excreted directly from blood (0.37)
Adult, 15 years 0.26
10 years 0.23
5 years, 1 year 0.15

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99m
Table C.69. Absorbed doses for Tc-labelled human immunoglobulin.

Absorbed dose per unit activity administered (mGy MBq1)

Organ Adult 15 years 10 years 5 years 1 year

Adrenals 8.4E03 1.0E02 1.6E02 2.5E02 4.5E02

Bone surfaces 6.9E03 1.0E02 1.6E02 2.7E02 5.5E02
Brain 3.1E03 3.9E03 6.4E03 1.0E02 1.9E02
Breast 2.9E03 3.5E03 5.8E03 9.1E03 1.6E02
Gallbladder wall 6.4E03 8.0E03 1.2E02 1.9E02 2.7E02
Gastrointestinal tract
Stomach wall 4.3E03 5.5E03 9.0E03 1.3E02 2.3E02
Small intestine wall 4.0E03 5.0E03 7.8E03 1.2E02 2.1E02
Colon wall 3.9E03 5.0E03 7.7E03 1.2E02 2.0E02
(Upper large intestine wall 4.0E03 5.2E03 8.0E03 1.3E02 2.1E02)
(Lower large intestine wall 3.7E03 4.7E03 7.3E03 1.0E02 1.9E02)
Heart wall 1.6E02 2.0E02 3.1E02 4.7E02 8.1E02
Kidneys 2.3E02 2.8E02 4.0E02 6.0E02 1.1E01
Liver 1.3E02 1.6E02 2.5E02 3.6E02 6.5E02
Lungs 1.3E02 1.6E02 2.5E02 4.0E02 7.5E02
Muscles 3.1E03 3.9E03 5.8E03 8.8E03 1.6E02
Oesophagus 4.9E03 5.8E03 8.1E03 1.2E02 2.0E02
Ovaries 3.9E03 5.0E03 7.2E03 1.1E02 1.9E02
Pancreas 6.1E03 7.5E03 1.1E02 1.8E02 3.0E02
Red marrow 5.5E03 6.8E03 1.1E02 1.7E02 3.1E02
Skin 1.9E03 2.3E03 3.7E03 6.0E03 1.1E02
Spleen 1.0E02 1.3E02 2.1E02 3.3E02 6.0E02
Testes 7.6E03 1.6E02 1.0E01 1.2E01 1.6E01
Thymus 4.9E03 5.8E03 8.1E03 1.2E02 2.0E02
Thyroid 4.6E03 5.8E03 9.5E03 1.5E02 2.9E02
Urinary bladder wall 1.3E02 1.7E02 2.2E02 2.4E02 4.4E02
Uterus 4.5E03 5.5E03 8.2E03 1.2E02 2.0E02
Remaining organs 3.2E03 4.0E03 6.9E03 1.2E02 2.1E02

Effective dose (mSv MBq1) 7.0E03 9.4E03 2.1E02 2.9E02 4.7E02

99m
The physical half-life of Tc is 6.01 h.

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 99m
C.35. Tc-labelled hexamethylpropyleneamineoxine (HM-PAO)
C.35.1. Biokinetic model

(C111) The d,1 diastereoisomer of hexamethylpropyleneamineoxine (HM-PAO)

labelled with 99mTc is a lipophilic complex that crosses the intact blood–brain barrier
rapidly and is retained in the brain for a long time, making detailed tomographic
studies of the regional cerebral blood flow possible. Quantitative studies in man have
shown that the substance is rapidly cleared from the blood after intravenous injec-
tion. Uptake in the brain reaches a maximum of 4–6% within 1 min, and there is little
loss of activity for the following 24 h. Early whole-body scans also show uptake in
lungs, liver, gastrointestinal tract, kidneys, and thyroid. A great part of the activity is
widely distributed throughout the body, particularly in muscle and soft tissue.
Except for the brain, the activity leaves the organs and tissues within a few days
by excretion in urine and faeces. At 48 h, approximately 40% has been excreted in
urine and 15% in faeces. The reader is referred to Costa et al. (1986), Sharp et al.
(1986), Soundy et al. (1990), and Vestergren et al. (1991) for further information.
(C112) In the model, it is assumed that there is an immediate cellular uptake of the
substance in the brain (0.05), lungs (0.10), liver (0.15), gastrointestinal tract (0.05),
kidneys (0.09), and thyroid (0.008). The uptake in gastrointestinal walls (0.05) is
assumed to be apportioned according to the relative weights of the walls. The activity
of the labelled radiopharmaceutical is cleared from the brain mono-exponentially
with a half-time of 4 days, while most of the other organs and tissues are cleared bi-
exponentially. Activity in the liver is assumed to be excreted to the intestine, partly
via the gallbladder, according to the model described in Section A.9 in Publication 53
(ICRP, 1987).
(C113) For children, the fractional uptake in the brain is higher due to the higher
relative weight of the brain. In some cases, uptake in the lacrimal gland has also been
seen. Villanueva-Meyer et al. (1990) reported significant uptake in 15 of their 138
adult patients, resulting in an absorbed dose of 0.014 mGy MBq1 to the lacrimal
gland. This does not influence the effective dose value.

99m
C.35.2. References for Tc-labelled hexamethylpropyleneamineoxine
Costa, D.C., Ell, P.J., Cullum, I.D., et al., 1986. The in vivo distribution of 99mTc-HM-PAO in
normal man. Nucl. Med. Comm. 7, 647–658.
ICRP, 1987. Radiation dose to patients from radiopharmaceuticals. ICRP Publication 53.
Ann. ICRP 18(1–4).
Sharp, P.F., Smith, F.W., Gemmel, H.G., et al., 1986. Technetium-99m HM-PAO stereoi-
somers as potential agents for imaging regional cerebral blood flow: human volunteer
studies. J. Nucl. Med. 27, 171–177.
Soundy, R.G., Tyrrell, D.A., Pickett, R.D., et al., 1990. The radiation dosimetry of 99mTc-
exametazime. Nucl. Med. Comm. 11, 791–799.
Vestergren, E., Jacobsson, L., Mattsson, S., et al., 1992. Biokinetics and dosimetry of Tc-99 m
HM-PAO in children. In: S-Stelson, A., Watson, E.E. (Eds.), Fifth International

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 Radiation dose to patients from radiopharmaceuticals

Radiopharmaceutical Dosimetry Symposium, Oak Ridge, TN, USA, May 7–10, 1992.
CONF-910529. Oak Ridge Associated Universities, Oak Ridge, TN, USA, pp. 444–456.
Villanueva-Meyer, J., Thompson, D., Mena, I., et al., 1990. Lachrymal gland dosimetry for
the brain imaging agent technetium-99m-HMPAO. J. Nucl. Med. 31, 1237–1239.

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 ICRP Publication 128

99m
Table C.70. Biokinetic data for Tc-labelled hexamethylpropyleneamineoxine.

Organ (S) Fs T (h) a Ãs/A0 (h)

Brain 96 1.0
Adult 0.05 0.41
15 years 0.08 0.65
10 years 0.12 0.98
5 years 0.15 1.2
1 year, newborn 0.20 1.6

Thyroid 0.008 1.0 0.35 0.043

48 0.65
Lungs 0.10 1.67 0.15 0.71
72 0.85
Liver 0.15 0.75 0.50 0.51
12 0.50
Other organs and tissues 1.0 0.35
48 0.65
Adult 0.55 3.0
15 years 0.52 2.8
10 years 0.48 2.6
5 years 0.45 2.5
1 year, newborn 0.40 2.2
Gallbladder contents 0.05 0.098
Gastrointestinal tract
Stomach wall 0.0065 2.0 0.15 0.047
Small intestine wall 0.028 96 0.85 0.20
2.0 0.15
96 0.85
Upper large intestine wall 0.0091 2.0 0.15 0.065
96 0.85
Lower large intestine wall 0.0069 2.0 0.15 0.050
96 0.85
Stomach contents 0.0065 0.00094
Small intestine contents 0.185 0.24
Upper large intestine contents 0.194 0.32
Lower large intestine contents 0.20 0.16
Kidneys 0.09 24 1.00 0.65
Urinary bladder contents 0.80
Adult 0.49
15 years 0.47
10 years 0.38
5 years 0.24
1 year, newborn 0.22

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99m
Table C.71. Absorbed doses for Tc-labelled hexamethylpropyleneamineoxine.

Absorbed dose per unit activity administered(mGy MBq1)

Organ Adult 15 years 10 years 5 years 1 year Newborn

Adrenals 5.3E03 6.7E03 9.9E03 1.4E02 2.4E02 6.6E02

Bone surfaces 5.1E03 6.4E03 9.4E03 1.4E02 2.4E02 7.3E02
Brain 6.8E03 1.1E02 1.6E02 2.1E02 3.7E02 8.4E02
Breast 2.0E03 2.4E03 3.7E03 5.6E03 9.5E03 3.4E02
Gallbladder wall 1.8E02 2.1E02 2.8E02 4.8E02 1.4E01 3.2E01
Gastrointestinal tract
Stomach wall 6.4E03 8.5E03 1.2E02 1.9E02 3.6E02 1.4E01
Small intestine wall 1.2E02 1.5E02 2.4E02 3.6E02 6.5E02 2.1E01
Colon wall 1.7E02 2.2E02 3.5E02 5.5E02 1.0E01 2.9E01
(Upper large intestine wall 1.8E02 2.4E02 3.8E02 6.0E02 1.1E01 3.1E01)
(Lower large intestine wall 1.5E02 1.9E02 3.1E02 4.8E02 9.0E02 2.7E01)
Heart wall 3.7E03 4.7E03 6.7E03 9.7E03 1.6E02 5.0E02
Kidneys 3.4E02 4.1E02 5.7E02 8.1E02 1.4E01 3.6E01
Liver 8.6E03 1.1E02 1.6E02 2.3E02 4.0E02 9.2E02
Lungs 1.1E02 1.6E02 2.2E02 3.4E02 6.3E02 1.7E01
Muscles 2.8E03 3.5E03 5.0E03 7.3E03 1.3E02 4.5E02
Oesophagus 2.6E03 3.3E03 4.7E03 6.9E03 1.1E02 4.1E02
Ovaries 6.6E03 8.3E03 1.2E02 1.7E02 2.7E02 8.1E02
Pancreas 5.1E03 6.5E03 9.7E03 1.4E02 2.3E02 6.9E02
Red marrow 3.4E03 4.1E03 5.9E03 8.0E03 1.4E02 4.2E02
Skin 1.6E03 1.9E03 2.9E03 4.5E03 8.3E03 3.2E02
Spleen 4.3E03 5.4E03 8.2E03 1.2E02 2.0E02 5.9E02
Testes 2.4E03 3.0E03 4.4E03 6.1E03 1.1E02 3.9E02
Thymus 2.6E03 3.3E03 4.7E03 6.9E03 1.1E02 4.1E02
Thyroid 2.6E02 4.2E02 6.3E02 1.4E01 2.6E01 3.7E01
Urinary bladder wall 2.3E02 2.8E02 3.3E02 3.3E02 5.6E02 1.5E01
Uterus 6.6E03 8.1E03 1.2E02 1.5E02 2.5E02 7.5E02
Remaining organs 3.2E03 4.0E03 6.0E03 9.2E03 1.7E02 5.3E02

Effective dose (mSv MBq1) 9.3E03 1.1E02 1.7E02 2.7E02 4.9E02 1.2E01
99m
The physical half-life of Tc is 6.01 h.

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 99m
C.36. Tc-labelled iminodiacetic acid derivatives (HIDA, etc.)
C36.1. Biokinetic model

(C114) 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
IDA, and are named according to type of substitute [e.g. BIDA, DISIDA (diso-
fenin), EIDA, HIDA, PBIDA, PIPIDA, and mebrofenin].
(C115) The dosimetry model has been presented in Section A.9 in Publication 53
(ICRP, 1987). Calculations are performed for the normal case, and for three patho-
logical conditions, namely parenchymal liver disease, cholecystitis with occlusion of
the cystic duct, and occlusion of the common bile duct. The assumed magnitude and
rate of the different flows in the model are evident from the FS and T values in
Table C.72. The final excretion from the body follows the model for the gastroin-
testinal tract [Section A.3 in Publication 53 (ICRP, 1987)] and the kidney–bladder
model [Section A.5 in Publication 53 (ICRP, 1987)]. In the atresia case, it is assumed
that activity initially taken up in the liver is transported slowly (T1/2 ¼ 8 days) back to
blood for excretion by the kidneys.

99m
C36.2. Reference for Tc-labelled iminodiacetic acid derivatives
ICRP, 1987. Radiation dose to patients from radiopharmaceuticals. ICRP Publication 53.
Ann. ICRP 18(1–4).

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99m
Table C.72. Biokinetic data for Tc-labelled iminodiacetic acid derivatives.

Organ (S) Fs T (h) a Ãs/A0 (h)

Normal hepatobiliary conditions

Blood 1.0 0.10 1.0 0.14
Liver 0.85 0.10 1.0 0.80
0.75 1.0
Gallbladder contents 0.30 0.77
Gastrointestinal tract contents
Small intestine 0.85 1.8
Upper large intestine 0.85 2.3
Lower large intestine 0.85 1.1
Kidneys 0.15 0.012
Urinary bladder contents 0.15
Adult, 15 years, 10 years 0.41
5 years 0.36
1 year 0.24

Parenchymal liver disease

Blood 1.0 0.33 1.0 0.46
Liver 0.35 0.33 1.0 0.72
2.0 1.0
Gallbladder contents 0.10 0.22
Gastrointestinal tract contents
Small intestine 0.35 0.61
Upper large intestine 0.35 0.80
Lower large intestine 0.35 0.39
Kidneys 0.65 0.079
Urinary bladder contents 0.65
Adult, 15 years, 10 years 1.6
5 years 1.3
1 year 0.87

Occlusion of the cystic duct

Blood 1.0 0.17 1.0 0.23
Liver 0.7 0.17 1.0 0.66
0.75 1.0
Gastrointestinal tract contents
Small intestine 0.7 1.7
Upper large intestine 0.7 2.2
Lower large intestine 0.7 1.1
(continued on next page)

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Table C.72. (continued)

Organ (S) Fs T (h) a Ãs/A0 (h)

Kidneys 0.3 0.024

Urinary bladder contents 0.3
Adult, 15 years, 10 years 0.79
5 years 0.68
1 year 0.46

Occlusion of the common bile duct

Blood 1.0 0.10 1.0 0.14
Liver 0.85 0.10 1.0 7.0
Kidneys 1.0 190 1.0 0.014
Urinary bladder contents 1.0 0.46

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99m
Table C.73. Absorbed doses for Tc-labelled iminodiacetic acid derivatives.

Absorbed dose per unit administrated activity (mGy MBq1)

Organ Adult 15 years 10 years 5 years 1 year

Normal hepatobiliary conditions

Adrenals 3.7E03 4.7E03 7.5E03 1.1E02 1.8E02
Bone surfaces 3.6E03 4.5E03 6.4E03 9.5E03 1.8E02
Brain 7.0E05 9.0E05 1.6E04 2.7E04 5.2E04
Breast 4.7E04 6.4E04 1.3E03 2.4E03 4.7E03
Gallbladder wall 1.1E01 1.2E01 1.6E01 2.8E01 9.5E01
Gastrointestinal tract
Stomach wall 5.6E03 7.7E03 1.3E02 2.0E02 3.4E02
Small intestine wall 4.3E02 5.4E02 8.9E02 1.4E01 2.5E01
Colon wall 7.2E02 9.3E02 1.5E01 2.4E01 4.6E01
(Upper large intestine wall 8.4E02 1.1E01 1.8E01 2.8E01 5.3E01)
(Lower large intestine wall 5.6E02 7.2E02 1.2E01 1.9E01 3.7E01)
Heart wall 1.8E03 2.4E03 3.9E03 6.3E03 1.2E02
Kidneys 6.1E03 7.5E03 1.1E02 1.6E02 2.5E02
Liver 1.4E02 1.8E02 2.7E02 4.0E02 7.1E02
Lungs 1.4E03 1.9E03 2.9E03 4.8E03 8.9E03
Muscles 2.7E03 3.4E03 5.0E03 7.5E03 1.3E02
Oesophagus 4.0E04 5.9E04 8.9E04 1.6E03 3.2E03
Ovaries 1.8E02 2.3E02 3.4E02 4.8E02 8.0E02
Pancreas 5.6E03 7.6E03 1.4E02 2.2E02 3.4E02
Red marrow 3.8E03 4.5E03 6.1E03 7.5E03 9.8E03
Skin 8.3E04 1.0E03 1.5E03 2.5E03 4.8E03
Spleen 2.6E03 3.5E03 6.2E03 9.8E03 1.7E02
Testes 1.0E03 1.5E03 2.9E03 5.0E03 9.6E03
Thymus 4.0E04 5.9E04 8.9E04 1.6E03 3.2E03
Thyroid 1.4E04 2.1E04 4.2E04 7.7E04 1.9E03
Urinary bladder wall 6.5E03 8.6E03 1.3E02 2.0E02 3.4E02
Uterus 1.1E02 1.5E02 2.3E02 3.5E02 5.7E02
Remaining organs 4.1E03 5.6E03 8.9E03 1.5E02 2.3E02

Effective dose (mSv MBq1) 1.6E02 2.0E02 2.7E02 4.3E02 1.0E01

(continued on next page)

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Table C.73. (continued)

Absorbed dose per unit administrated activity (mGy MBq1)

Organ Adult 15 years 10 years 5 years 1 year

Parenchymal liver disease

Adrenals 2.7E03 3.3E03 5.2E03 7.6E03 1.3E02
Bone surfaces 2.5E03 3.1E03 4.5E03 6.7E03 1.3E02
Brain 2.2E04 2.8E04 4.7E04 7.6E04 1.4E03
Breast 4.6E04 5.9E04 1.1E03 1.9E03 3.6E03
Gallbladder wall 3.4E02 3.8E02 5.0E02 8.7E02 2.8E01
Gastrointestinal tract
Stomach wall 2.5E03 3.4E03 5.8E03 9.4E03 1.6E02
Small intestine wall 1.6E02 2.1E02 3.4E02 5.3E02 9.5E02
Colon wall 2.7E02 3.5E02 5.8E02 9.2E02 1.7E01
(Upper large intestine wall 3.1E02 3.9E02 6.5E02 1.0E01 1.9E01)
(Lower large intestine wall 2.3E02 3.0E02 4.9E02 7.7E02 1.4E01)
Heart wall 2.2E03 2.8E03 4.4E03 6.7E03 1.2E02
Kidneys 6.9E03 8.3E03 1.2E02 1.8E02 3.0E02
Liver 1.1E02 1.4E02 2.0E02 2.9E02 5.3E02
Lungs 1.7E03 2.2E03 3.5E03 5.5E03 1.0E02
Muscles 2.0E03 2.4E03 3.6E03 5.4E03 9.3E03
Oesophagus 5.7E04 7.1E04 1.0E03 1.7E03 2.9E03
Ovaries 9.5E03 1.2E02 1.8E02 2.6E02 4.2E02
Pancreas 3.0E03 3.9E03 6.8E03 1.1E02 1.7E02
Red marrow 2.2E03 2.7E03 3.8E03 4.9E03 7.0E03
Skin 6.8E04 8.2E04 1.3E03 2.1E03 3.9E03
Spleen 1.9E03 2.5E03 4.3E03 6.9E03 1.2E02
Testes 2.6E03 3.7E03 6.7E03 1.0E02 1.9E02
Thymus 5.7E04 7.1E04 1.0E03 1.7E03 2.9E03
Thyroid 3.7E04 4.8E04 8.3E04 1.4E03 2.9E03
Urinary bladder wall 6.7E02 8.4E02 1.2E01 1.8E01 3.3E01
Uterus 1.1E02 1.4E02 2.1E02 3.1E02 5.1E02
Remaining organs 2.5E03 3.3E03 4.9E03 7.7E03 1.2E02

Effective dose (mSv MBq1) 9.4E03 1.2E02 1.9E02 2.8E02 5.1E02

(continued on next page)

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 Radiation dose to patients from radiopharmaceuticals

Table C.73. (continued)

Absorbed dose per unit administrated activity (mGy MBq1)

Organ Adult 15 years 10 years 5 years 1 year

Occlusion of the cystic duct

Adrenals 2.7E03 3.5E03 5.6E03 8.5E03 1.4E02
Bone surfaces 3.5E03 4.3E03 6.2E03 9.2E03 1.8E02
Brain 1.1E04 1.4E04 2.4E04 4.0E04 7.6E04
Breast 3.9E04 5.2E04 1.0E03 2.0E03 3.8E03
Gallbladder wall 1.1E02 1.4E02 2.3E02 3.2E02 5.4E02
Gastrointestinal tract
Stomach wall 4.6E03 6.3E03 9.6E03 1.5E02 2.6E02
Small intestine wall 4.0E02 5.1E02 8.3E02 1.3E01 2.4E01
Colon wall 6.9E02 8.9E02 1.5E01 2.3E01 4.4E01
(Upper large intestine wall 7.9E02 1.0E01 1.7E01 2.6E01 5.0E01)
(Lower large intestine wall 5.7E02 7.3E02 1.2E01 2.0E01 3.7E01)
Heart wall 1.6E03 2.1E03 3.4E03 5.5E03 1.0E02
Kidneys 5.5E03 6.8E03 1.0E02 1.5E02 2.4E02
Liver 1.0E02 1.3E02 2.1E02 3.1E02 5.5E02
Lungs 1.3E03 1.7E03 2.7E03 4.4E03 8.4E03
Muscles 2.7E03 3.3E03 4.9E03 7.4E03 1.3E02
Oesophagus 4.1E04 5.2E04 7.8E04 1.5E03 2.8E03
Ovaries 1.8E02 2.3E02 3.5E02 5.0E02 8.1E02
Pancreas 3.5E03 4.9E03 7.9E03 1.2E02 2.2E02
Red marrow 3.6E03 4.4E03 5.9E03 7.3E03 9.6E03
Skin 8.3E04 1.0E03 1.6E03 2.5E03 4.8E03
Spleen 2.3E03 3.1E03 5.2E03 8.3E03 1.5E02
Testes 2.0E03 2.9E03 5.4E03 8.7E03 1.6E02
Thymus 4.1E04 5.2E04 7.8E04 1.5E03 2.8E03
Thyroid 2.0E04 2.7E04 5.1E04 8.8E04 2.0E03
Urinary bladder wall 3.7E02 4.7E02 6.9E02 1.0E01 1.8E01
Uterus 1.4E02 1.8E02 2.7E02 4.1E02 6.6E02
Remaining organs 3.9E03 5.4E03 8.5E03 1.4E02 2.2E02

Effective dose (mSv MBq1) 1.4E02 1.8E02 2.9E02 4.5E02 8.2E02

(continued on next page)

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 ICRP Publication 128

Table C.73. (continued)

Absorbed dose per unit administrated activity (mGy MBq1)

Organ Adult 15 years 10 years 5 years 1 year

Occlusion of the common bile duct

Adrenals 1.1E02 1.3E02 1.9E02 2.5E02 3.6E02
Bone surfaces 3.4E03 4.4E03 6.4E03 9.5E03 1.8E02
Brain 8.6E05 1.2E04 2.1E04 3.7E04 7.7E04
Breast 1.8E03 2.3E03 4.0E03 6.3E03 1.2E02
Gallbladder wall 2.2E02 2.5E02 3.3E02 5.2E02 9.2E02
Gastrointestinal tract
Stomach wall 3.9E03 5.5E03 1.0E02 1.7E02 3.0E02
Small intestine wall 3.4E03 4.4E03 8.1E03 1.4E02 2.3E02
Colon wall 3.5E03 4.4E03 8.1E03 1.4E02 2.4E02
(Upper large intestine wall 5.1E03 6.3E03 1.2E02 2.1E02 3.5E02)
(Lower large intestine wall 1.4E03 1.8E03 3.3E03 5.6E03 1.0E02)
Heart wall 6.3E03 8.2E03 1.2E02 1.7E02 3.0E02
Kidneys 8.3E03 1.0E02 1.5E02 2.1E02 3.1E02
Liver 8.1E02 1.0E01 1.5E01 2.1E01 3.8E01
Lungs 5.6E03 7.1E03 9.7E03 1.4E02 2.4E02
Muscles 2.2E03 2.8E03 4.0E03 5.8E03 1.1E02
Oesophagus 1.6E03 2.0E03 2.8E03 4.4E03 7.3E03
Ovaries 1.9E03 2.6E03 4.6E03 7.6E03 1.4E02
Pancreas 9.9E03 1.3E02 2.0E02 3.0E02 4.8E02
Red marrow 2.3E03 2.7E03 3.8E03 5.2E03 7.9E03
Skin 1.0E03 1.2E03 1.9E03 2.9E03 5.6E03
Spleen 2.1E03 3.1E03 5.5E03 8.8E03 1.5E02
Testes 7.0E04 1.0E03 1.9E03 3.2E03 6.4E03
Thymus 1.6E03 2.0E03 2.8E03 4.4E03 7.3E03
Thyroid 3.2E04 4.8E04 9.5E04 1.9E03 3.7E03
Urinary bladder wall 1.9E02 2.4E02 3.6E02 5.5E02 9.9E02
Uterus 2.9E03 3.7E03 6.5E03 1.0E02 1.9E02
Remaining organs 2.2E03 2.8E03 3.9E03 5.3E03 8.4E03

Effective dose (mSv MBq1) 7.5E03 9.6E03 1.5E02 2.2E02 3.8E02

99m
The physical half-life of Tc is 6.01 h.

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 99m
C.37. Tc-labelled macro-aggregated albumin (MAA)
C.37.1. Biokinetic model

(C116) The model for 99mTc-labelled macro-aggregated albumin (MAA) is the

same as that used for iodine-labelled MAA [see p. 293 in Publication 53 (ICRP,
1987)], 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.

99m
C.37.2. Reference for Tc-labelled macro-aggregated albumin
ICRP, 1987. Radiation dose to patients from radiopharmaceuticals. ICRP Publication 53.
Ann. ICRP 18(1–4).

99m
Table C.74. Biokinetic data for Tc-labelled macro-aggregated albumin.

Organ (S) Fs T (h) a Ãs/A0 (h)

Total body (excluding urinary 1.0 7.6

bladder contents)
Lungs 1.0 6.0 0.85 4.9
72 0.15
Liver 0.25 6.0 1.0 1.0
120 1.0
Kidneys 1.0 0.018
Urinary bladder contents 1.0 0.22

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99m
Table C.75. Absorbed doses for Tc-labelled macro-aggregated albumin.

Absorbed dose per unit activity administered (mGy MBq1)

Organ Adult 15 years 10 years 5 years 1 year

Adrenals 6.8E03 8.8E03 1.3E02 1.9E02 3.1E02

Bone surfaces 5.1E03 6.4E03 9.1E03 1.4E02 2.6E02
Brain 9.2E04 1.2E03 2.0E03 3.2E03 5.5E03
Breast 5.0E03 5.6E03 9.9E03 1.4E02 2.1E02
Gallbladder wall 5.6E03 7.0E03 1.0E02 1.6E02 2.4E02
Gastrointestinal tract
Stomach wall 3.7E03 5.2E03 8.0E03 1.2E02 2.0E02
Small intestine wall 2.0E03 2.6E03 4.3E03 6.8E03 1.2E02
Colon wall 1.9E03 2.6E03 4.3E03 6.9E03 1.2E02
(Upper large intestine wall 2.2E03 2.9E03 5.0E03 8.3E03 1.4E02)
(Lower large intestine wall 1.6E03 2.1E03 3.3E03 5.0E03 9.5E03)
Heart wall 9.6E03 1.3E02 1.8E02 2.5E02 3.8E02
Kidneys 3.7E03 4.8E03 7.2E03 1.1E02 1.8E02
Liver 1.6E02 2.1E02 3.0E02 4.2E02 7.4E02
Lungs 6.6E02 9.7E02 1.3E01 2.0E01 3.9E01
Muscles 2.8E03 3.7E03 5.2E03 7.7E03 1.4E02
Oesophagus 6.1E03 7.7E03 1.1E02 1.5E02 2.2E02
Ovaries 1.8E03 2.3E03 3.5E03 5.4E03 1.0E02
Pancreas 5.6E03 7.5E03 1.1E02 1.7E02 2.9E02
Red marrow 3.2E03 3.8E03 5.3E03 7.2E03 1.2E02
Skin 1.5E03 1.7E03 2.7E03 4.3E03 7.8E03
Spleen 4.1E03 5.5E03 8.3E03 1.3E02 2.2E02
Testes 1.1E03 1.4E03 2.2E03 3.3E03 6.2E03
Thymus 6.1E03 7.7E03 1.1E02 1.5E02 2.2E02
Thyroid 2.5E03 3.3E03 5.7E03 9.0E03 1.6E02
Urinary bladder wall 8.7E03 1.1E02 1.4E02 1.6E02 3.0E02
Uterus 2.2E03 2.8E03 4.2E03 6.0E03 1.1E02
Remaining organs 2.8E03 3.6E03 5.0E03 7.4E03 1.3E02

Effective dose (mSv MBq1) 1.1E02 1.6E02 2.3E02 3.4E02 6.3E02

99m
The physical half-life of Tc is 6.01 h.

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 99m
C.38. Tc-labelled mercaptoacetyl triglycine (MAG3)
C.38.1. Biokinetic model

(C117) 99mTc-labelled mercaptoacetyl triglycine (MAG3) has been developed as a

possible replacement for radioiodine-labelled Hippuran for investigation of renal
function with improved imaging quality.
(C118) In the normal case, following intravenous administration of MAG3, 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 tri-exponential functions (Stabin et al., 1992). The renal transit time
is assumed to be 4 min, as for Hippuran. The reader is referred to Bubeck et al.
(1990), Jafri et al. (1988), and Taylor et al. (1986) for further information.
(C119) 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, that the renal transit
time is increased to 20 min, and that a fraction of 0.04 is taken up in the liver.
(C120) As an example of acute unilateral renal blockage, it is assumed that a
fraction of 0.5 of the administered radiopharmaceutical is taken up by one kidney,
slowly released to the blood with a half-time of 5 days, and subsequently excreted by
the other kidney, which is assumed to function normally.

99m
C.38.2. References for Tc-labelled mercaptoacetyl triglycine
Bubeck, B., Brandau, W., Weber, E., et al., 1990. Pharmacokinetics of technetium-99m-
MAG3 in humans. J. Nucl. Med. 31, 1285–1293.
Jafri, R.A., Britton, K.E., Nimmon, C.C., et al., 1988. Technetium-99m-MAG3, a comparison
with iodine-123 and iodine-131 orthoiodohippurate, in patients with renal disorders.
J. Nucl. Med. 29, 147–158.
Stabin, M.G., Taylor, A. Jr, Eshima, D., et al., 1992. Radiation dosimetry for Tc-99m MAG3,
technetium-99m-DTPA, and iodine-131 OIH based on human distribution studies. J. Nucl.
Med. 33, 33–40.
Taylor, A. Jr, Eshima, D., Fritzberg, A.R., et al., 1986. Comparison of iodine-131 OIH and
technetium-99m MAG3 renal imaging in volunteers. J. Nucl. Med. 27, 795–803.

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99m
Table C.76. Biokinetic data for Tc-labelled mercaptoacetyl triglycine.

Organ (S) Fs T (h) a Ãs/A0 (h)

Normal renal function

Total body (excluding urinary bladder 1.0 0.028 0.40 0.23
contents and kidneys) 0.053 0.40
0.72 0.20
Kidneys 1.0 0.065
Urinary bladder contents 1.0
Adult, 15 years 2.7
10 years 2.3
5 years, 1 year 1.6

Abnormal renal function

Total body (excluding urinary 1.0 0.28 0.40 1.4
bladder contents and kidneys) 0.53 0.40
7.2 0.20
Kidneys 1.0 0.28
Liver 0.04 0.28 0.40 0.055
0.53 0.40
7.2 0.20
Urinary bladder contents 1.0
Adult, 15 years 2.0
10 years 1.7
5 years, 1 year 1.1

Acute unilateral renal blockage

Total body (excluding urinary bladder 1.0 0.028 0.40 4.4
contents and kidneys) 0.053 0.40
0.72 0.20
Abnormal kidney 0.5 120 1.0 4.0
Normal kidney 1.0 0.033
Urinary bladder contents 1.0
Adult, 15 years 1.4
10 years 1.2
5 years, 1 year 0.82

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99m
Table C.77. Absorbed doses for Tc-labelled mercaptoacetyl triglycine.

Absorbed dose per unit activity administered (mGy MBq1)

Organ Adult 15 years 10 years 5 years 1 year

Normal renal function

Adrenals 3.9E04 5.1E04 8.2E04 1.2E03 2.5E03
Bone surfaces 1.3E03 1.6E03 2.1E03 2.4E03 4.3E03
Brain 1.0E04 1.3E04 2.2E04 3.5E04 6.1E04
Breast 1.0E04 1.4E04 2.4E04 3.9E04 8.2E04
Gallbladder wall 5.7E04 8.7E04 2.0E03 1.7E03 2.8E03
Gastrointestinal tract
Stomach wall 3.9E04 4.9E04 9.7E04 1.3E03 2.5E03
Small intestine wall 2.3E03 3.0E03 4.2E03 4.6E03 7.8E03
Colon wall 3.4E03 4.3E03 5.9E03 6.0E03 9.8E03
(Upper large intestine wall 1.7E03 2.3E03 3.4E03 4.0E03 6.7E03)
(Lower large intestine wall 5.7E03 7.0E03 9.2E03 8.7E03 1.4E02)
Heart wall 1.8E04 2.4E04 3.7E04 5.7E04 1.2E03
Kidneys 3.4E03 4.2E03 5.9E03 8.4E03 1.5E02
Liver 3.1E04 4.3E04 7.5E04 1.1E03 2.1E03
Lungs 1.5E04 2.1E04 3.3E04 5.0E04 1.0E03
Muscles 1.4E03 1.7E03 2.2E03 2.4E03 4.1E03
Oesophagus 1.3E04 1.8E04 2.8E04 4.4E04 8.2E04
Ovaries 5.4E03 6.9E03 8.7E03 8.7E03 1.4E02
Pancreas 4.0E04 5.0E04 9.3E04 1.3E03 2.5E03
Red marrow 9.3E04 1.2E03 1.6E03 1.5E03 2.1E03
Skin 4.6E04 5.7E04 8.3E04 9.7E04 1.8E03
Spleen 3.6E04 4.9E04 7.9E04 1.2E03 2.3E03
Testes 3.7E03 5.3E03 8.1E03 8.7E03 1.6E02
Thymus 1.3E04 1.8E04 2.8E04 4.4E04 8.2E04
Thyroid 1.3E04 1.6E04 2.7E04 4.4E04 8.2E04
Urinary bladder wall 1.1E01 1.4E01 1.7E01 1.8E01 3.2E01
Uterus 1.2E02 1.4E02 1.9E02 1.9E02 3.1E02
Remaining organs 1.3E03 1.6E03 2.1E03 2.2E03 3.6E03

Effective dose (mSv MBq1) 7.0E03 9.0E03 1.2E02 1.2E02 2.2E02

Effective dose if urinary bladder is emptied 1 or 0.5 h after administration
1h 2.5E03 3.1E03 4.5E03 6.4E03 6.4E03
0.5 h 1.7E03 2.1E03 2.9E03 3.9E03 6.8E03
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 ICRP Publication 128

Table C.77. (continued)

Absorbed dose per unit activity administered (mGy MBq1)

Organ Adult 15 years 10 years 5 years 1 year

Abnormal renal function

Adrenals 1.6E03 2.1E03 3.2E03 4.8E03 8.6E03
Bone surfaces 2.2E03 2.7E03 3.8E03 5.0E03 9.1E03
Brain 6.1E04 7.7E04 1.3E03 2.0E03 3.6E03
Breast 5.4E04 7.0E04 1.1E03 1.7E03 3.2E03
Gallbladder wall 1.6E03 2.2E03 3.8E03 4.6E03 6.4E03
Gastrointestinal tract
Stomach wall 1.2E03 1.5E03 2.6E03 3.5E03 6.1E03
Small intestine wall 2.7E03 3.5E03 5.0E03 6.0E03 1.0E02
Colon wall 3.5E03 4.4E03 6.1E03 6.9E03 1.1E02
(Upper large intestine wall 2.2E03 3.0E03 4.3E03 5.6E03 9.3E03)
(Lower large intestine wall 5.1E03 6.3E03 8.5E03 8.6E03 1.4E02)
Heart wall 9.1E04 1.2E03 1.8E03 2.7E03 4.8E03
Kidneys 1.4E02 1.7E02 2.4E02 3.4E02 5.9E02
Liver 1.4E03 1.8E03 2.7E03 3.8E03 6.6E03
Lungs 7.9E04 1.1E03 1.6E03 2.4E03 4.5E03
Muscles 1.7E03 2.1E03 2.9E03 3.6E03 6.4E03
Oesophagus 7.4E04 9.7E04 1.5E03 2.3E03 4.1E03
Ovaries 4.9E03 6.3E03 8.1E03 8.7E03 1.4E02
Pancreas 1.5E03 1.9E03 2.9E03 4.3E03 7.4E03
Red marrow 1.5E03 1.9E03 2.6E03 3.1E03 5.0E03
Skin 7.8E04 9.6E04 1.5E03 2.0E03 3.8E03
Spleen 1.5E03 1.9E03 2.9E03 4.3E03 7.4E03
Testes 3.4E03 4.7E03 7.1E03 7.8E03 1.4E02
Thymus 7.4E04 9.7E04 1.5E03 2.3E03 4.1E03
Thyroid 7.3E04 9.5E04 1.5E03 2.4E03 4.4E03
Urinary bladder wall 8.3E02 1.1E01 1.3E01 1.3E01 2.3E01
Uterus 1.0E02 1.2E02 1.6E02 1.6E02 2.7E02
Remaining organs 1.7E03 2.1E03 2.8E03 3.4E03 6.0E03

Effective dose (mSv MBq1) 6.1E03 7.8E03 1.0E02 1.1E02 1.9E02

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 Radiation dose to patients from radiopharmaceuticals

Table C.77. (continued)

Absorbed dose per unit activity administered (mGy MBq1)

Organ Adult 15 years 10 years 5 years 1 year

Acute unilateral renal blockage

Adrenals 1.1E02 1.4E02 2.2E02 3.2E02 5.5E02
Bone surfaces 3.1E03 4.0E03 5.8E03 8.4E03 1.7E02
Brain 1.1E04 1.4E04 2.3E04 3.9E04 7.5E04
Breast 3.8E04 5.1E04 1.0E03 1.6E03 3.0E03
Gallbladder wall 6.2E03 7.3E03 1.0E02 1.6E02 2.3E02
Gastrointestinal tract
Stomach wall 3.9E03 4.4E03 7.0E03 9.3E03 1.2E02
Small intestine wall 4.3E03 5.5E03 8.5E03 1.2E02 1.9E02
Colon wall 3.9E03 5.0E03 7.2E03 9.2E03 1.5E03
(Upper large intestine wall 4.0E03 5.1E03 7.6E03 1.0E02 1.6E02)
(Lower large intestine wall 3.8E03 4.8E03 6.7E03 8.2E03 1.3E02)
Heart wall 1.3E03 1.6E03 2.7E03 4.0E03 6.1E03
Kidneys 2.0E01 2.4E01 3.3E01 4.7E01 8.1E01
Liver 4.4E03 5.4E03 8.1E03 1.1E02 1.7E02
Lungs 1.1E03 1.6E03 2.5E03 3.9E03 7.2E03
Muscles 2.2E03 2.7E03 3.7E03 5.1E03 8.9E03
Oesophagus 3.8E04 5.4E04 8.5E04 1.5E03 2.3E03
Ovaries 3.8E03 5.1E03 7.1E03 9.2E03 1.5E02
Pancreas 7.4E03 9.0E03 1.3E02 1.8E02 2.9E02
Red marrow 3.0E03 3.6E03 5.0E03 6.0E03 8.3E03
Skin 8.2E04 1.0E03 1.5E03 2.2E03 4.2E03
Spleen 9.8E03 1.2E02 1.8E02 2.6E02 4.0E02
Testes 2.0E03 2.9E03 4.5E03 5.0E03 9.8E03
Thymus 3.8E04 5.4E04 8.5E04 1.5E03 2.3E03
Thyroid 1.7E04 2.3E04 4.5E04 9.2E04 1.6E03
Urinary bladder wall 5.6E02 7.1E02 9.1E02 9.3E02 1.7E01
Uterus 7.2E03 8.7E03 1.2E02 1.3E02 2.2E02
Remaining organs 2.1E03 2.6E03 3.6E03 4.7E03 8.0E03

Effective dose (mSv MBq1) 1.0E02 1.2E02 1.7E02 2.2E02 3.8E02

The physical half-life of 99mTc is 6.01 h.
The urinary bladder wall contributes up to 80% of the effective dose.

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 99m
C.39. Tc-labelled non-absorbable markers
C.39.1. Biokinetic model

(C121) 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 Section A.3 in
Publication 53 (ICRP, 1987). The reader is referred to Chadhuri (1974), Fisher
et al. (1976), and Meyer et al. (1976) for further information.

99m
C.39.2. References for Tc-labelled non-absorbable markers
99m
Chadhuri, T.K., 1974. Use of Tc-DTPA for measuring gastric emptying time. J. Nucl.
Med. 15, 391–395.
Fisher, R.S., Malmud, L.S., Roberts, G.S., Lobis, I.F., 1976. Gastroesophageal (GE) scinti-
scanning to detect and quantitate GE reflux. Gastroenterology 70, 301–308.
ICRP, 1987. Radiation dose to patients from radiopharmaceuticals. ICRP Publication 53.
Ann. ICRP 18(1–4).
Meyer, J.H., MacGregor, I.L., Gueller, R., Martin, P., Cavalieri, R., 1976. 99mTc-tagged
chicken liver as a marker of solid food in the human stomach. Am. J. Dig. Dis. 21, 296–304.

99m
Table C.78. Biokinetic data for Tc-labelled non-absorbable markers.

Organ (S) Fs Ãs/A0 (h)

Oral administration of fluids

Gastrointestinal tract contents
Stomach 1.0 0.52
Small intestine 1.0 2.6
Upper large intestine 1.0 3.4
Lower large intestine 1.0 1.6
Oral administration of solids
Gastrointestinal tract contents
Stomach 1.0 1.7
Small intestine 1.0 2.2
Upper large intestine 1.0 2.9
Lower large intestine 1.0 1.4

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99m
Table C.79. Absorbed doses for Tc-labelled non-absorbable markers.

Absorbed dose per unit activity administered (mGy MBq1)

Organ Adult 15 years 10 years 5 years 1 year

Oral administration of fluids

Adrenals 2.5E03 3.3E03 5.5E03 8.9E03 1.5E02
Bone surfaces 4.2E03 5.2E03 7.4E03 1.1E02 2.1E02
Brain 1.8E06 3.4E06 1.2E05 4.0E05 1.0E04
Breast 2.8E04 4.2E04 9.4E04 2.0E03 3.8E03
Gallbladder wall 1.4E02 1.8E02 3.0E02 4.3E02 7.1E02
Gastrointestinal tract
Stomach wall 2.2E02 2.9E02 4.1E02 6.6E02 1.2E01
Small intestine wall 6.0E02 7.6E02 1.2E01 1.9E01 3.5E01
Colon wall 1.0E01 1.3E01 2.2E01 3.5E01 6.6E01
(Upper large intestine wall 1.2E01 1.5E01 2.5E01 4.0E01 7.5E01)
(Lower large intestine wall 8.3E02 1.1E01 1.8E01 2.9E01 5.4E01)
Heart wall 1.0E03 1.4E03 2.5E03 4.3E03 8.6E03
Kidneys 5.5E03 6.7E03 1.0E02 1.5E02 2.3E02
Liver 3.7E03 4.8E03 9.3E03 1.5E02 2.7E02
Lungs 5.7E04 9.1E04 1.6E03 2.9E03 5.7E03
Muscles 3.2E03 4.0E03 6.0E03 9.0E03 1.5E02
Oesophagus 1.9E04 3.0E04 5.0E04 1.2E03 2.6E03
Ovaries 2.5E02 3.2E02 4.8E02 6.8E02 1.1E01
Pancreas 5.9E03 7.9E03 1.2E02 1.8E02 3.1E02
Red marrow 4.7E03 5.7E03 7.5E03 9.2E03 1.1E02
Skin 9.3E04 1.1E03 1.7E03 2.9E03 5.4E03
Spleen 4.0E03 5.0E03 7.8E03 1.2E02 2.0E02
Testes 1.3E03 2.0E03 3.8E03 6.5E03 1.2E02
Thymus 1.9E04 3.0E04 5.0E04 1.2E03 2.6E03
Thyroid 2.0E05 4.8E05 1.5E04 3.0E04 1.2E03
Urinary bladder wall 6.9E03 9.1E03 1.4E02 2.2E02 3.5E02
Uterus 1.6E02 2.0E02 3.1E02 4.7E02 7.6E02
Remaining organs 5.2E03 7.2E03 1.1E02 2.0E02 3.0E02

Effective dose (mSv MBq1) 1.9E02 2.5E02 3.9E02 6.2E02 1.1E01

(continued on next page)

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 ICRP Publication 128

Table C.79. (continued)

Absorbed dose per unit activity administered (mGy MBq1)

Organ Adult 15 years 10 years 5 years 1 year

Oral administration of solids

Adrenals 3.6E03 4.7E03 7.4E03 1.2E02 2.0E02
Bone surfaces 4.6E03 5.8E03 8.2E03 1.2E02 2.3E02
Brain 3.6E06 6.1E06 1.9E05 5.6E05 1.4E04
Breast 5.3E04 7.3E04 1.5E03 3.0E03 5.5E03
Gallbladder wall 1.5E02 2.0E02 3.5E02 4.9E02 8.1E02
Gastrointestinal tract
Stomach wall 5.9E02 7.7E02 1.1E01 1.7E01 3.3E01
Small intestine wall 6.1E02 7.7E02 1.3E01 2.0E01 3.6E01
Colon wall 1.0E01 1.3E01 2.2E01 3.5E01 6.6E01
(Upper large intestine wall 1.2E01 1.5E01 2.5E01 4.0E01 7.5E01)
(Lower large intestine wall 8.3E02 1.1E01 1.8E01 2.9E01 4.5E01)
Heart wall 2.0E03 2.8E03 4.5E03 7.2E03 1.4E02
Kidneys 6.6E03 8.0E03 1.2E02 1.7E02 2.7E02
Liver 4.3E03 5.7E03 1.1E02 1.8E02 3.2E02
Lungs 1.0E03 1.5E03 2.5E03 4.3E03 8.3E03
Muscles 3.7E03 4.6E03 6.7E03 1.0E02 1.7E02
Oesophagus 3.4E04 5.2E04 8.6E04 1.8E03 3.7E03
Ovaries 2.6E02 3.2E02 4.8E02 6.9E02 1.1E01
Pancreas 1.1E02 1.4E02 2.1E02 2.9E02 4.8E02
Red marrow 5.0E03 6.0E03 8.0E03 9.8E03 1.2E02
Skin 1.1E03 1.3E03 2.0E03 3.3E03 6.2E03
Spleen 7.3E03 8.7E03 1.3E02 1.8E02 2.9E02
Testes 1.3E03 2.0E03 3.9E03 6.6E03 1.3E02
Thymus 3.4E04 5.2E04 8.6E04 1.8E03 3.7E03
Thyroid 3.1E05 7.9E05 2.1E04 4.7E04 1.6E03
Urinary bladder wall 7.0E03 9.2E03 1.5E02 2.2E02 3.6E02
Uterus 1.6E02 2.0E02 3.2E02 4.9E02 7.8E02
Remaining organs 5.6E03 7.8E03 1.2E02 2.1E02 3.1E02

Effective dose (mSv MBq1) 2.4E02 3.1E02 4.8E02 7.6E02 1.4E01

99m
The physical half-life of Tc is 6.01 h.

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 99m
C.40. Tc-labelled methoxy-isobutyl-isonitrile (MIBI, Sestamibi, Hexamibi)
C.40.1. Biokinetic model

(C122) Technetium-methyl oxy-isobutyl-isonitrile (MIBI, Sestamibi, Hexamibi) is

a cationic complex prepared from a lyophilised kit (Cardiolite). It is used for studies
of myocardial perfusion and cardiac ventricular function.
(C123) 99mTc MIBI is accumulated in viable myocardial tissue in proportion to
regional blood flow in a manner similar to thallous chloride. After intravenous
injection, the substance is cleared rapidly from the blood and taken up predomi-
nantly in muscular tissues (including heart), liver, and kidneys, with a smaller
amount in salivary glands and thyroid. Other organs and tissues show low uptake
with a uniform distribution. When the substance is injected in conjunction with a
stress test, there is a considerable increase of uptake in heart and skeletal muscles,
with correspondingly lower uptake in all other organs and tissues. No redistribution
takes place, and there is no evidence of any metabolism of the substance. The
principal pathway for excretion is via the hepatobiliary system to the gastrointestinal
tract, with some additional excretion via the kidneys. Results of animal studies do
not indicate direct uptake and excretion via the gastrointestinal wall (Andersson et
al., 1990). The major part of the injected substance is excreted within 48 h.
(C124) The quantitative figures for uptake and excretion in man, presented in
Table C.80, are based on reports by Wackers et al. (1988) and Leide et al. (1992).
Substance excreted by the hepatobiliary system is assumed to leave the body via the
intestinal tract according to the Publication 30 gastrointestinal tract model (ICRP,
1979). The kidney–bladder model presented in Publication 53 (ICRP, 1987) is used
for substance excreted in urine. It is further assumed that all substance leaving
organs and tissues with half-times stated in Table C.80 is excreted by the liver
(75%) and kidneys (25%).

99m
C.40.2. References for Tc-labelled methoxy-isobutyl-isonitrile
Andersson, L., Jönsson, B-A., Leide, S., et al., 1990. Biodistribution and retention of Tc-99m-
HEXA-MIBI evaluated in the rat, Eur. J. Nucl. Med. 16(Suppl.), S105.
ICRP, 1979. Limits for intakes of radionuclides by workers. Part 1. ICRP Publication 30.
Ann. ICRP 2(3/4).
ICRP, 1987. Radiation dose to patients from radiopharmaceuticals. ICRP Publication 53.
Ann. ICRP 18(1–4).
Leide, S., Diemer, H., Ahlgren, L., et al., 1992. In vivo distribution and dosimetry of Tc-99m
MIBI in man. In: S-Stelson, A., Watson, E.E. (Eds.), Fifth International
Radiopharmaceutical Dosimetry Symposium, Oak Ridge, TN, USA, May 7–10, 1992.
CONF-910529. Oak Ridge Associated Universities, Oak Ridge, TN, USA, pp. 483–497.
Wackers, F.J.T., Berman, D.S., Maddahi, J., et al., 1989. Technetium-99m hexakis-2 methoxy
isobutyl isonitrile; human biodistribution, dosimetry, safety, preliminary comparison to Tl-
201 for myocardial perfusion imaging. J. Nucl. Med. 30, 301–311.

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99m
Table C.80. Biokinetic data for Tc-labelled methoxy-isobutyl-isonitrile.

Organ (S) Fs T (h) a Ãs/A0 (h)

Resting subject
Heart wall 0.015 4.0 0.67 0.070
24 0.33
Liver 0.68
Immediate uptake 0.18 1.3 0.85
24 0.15
Delayed uptake 0.51
Gallbladder 0.23 0.25
Gastrointestinal tract contents
Small intestine 0.69 0.50
Upper large intestine 0.69 0.65
Lower large intestine 0.69 0.32
Kidneys 0.14 7.0 1.00 0.66
Muscles 0.20 24 1.00 1.4
Salivary glands 0.015 24 1.00 0.10
Thyroid 0.003 2.0 1.00 0.0064
Other organs and tissues 0.45 24 1.00 3.1
Urinary bladder contents 0.31
Adult, 15 years 0.17
10 years 0.15
5 years, 1 year 0.099

Exercise
Heart wall 0.02 4.0 0.67 0.093
24 0.33
Liver 0.53
Immediate uptake 0.10 1.3 0.85
Delayed uptake 0.60 24 0.15
Gallbladder 0.23 0.20
Gastrointestinal tract contents
Small intestine 0.70 0.39
Upper large intestine 0.70 0.50
Lower large intestine 0.70 0.25
Kidneys 0.10 7.0 1.00 0.47
Muscles 0.40 24 1.00 2.8
Salivary glands 0.01 24 1.00 0.070
Thyroid 0.002 2.0 1.00 0.0044
Other organs and tissues 0.37 24 1.00 2.6
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 Radiation dose to patients from radiopharmaceuticals

Table C.80. (continued)

Organ (S) Fs T (h) a Ãs/A0 (h)

Urinary bladder contents 0.30

Adult, 15 years 0.15
10 years 0.13
5 years, 1 year 0.087

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99m
Table C.81. Absorbed doses for Tc-labelled methoxy-isobutyl-isonitrile.

Absorbed dose per unit activity administered (mGy MBq1)

Organ Adult 15 years 10 years 5 years 1 year

Resting subject
Adrenals 7.5E03 9.9E03 1.5E02 2.2E02 3.8E02
Bone surfaces 8.2E03 1.0E02 1.6E02 2.1E02 3.8E02
Brain 5.2E03 7.1E03 1.1E02 1.6E02 2.7E02
Breast 3.8E03 5.3E03 7.1E03 1.1E02 2.0E02
Gallbladder wall 3.9E02 4.5E02 5.8E02 1.0E01 3.2E01
Gastrointestinal tract
Stomach wall 6.5E03 9.0E03 1.5E02 2.1E02 3.5E02
Small intestine wall 1.5E02 1.8E02 2.9E02 4.5E02 8.0E02
Colon wall 2.4E02 3.1E02 5.0E02 7.9E02 1.5E02
(Upper large intestine wall 2.7E02 3.5E02 5.7E02 8.9E02 1.7E01)
(Lower large intestine wall 1.9E02 2.5E02 4.1E02 6.5E02 1.2E01)
Heart wall 6.3E03 8.2E03 1.2E02 1.8E02 3.0E02
Kidneys 3.6E02 4.3E02 5.9E02 8.5E02 1.5E01
Liver 1.1E02 1.4E02 2.1E02 3.0E02 5.2E02
Lungs 4.6E03 6.4E03 9.7E03 1.4E02 2.5E02
Muscles 2.9E03 3.7E03 5.4E03 7.6E03 1.4E02
Oesophagus 4.1E03 5.7E03 8.6E03 1.3E02 2.3E02
Ovaries 9.1E03 1.2E02 1.8E02 2.5E02 4.5E02
Pancreas 7.7E03 1.0E02 1.6E02 2.4E02 3.9E02
Red marrow 5.5E03 7.1E03 1.1E02 3.0E02 4.4E02
Salivary glands 1.4E02 1.7E02 2.2E02 1.5E02 2.6E02
Skin 3.1E03 4.1E03 6.4E03 9.8E03 1.9E02
Spleen 6.5E03 8.6E03 1.4E02 2.0E02 3.4E02
Testes 3.8E03 5.0E03 7.5E03 1.1E02 2.1E02
Thymus 4.1E03 5.7E03 8.6E03 1.3E02 2.3E02
Thyroid 5.3E03 7.9E03 1.2E02 2.4E02 4.5E02
Urinary bladder wall 1.1E02 1.4E02 1.9E02 2.3E02 4.1E02
Uterus 7.8E03 1.0E02 1.5E02 2.2E02 3.8E02
Remaining organs 3.1E03 3.9E03 6.0E03 8.8E03 1.6E02

Effective dose (mSv MBq1) 9.0E03 1.2E02 1.8E02 2.8E02 5.3E02

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Table C.81. (continued)

Absorbed dose per unit activity administered (mGy MBq1)

Organ Adult 15 years 10 years 5 years 1 year

Exercise
Adrenals 6.6E03 8.7E03 1.3E02 1.9E02 3.3E02
Bone surfaces 7.8E03 9.7E03 1.4E02 2.0E02 3.6E02
Brain 4.4E03 6.0E03 9.3E03 1.4E02 2.3E02
Breast 3.4E03 4.7E03 6.2E03 9.7E03 1.8E02
Gallbladder wall 3.3E02 3.8E02 4.9E02 8.6E02 2.6E01
Gastrointestinal tract
Stomach wall 5.9E03 8.1E03 1.3E02 1.9E02 3.2E02
Small intestine wall 1.2E02 1.5E02 2.4E02 3.7E02 6.6E02
Colon wall 1.9E02 2.5E02 4.1E02 6.4E02 1.2E01
(Upper large intestine wall 2.2E02 2.8E02 4.6E02 7.2E02 1.3E01)
(Lower large intestine wall 1.6E02 2.1E02 3.4E02 5.3E02 9.9E02)
Heart wall 7.2E03 9.4E03 1.0E02 2.1E02 3.5E02
Kidneys 2.6E02 3.2E02 4.4E02 6.3E02 1.1E01
Liver 9.2E03 1.2E02 1.8E02 2.5E02 4.4E02
Lungs 4.4E03 6.0E03 8.7E03 1.3E02 2.3E02
Muscles 3.2E03 4.1E03 6.0E03 9.0E03 1.7E02
Oesophagus 4.0E03 5.5E03 8.0E03 1.2E02 2.3E02
Ovaries 8.1E03 1.1E02 1.5E02 2.3E02 4.0E02
Pancreas 6.9E03 9.1E03 1.4E02 2.1E02 3.5E02
Red marrow 5.0E03 6.4E03 9.5E03 1.3E02 2.3E02
Salivary glands 9.2E03 1.1E02 1.5E03 2.0E03 2.9E03
Skin 2.9E03 3.7E03 5.8E03 9.0E03 1.7E02
Spleen 5.8E03 7.6E03 1.2E02 1.7E02 3.0E02
Testes 3.7E03 4.8E03 7.1E03 1.1E02 2.0E02
Thymus 4.0E03 5.5E03 8.0E03 1.2E02 2.3E02
Thyroid 4.4E03 6.4E03 9.9E03 1.9E02 3.5E02
Urinary bladder wall 9.8E03 1.3E02 1.7E02 2.1E02 3.8E02
Uterus 7.2E03 9.3E03 1.4E02 2.0E02 3.5E02
Remaining organs 3.3E03 4.3E03 6.4E03 9.8E03 1.8E02

Effective dose (mSv MBq1) 7.9E03 1.0E02 1.6E02 2.3E02 4.5E02

99m
The physical half-life of Tc is 6.01 h.

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C.41. Tc-labelled monoclonal tumour-associated antibodies
C.41.1. Biokinetic model

(C125) Radiolabelled monoclonal antibodies against antigenic substances within

or on the surface of malignant cells are used in medical research and for diagnosis
and treatment of cancer. The antibody is an immunoglobulin, usually IgG1 or IgG2a,
and is used either as the intact molecule (molecular weight 150 kDa) or as fragments
F(ab’)2 (100 kDa) and F(ab’) (50 kDa). Antibodies against a large number of
tumour-associated antigens have been produced and investigated, but only a few
are in regular use as commercial products for diagnostic purposes.
(C126) There is great variation in production with regard to type of antigen, type
of cells used (mouse, goat, human, etc.), and possible genetic modification (chimeric,
humanised). There is also variation in the mode of application of the product with
regard to amount of substance administered, possible pre-treatment with unlabelled
antibody or other modifying substances, route of administration (intravenous injec-
tion or infusion, subcutaneous or intraperitoneal injection, etc.), type of radionuclide
used as label, and method of labelling.
(C127) In spite of these variations, certain common features in the behaviour of
the antibodies can be distinguished. Directly after intravenous injection, the highest
activity is seen in organs with high vascular perfusion, such as liver, spleen, bone
marrow, and kidneys. Organ uptake is mainly a function of molecular size, with the
intact molecule showing uptake mainly in liver and bone marrow, while smaller
fragments concentrate to a greater degree in the kidneys. Also, the rate of degrada-
tion and elimination is mainly a function of molecular size, being more rapid with
smaller fragments (Bischof Delaloye and Delaloye, 1995; Britton and Granowska,
1987; Fishman et al., 1989; ICRP, 1987).
(C128) Based on these general properties, a set of models can be defined, assuming
principal uptake in the above-mentioned organs and even distribution of the remain-
der in the rest of the body. The quantitative data for uptake and elimination have
been defined after an extensive survey of published reports, and are to be looked
upon as typical values for the intact antibody and ‘large’ and ‘small’ fragments.
(C129) The antibodies and fragments are metabolised within the body. The tech-
netium thus set free is assumed to be handled by the body according to the biokinetic
model for pertechnetate. The contribution from released technetium can be calcu-
lated as:

Tp  Teff
ðC:1Þ
Teff

where Tp is the physical half-life, and Teff is the effective half-time of the antibody.

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99m
C.41.2. References for Tc-labelled monoclonal tumour-associated antibodies
Bischof Delaloye, A., Delaloye, B., 1995. Radiolabelled monoclonal antibodies in tumour
imaging and therapy: out of fashion? Eur. J. Nucl. Med. 22, 571–580.
Britton, K.E., Granowska, M., 1987. Radioimmunoscintigraphy in tumour identification.
Cancer Surv. 6, 247–267.
Fishman, A.J., Khaw, B.A., Strauss, H.N., 1989. Quo vadis radioimmune imaging. J. Nucl.
Med. 20, 1911–1915.
ICRP, 1987. Radiation dose to patients from radiopharmaceuticals. ICRP Publication 53.
Ann. ICRP 18(1–4).

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Table C.82. Biokinetic data for Tc-labelled monoclonal tumour-associated antibodies.

Organ (S) Fs T (h) a Ãs/A0 (h)

Intact antibody
Kidneys 0.03 24 0.5 0.23
96 0.5
Liver 0.50 24 0.5 3.8
96 0.5
Spleen 0.09 24 0.5 0.68
96 0.5
Red marrow 0.20 24 0.5 1.5
96 0.5
Other organs and tissues 0.18 24 0.5 1.4
96 0.5
*
Released technetium 1.0 24 0.5
96 0.5
F(ab’)2 fragments
Kidneys 0.20 12 1.0 1.2
Liver 0.30 12 1.0 1.7
Spleen 0.06 12 1.0 0.35
Red marrow 0.10 12 1.0 0.58
Other organs and tissues 0.34 12 1.0 2.0
y
Released technetium 1.0 12 1.0

F(ab’) fragments
Kidneys 0.40 6.0 1.0 1.7
Liver 0.10 6.0 1.0 0.43
Spleen 0.02 6.0 1.0 0.09
Red marrow 0.03 6.0 1.0 0.13
Other organs and tissues 0.45 6.0 1.0 2.0
z
Released technetium 1.0 6.0 1.0
*To obtain the contribution from released technetium, the cumulated activities given in the pertechnetate
model should be multiplied by 0.13.
y
To obtain the contribution from released technetium, the cumulated activities given in the pertechnetate
model should be multiplied by 0.33.
z
To obtain the contribution from released technetium, the cumulated activities given in the pertechnetate
model should be multiplied by 0.50.

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Table C.83. Absorbed doses for Tc-labelled monoclonal tumour-associated antibodies.

Absorbed dose per unit activity administered (mGy MBq1)

Organ Adult 15 years 10 years 5 years 1 year

Intact antibody
Adrenals 1.0E02 1.2E02 1.8E02 2.4E02 3.7E02
Bone surfaces 1.2E02 1.6E02 2.6E02 4.4E02 1.0E01
Brain 1.4E03 1.7E03 2.6E03 4.2E03 7.9E03
Breast 2.1E03 2.6E03 4.3E03 6.6E03 1.2E02
Gallbladder wall 1.5E02 1.7E02 2.4E02 3.7E02 6.1E02
Gastrointestinal tract
Stomach wall 8.4E03 1.1E02 1.6E02 2.6E02 4.6E02
Small intestine wall 5.6E03 7.0E03 1.1E02 1.7E02 2.9E02
Colon wall 8.9E03 1.1E02 1.9E02 3.0E02 5.4E02
(Upper large intestine wall 1.2E02 1.5E02 2.5E02 4.1E02 7.3E02)
(Lower large intestine wall 4.9E03 6.4E03 1.0E02 1.6E02 2.8E02)
Heart wall 5.5E03 6.9E03 1.0E02 1.4E02 2.5E02
Kidneys 1.9E02 2.2E02 3.2E02 4.5E02 7.4E02
Liver 4.5E02 5.8E02 8.5E02 1.2E01 2.1E01
Lungs 4.9E03 6.3E03 8.7E03 1.3E02 2.2E02
Muscles 2.9E03 3.7E03 5.4E03 7.9E03 1.4E02
Oesophagus 2.5E03 3.0E03 4.3E03 6.5E03 1.1E02
Ovaries 4.0E03 5.1E03 7.6E03 1.1E02 1.9E02
Pancreas 1.1E02 1.4E02 2.0E02 3.0E02 4.8E02
Red marrow 1.7E02 1.9E02 3.0E02 5.2E02 1.1E01
Salivary glands 4.2E03 5.4E03 7.6E03 1.1E02 1.7E02
Skin 1.6E03 1.9E03 3.0E03 4.7E03 8.9E03
Spleen 6.0E02 8.4E02 1.3E01 1.9E01 3.4E01
Testes 1.3E03 1.6E03 2.6E03 4.2E03 7.7E03
Thymus 2.5E03 3.0E03 4.3E03 6.5E03 1.1E02
Thyroid 4.0E03 6.0E03 9.2E03 1.9E02 3.5E02
Urinary bladder wall 3.7E03 4.9E03 6.9E03 9.6E03 1.6E02
Uterus 3.3E03 4.2E03 6.6E03 1.0E02 1.7E02
Remaining organs 3.1E03 4.0E03 5.8E03 8.7E03 1.4E02

Effective dose (mSv MBq1) 9.8E03 1.2E02 1.9E02 3.0E02 5.4E02

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 ICRP Publication 128

Table C.83. (continued)

Absorbed dose per unit activity administered (mGy MBq1)

Organ Adult 15 years 10 years 5 years 1 year

F(ab’)2 fragments
Adrenals 9.1E03 1.1E02 1.7E02 2.4E02 4.0E02
Bone surfaces 8.3E03 1.0E02 1.6E02 2.6E02 5.6E02
Brain 1.8E03 2.3E03 3.6E03 5.8E03 1.0E02
Breast 2.0E03 2.6E03 4.0E03 6.4E03 1.2E02
Gallbladder wall 1.1E02 1.3E02 1.9E02 2.9E02 4.6E02
Gastrointestinal tract
Stomach wall 1.3E02 1.6E02 2.3E02 3.7E02 7.0E02
Small intestine wall 8.1E03 1.0E02 1.6E02 2.4E02 4.2E02
Colon wall 1.6E02 2.2E02 3.6E02 5.7E02 1.0E01
(Upper large intestine wall 2.2E02 2.9E02 4.8E02 7.7E02 1.4E01)
(Lower large intestine wall 9.0E03 1.2E02 1.9E02 3.0E02 5.5E02)
Heart wall 4.4E03 5.6E03 8.3E03 1.2E02 2.1E02
Kidneys 6.2E02 7.4E02 1.0E01 1.5E01 2.5E01
Liver 2.3E02 2.9E02 4.3E02 6.1E02 1.1E01
Lungs 3.9E03 5.1E03 7.3E03 1.1E02 1.9E02
Muscles 3.3E03 4.1E03 6.0E03 8.9E03 1.6E02
Oesophagus 2.6E03 3.3E03 4.8E03 7.5E03 1.3E02
Ovaries 5.6E03 7.1E03 1.1E02 1.6E02 2.7E02
Pancreas 9.4E03 1.2E02 1.7E02 2.5E02 4.1E02
Red marrow 8.7E03 9.7E03 1.5E02 2.5E02 4.8E02
Salivary glands 6.4E03 7.2E03 1.1E02 1.6E02 2.6E02
Skin 1.8E03 2.2E03 3.5E03 5.5E03 1.0E02
Spleen 3.4E02 4.7E02 7.1E02 1.1E01 1.9E01
Testes 2.0E03 2.6E03 4.0E03 6.3E03 1.2E02
Thymus 2.6E03 3.3E03 4.8E03 7.5E03 1.3E02
Thyroid 8.5E03 1.3E02 2.0E02 4.3E02 8.0E02
Urinary bladder wall 7.3E03 9.6E03 1.3E02 1.6E02 2.8E02
Uterus 4.8E03 6.0E03 9.3E03 1.4E02 2.4E02
Remaining organs 3.6E03 4.5E03 6.8E03 1.0E02 1.8E02

Effective dose (mSv MBq1) 9.7E03 1.2E02 1.8E02 2.9E02 5.2E02

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Table C.83. (continued)

Absorbed dose per unit activity administered (mGy MBq1)

Organ Adult 15 years 10 years 5 years 1 year

F(ab’) fragments
Adrenals 8.4E03 1.1E02 1.6E02 2.4E02 4.2E02
Bone surfaces 6.3E03 7.5E03 1.1E02 1.7E02 3.2E02
Brain 2.0E03 2.5E03 4.1E03 6.5E03 1.2E02
Breast 1.9E03 2.5E03 3.8E03 6.0E03 1.1E02
Gallbladder wall 8.7E03 1.1E02 1.7E02 2.4E02 3.6E02
Gastrointestinal tract
Stomach wall 1.6E02 2.1E02 2.9E02 4.6E02 9.0E02
Small intestine wall 1.0E02 1.3E02 2.0E02 3.0E02 5.2E02
Colon wall 2.3E02 3.0E02 4.9E02 8.0E02 1.5E01
(Upper large intestine wall 3.1E02 4.0E02 6.6E02 1.1E01 2.0E01)
(Lower large intestine wall 1.2E02 1.6E02 2.6E02 4.1E02 7.6E02)
Heart wall 3.7E03 4.7E03 7.1E03 1.1E02 1.8E02
Kidneys 8.9E02 1.1E01 1.5E01 2.1E01 3.7E01
Liver 8.7E03 1.1E02 1.7E02 2.4E02 4.0E02
Lungs 3.1E03 4.2E03 6.2E03 9.5E03 1.7E02
Muscles 3.4E03 4.2E03 6.2E03 9.4E03 1.7E02
Oesophagus 2.6E03 3.3E03 4.9E03 7.8E03 1.4E02
Ovaries 6.8E03 8.6E03 1.3E02 1.9E02 3.3E02
Pancreas 8.1E03 1.0E02 1.5E02 2.2E02 3.5E02
Red marrow 4.7E03 5.5E03 8.1E03 1.2E02 2.0E02
Salivary glands 7.9E03 9.8E03 1.4E02 1.9E02 3.1E02
Skin 1.9E03 2.3E03 3.7E03 5.9E03 1.1E02
Spleen 1.4E02 1.8E02 2.8E02 4.1E02 7.0E02
Testes 2.5E03 3.2E03 4.9E03 7.5E03 1.4E02
Thymus 2.6E03 3.3E03 4.9E03 7.8E03 1.4E02
Thyroid 1.2E02 1.9E02 2.9E02 6.2E02 1.2E01
Urinary bladder wall 1.0E02 1.3E02 1.7E02 2.0E02 3.7E02
Uterus 5.8E03 7.3E03 1.1E02 1.7E02 2.8E02
Remaining organs 3.7E03 4.6E03 6.9E03 1.0E02 1.8E02

Effective dose (mSv MBq1) 1.1E02 1.4E02 2.0E02 3.2E02 5.9E02

99m
The physical half-life of Tc is 6.01 h.

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 99m
C.42. Tc-Pertechnegas
C.42.1. Biokinetic model

(C130) Pertechnegas is a 99mTc-labelled sodium chloride aerosol that is soluble

because it lacks the carbon coating of Technegas, and has a median particle diameter
of 167 nm (Lloyd et al., 1995). Pertechnegas is thus a modified form of Technegas,
produced by heating 99mTc pertechnetate in argon containing 3% oxygen. Following
inhalation, Pertechnegas shows lung clearance properties similar to those of a
99m
Tc-pertechnetate aerosol. Approximately 75% of inhaled Pertechnegas is lost
from the lungs with a half-time of 9–11 min in both smokers and non-smokers.
The remainder of the material appears to leave the lungs with a half-time of 2–3 h
(Isawa et al., 1996; Kotzerke et al., 1996). The material leaving the lungs is assumed
to enter the blood as pertechnetate.
(C131) The biokinetic model for Pertechnegas assumes that 75% of the total
inhaled activity is lost from the lungs with a half-time of 10 min; the remaining
25% leaves the lungs with a half-time of 160 min. All of the activity leaving the
lungs is assumed to be absorbed to blood and to behave as intravenously injected
99m
Tc-pertechnetate.

99m
C.42.2. References for Tc-Pertechnegas
Isawa, T., Lee, B.T., Hiraga, K., 1996. High-resolution electron microscopy of Technegas and
Pertechnegas. Nucl. Med. Commun. 17, 147–152.
Kotzerke, J., van den Hoff, J., Burchert, W., et al., 1996. A compartmental model for alveolar
clearance of Pertechnegas. J. Nucl. Med. 37, 2066–2071.
Lloyd, J.J., Shields, R.A., Taylor, C.J., et al., 1995. Technegas and Pertechnegas particle size
distribution. Eur. J. Nucl. Med. 22, 473–476.

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Table C.84. Biokinetic data for Tc-Pertechnegas.

Organ (S) Fs T (h) a Ãs/A0 (h)

Lungs 1.0 0.17 0.75 0.84

2.7 0.25
99m
Tc pertechnetate to blood 1.0
Thyroid 0.030
Salivary glands 0.045
Stomach contents 0.12
Stomach wall 0.20
Small intestine contents 0.34
Upper large intestine contents 0.60
Upper large intestine wall 0.44
Lower large intestine contents 0.30
Other organs and tissues 4.0
Urinary bladder contents
Adult, 15 years 0.39
10 years 0.33
5 years, 1 year 0.22

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Table C.85. Absorbed doses for Tc-Pertechnegas.

Absorbed dose per unit activity administered (mGy MBq1)

Organ Adult 15 years 10 years 5 years 1 year

Inhalation
Adrenals 3.7E03 4.7E03 7.2E03 1.1E02 1.9E02
Bone surfaces 5.2E03 6.3E03 9.3E03 1.4E02 2.5E02
Brain 1.9E03 2.4E03 3.9E03 6.2E03 1.1E02
Breast 2.0E03 2.6E03 3.9E03 6.2E03 1.1E02
Gallbladder wall 6.5E03 8.7E03 1.4E02 2.0E02 3.1E02
Gastrointestinal tract
Stomach wall 2.1E02 2.8E02 3.9E02 6.4E02 1.3E01
Small intestine wall 1.3E02 1.6E02 2.6E02 3.9E02 6.8E02
Colon wall 3.4E02 4.4E02 7.3E02 1.2E01 2.2E01
(Upper large intestine wall 4.6E02 6.0E02 1.0E01 1.6E01 3.1E01)
(Lower large intestine wall 1.8E02 2.3E02 3.8E02 5.9E02 1.1E01)
Heart wall 3.5E03 4.6E03 6.8E03 1.0E02 1.8E02
Kidneys 3.9E03 4.8E03 7.3E03 1.1E02 1.9E02
Liver 3.7E03 4.8E03 7.8E03 1.2E02 2.1E02
Lungs 8.1E03 1.2E02 1.6E02 2.5E02 4.7E02
Muscles 3.1E03 3.9E03 5.7E03 8.6E03 1.6E02
Oesophagus 2.7E03 3.5E03 5.2E03 8.0E03 1.4E02
Ovaries 8.6E03 1.1E02 1.6E02 2.3E02 3.9E02
Pancreas 5.2E03 6.7E03 1.0E02 1.5E02 2.5E02
Red marrow 3.4E03 4.2E03 6.2E03 8.5E03 1.4E02
Salivary glands 9.3E03 1.2E02 1.6E02 2.2E02 3.5E02
Skin 1.7E03 2.1E03 3.4E03 5.3E03 1.0E02
Spleen 4.1E03 5.1E03 7.7E03 1.1E02 2.0E02
Testes 2.7E03 3.6E03 5.5E03 8.2E03 1.5E02
Thymus 2.7E03 3.5E03 5.2E03 8.0E03 1.4E02
Thyroid 1.9E02 3.0E02 4.5E02 9.7E02 1.8E01
Urinary bladder wall 1.9E02 2.5E02 3.2E02 3.5E02 6.2E02
Uterus 7.4E03 9.3E03 1.4E02 2.0E02 3.3E02
Remaining organs 3.3E03 4.1E03 6.0E03 9.0E03 1.6E02

Effective dose (mSv MBq1) 1.2E02 1.6E02 2.3E02 3.7E02 7.1E02

99m
The physical half-life of Tc is 6.01 h.

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 99m
C.43. Tc-pertechnetate
C.43.1. Biokinetic model

(C132) The MIRD Dose Estimate Report No. 8 (MIRD, 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).
(C133) 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 early active uptake in the thyroid,
salivary glands, and stomach, and delayed uptake in the colon. The remaining frac-
tion of administered activity is assumed to be distributed uniformly throughout all
other organs and tissues (except brain). Elimination is by way of the kidneys and
intestines.
(C134) Pre-treatment 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 excre-
tion than in the standard model set out above.
(C135) For oral administration, the fractional absorption is taken to be 0.8 (ICRP,
1980).

99m
C.43.2. References for Tc-pertechnetate
Andros, G., Harper, P.V., Lathrop, K.A., McCardle, R.J., 1965. Pertechnetate-99m localisa-
tion in man with application to thyroid scanning and the study of thyroid physiology.
J. Clin. Endocrinol. 25, 1067–1076.
Beasley, T.M., Palmer, H.E., Nelp, W.B., 1966. Distribution and excretion of technetium in
humans. Health Phys. 12, 1425–1435.
Coffey, J.L., Hayes, R.L., Rafter, J.J., Watson, E.E., Carlton, J.E., 1984. Radiation dosimetry
and chemical toxicity considerations for 99Tc. Health Phys. 46, 418–422.
Dayton, D.A., Maher, F.T., Elveback, L.R., 1969. Renal clearance of technetium (99mTc) as
pertechnetate. Mayo Clin. Proc. 44, 549–551.
ICRP, 1980. Limits for Intakes of Radionuclides by Workers. ICRP Publication 30, Part 2.
Pergamon, Oxford.
MIRD, 1976. Summary of current radiation dose estimates to normal humans from 99mTc as
sodium pertechnetate. Dose Estimate Report No. 8. J. Nucl. Med. 17, 74–77.

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99m
Table C.86. Biokinetic data for Tc-pertechnetate.
Organ (S) Fs T (h) a Ãs/A0 (h)

Intravenous administration, no blocking agent given

Thyroid 0.02 1.0 0.85 0.037
10 0.15
Salivary glands 0.03 1.0 0.85 0.056
10 0.15
Stomach wall 0.20 1.0 0.25
Stomach contents 0.20 0.15
Small intestine contents 0.20 0.42
Upper large intestine wall 0.15 3.0 1.0 0.54
10 1.0
Upper large intestine contents 0.35 0.74
Lower large intestine contents 0.35 0.36
Kidneys 0.65 0.033
Other organs and tissues 0.75 3.0 0.20 4.3
4.5 0.24
45 0.56
Urinary bladder contents 0.65
Adult, 15 years, 10 years 0.35
5 years 0.30
1 year 0.23
Intravenous administration, blocking agent given
Total body (excluding bladder contents) 1.0 4.5 0.60 5.3
45 0.40
Kidneys 1.0 0.056
Urinary bladder contents 1.0
Adult, 15 years, 10 years 0.68
5 years 0.58
1 year 0.39
Oral administration, no blocking agent given (f1 ¼ 0.8)
Thyroid 0.025
Salivary glands 0.037
Stomach wall 0.16
Stomach contents 1.0
Small intestine contents 0.93
Upper large intestine wall 0.36
Upper large intestine contents 1.3
Lower large intestine contents 0.66
Kidneys 0.010
Other organs and tissues 2.8
Urinary bladder contents
Adult, 15 years, 10 years 0.19
5 years 0.17
1 year 0.12

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99m
Table C.87. Absorbed doses for Tc-pertechnetate.

Absorbed dose per unit activity administered (mGy MBq1)

Organ
Adult 15 years 10 years 5 years 1 year

Intravenous administration, no blocking agent given

Adrenals 3.7E03 4.6E03 7.1E03 1.1E02 1.9E02
Bone surfaces 5.4E03 6.5E03 9.6E03 1.4E02 2.5E02
Brain 2.0E03 2.5E03 4.1E03 6.5E03 1.1E02
Breast 1.8E03 2.3E03 3.4E03 5.6E03 1.1E02
Gallbladder wall 7.4E03 9.8E03 1.6E02 2.3E02 3.5E02
Gastrointestinal tract
Stomach wall 2.6E02 3.4E02 4.8E02 7.8E02 1.6E01
Small intestine wall 1.6E02 2.0E02 3.1E02 4.7E02 8.2E02
Colon wall 4.1E02 5.3E02 8.9E02 1.4E01 2.7E01
(Upper large intestine wall 5.6E02 7.3E02 1.2E01 2.0E01 3.7E01)
(Lower large intestine wall 2.1E02 2.7E02 4.5E02 7.1E02 1.3E01)
Heart wall 3.1E03 4.0E03 6.0E03 9.1E03 1.6E02
Kidneys 5.0E03 6.0E03 8.6E03 1.3E02 2.1E02
Liver 3.8E03 4.8E03 8.0E03 1.2E02 2.2E02
Lungs 2.6E03 3.4E03 5.1E03 7.9E03 1.4E02
Muscles 3.2E03 4.0E03 6.0E03 9.1E03 1.6E02
Oesophagus 2.5E03 3.2E03 4.8E03 7.5E03 1.4E02
Ovaries 9.9E03 1.3E02 1.8E02 2.7E02 4.4E02
Pancreas 5.6E03 7.2E03 1.1E02 1.6E02 2.7E02
Red marrow 3.7E03 4.4E03 6.5E03 9.0E03 1.5E02
Salivary glands 8.5E03 1.0E02 1.4E02 1.8E02 2.6E02
Skin 1.8E03 2.2E03 3.5E03 5.6E03 1.0E02
Spleen 4.3E03 5.3E03 8.0E03 1.2E02 2.0E02
Testes 2.8E03 3.7E03 5.9E03 9.1E03 1.6E02
Thymus 2.5E03 3.2E03 4.8E03 7.5E03 1.4E02
Thyroid 2.2E02 3.6E02 5.4E02 1.2E01 2.2E01
Urinary bladder wall 1.8E02 2.3E02 3.4E02 4.5E02 6.6E02
Uterus 8.1E03 1.0E02 1.6E02 2.3E02 3.7E02
Remaining organs 3.7E03 4.7E03 7.1E03 1.1E02 1.9E02

Effective dose (mSv MBq1) 1.3E02 1.7E02 2.6E02 4.2E02 7.9E02

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 ICRP Publication 128

Table C.87. (continued)

Absorbed dose per unit activity administered (mGy MBq1)

Organ
Adult 15 years 10 years 5 years 1 year

Intravenous administration, blocking agent given

Adrenals 3.3E03 4.1E03 6.2E03 9.3E03 1.7E02
Bone surfaces 5.1E03 6.1E03 9.0E03 1.3E02 2.3E02
Brain 2.3E03 2.9E03 4.7E03 7.6E03 1.3E02
Breast 1.9E03 2.5E03 3.5E03 5.6E03 1.1E02
Gallbladder wall 3.5E03 4.7E03 7.8E03 1.1E02 1.4E02
Gastrointestinal tract
Stomach wall 3.1E03 4.1E03 6.6E03 9.3E03 1.6E02
Small intestine wall 3.9E03 4.9E03 7.5E03 1.1E02 1.9E02
Colon wall 4.1E03 5.3E03 8.0E03 1.2E02 1.9E02
(Upper large intestine wall 3.7E03 4.8E03 7.1E03 1.1E02 1.8E02)
(Lower large intestine wall 4.7E03 5.9E03 9.1E03 1.2E02 2.1E02)
Heart wall 3.1E03 3.9E03 5.8E03 8.6E03 1.5E02
Kidneys 4.6E03 5.6E03 8.3E03 1.3E02 2.2E02
Liver 3.0E03 3.8E03 5.9E03 8.8E03 1.6E02
Lungs 2.7E03 3.5E03 5.2E03 7.9E03 1.4E02
Muscles 2.8E03 3.5E03 5.3E03 7.9E03 1.4E02
Oesophagus 2.7E03 3.5E03 5.2E03 8.0E03 1.5E02
Ovaries 4.8E03 5.9E03 8.7E03 1.3E02 2.0E02
Pancreas 3.5E03 4.4E03 6.6E03 1.0E02 1.8E02
Red marrow 2.9E03 3.6E03 5.4E03 7.9E03 1.4E02
Skin 1.9E03 2.2E03 3.6E03 5.6E03 1.0E02
Spleen 3.1E03 3.9E03 6.0E03 8.9E03 1.6E02
Testes 3.4E03 4.3E03 6.8E03 1.0E02 1.6E02
Thymus 2.7E03 3.5E03 5.2E03 8.0E03 1.5E02
Thyroid 2.8E03 3.5E03 5.6E03 9.0E03 1.6E02
Urinary bladder wall 3.0E02 3.8E02 5.5E02 7.1E02 9.1E02
Uterus 6.4E03 7.8E03 1.2E02 1.6E02 2.4E02
Remaining organs 2.9E03 3.6E03 5.4E03 8.2E03 1.4E02

Effective dose (mSv MBq1) 4.6E03 5.8E03 8.7E03 1.2E02 2.0E02

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 Radiation dose to patients from radiopharmaceuticals

Table C.87. (continued)

Absorbed dose per unit activity administered (mGy MBq1)

Organ
Adult 15 years 10 years 5 years 1 year

Oral administration, no blocking agent given (f1 ¼ 0.8)

Adrenals 3.8E3 4.7E3 7.2E3 1.1E2 1.9E2
Bone surfaces 4.9E3 5.9E3 8.6E3 1.3E2 2.3E2
Brain 1.3E3 1.6E3 2.6E3 4.2E3 7.5E3
Breast 1.4E3 1.8E3 2.8E3 4.8E3 9.0E3
Gallbladder wall 9.2E3 1.2E2 2.1E2 3.0E2 4.7E2
Gastrointestinal tract
Stomach wall 4.7E2 6.1E2 8.4E2 1.4E1 2.7E1
Small intestine wall 2.6E2 3.3E2 5.2E2 8.1E2 1.5E1
Colon wall 5.3E2 6.9E2 1.1E1 1.8E1 3.5E1
(Upper large intestine wall 6.7E2 8.6E2 1.4E1 2.3E1 4.3E1)
(Lower large intestine wall 3.6E2 4.6E2 7.6E2 1.2E1 2.3E1)
Heart wall 2.9E3 3.8E3 5.9E3 8.9E3 1.6E2
Kidneys 4.8E3 5.7E3 8.3E3 1.2E2 1.9E2
Liver 3.8E3 4.9E3 8.5E3 1.4E2 2.4E2
Lungs 2.1E3 2.8E3 4.3E3 6.8E3 1.2E2
Muscles 3.2E3 4.0E3 5.9E3 8.8E3 1.6E2
Oesophagus 1.8E3 2.3E3 3.5E3 5.6E3 1.1E2
Ovaries 1.3E2 1.6E2 2.4E2 3.5E2 5.8E2
Pancreas 8.5E3 1.1E2 1.6E2 2.2E2 3.6E2
Red marrow 3.8E3 4.5E3 6.4E3 8.6E3 1.3E2
Salivary glands 5.6E3 6.9E3 8.9E3 1.2E2 1.7E2
Skin 1.5E3 1.8E3 2.9E3 4.6E3 8.6E3
Spleen 6.0E3 7.1E3 1.0E2 1.5E2 2.4E2
Testes 2.1E3 2.9E3 4.7E3 7.5E3 1.4E2
Thymus 1.8E3 2.3E3 3.5E3 5.6E3 1.1E2
Thyroid 1.5E2 2.4E2 3.7E2 8.0E2 1.5E1
Urinary bladder wall 1.2E2 1.6E2 2.3E2 3.2E2 4.7E2
Uterus 9.2E3 1.2E2 1.8E2 2.7E2 4.4E2
Remaining organs 4.0E3 5.2E3 8.0E3 1.3E2 2.0E2

Effective dose (mSv MBq1) 1.6E2 2.1E2 3.2E2 5.2E2 9.8E2

99m
The physical half-life of Tc is 6.01 h.

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 99m
C.44. Tc-labelled phosphates and phosphonates
C.44.1. Biokinetic model

(C136) This group of radiopharmaceuticals includes phosphates, such as pyropho-

sphate and polyphosphate, and phosphonates such as methylene diphosphonate
(medronate), hydroxymethylene diphosphonate (oxidronate), hydroxyethylidene
diphosphonate, ethane-hydroxy diphosphonate, dicarboxypropane diphosphonate,
imido diphosphate, 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.
(C137) The main uptake is in bone, with further small uptake in kidneys, and
excretion is via the renal system. On the basis of the references given below
(Ackerhalt et al., 1974; Krishnamurthy et al., 1975; Makler and Charkes, 1980;
Rudd et al., 1977; Subramanian et al., 1975), 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 half-times of 2 h (0.3) and 3 days (0.7). In children, uptake is predomi-
nantly in the metaphyseal growth zones; this question is discussed in Section A.6,
paragraph A25. Kidney uptake is set at 0.02 with retention identical to that of the
total body, having half-times (with fractional retention) of 0.5 h (0.3), 2 h (0.3), and 3
days (0.4).
(C138) In pathological cases, there may be higher uptake and/or longer retention
in bone, especially in kidney diseases. The 24-h total body retention, which normally
amounts to 30%, has been reported as 40% in osteomalacia, 50% in primary hyper-
parathyroidism, 60% in Paget’s disease, and 90% in renal osteodystrophia
(Fogelman et al., 1978). For absorbed dose calculations in pathological cases, aver-
age bone uptake of 70% is assumed, with no excretion.

99m
C.44.2. References for Tc-labelled phosphates and phosphonates
Ackerhalt, R.E., Blau, M., Bakshi, S., Sondel, J.A., 1974. A comparative study of three
99mTc-labeled phosphorus compounds and 18F-fluoride for skeletal imaging. J. Nucl.
Med. 15, 1153–1157.
Fogelman, F., Bessent, R.G., Turner, J.G., Citrin, D.L., Boyle, I.T., 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., et al., 1975. Kinetics of 99mTc-labeled
pyrophosphate and polyphosphate in man. J. Nucl. Med. 16, 109–115.
Makler, P.T., 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., 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., Thomas, F.D., 1975. Technetium
99m methylene diphosphate-A superior agent for skeletal imaging. Comparison with other
technetium complexes. J. Nucl. Med. 16, 744–755.

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99m
Table C.88. Biokinetic data for Tc-labelled phosphates and phosphonates.

Organ (S) Fs T (h) a Ãs/A0 (h)

Normal uptake and excretion

Total body (excluding urinary bladder contents) 1.0 0.5 0.3 4.1
2.0 0.3
72 0.4
Bone 0.5 0.25 1.0 3.0
2.0 0.3
72 0.7
Kidneys 0.02 0.5 0.3 0.13
2.0 0.3
72 0.4
Urinary bladder contents 1.0
Adult, 15 years, 10 years 1.2
5 years 0.97
1 year 0.63

High bone uptake and/or severely

impaired kidney function
Total body 1.0 1 1.0 8.7
Bone 0.7 0.25 1.0 5.8
1 1.0

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99m
Table C.89. Absorbed doses for Tc-labelled phosphates and phosphonates.

Absorbed dose per unit activity administered (mGy MBq1)

Organ
Adult 15 years 10 years 5 years 1 year

Normal uptake and excretion

Adrenals 2.1E03 2.6E03 3.8E03 5.8E03 1.1E02
Bone surfaces 3.4E02 1.5E02 2.3E02 3.8E02 8.2E02
Brain 1.7E03 2.0E03 2.8E03 4.2E03 5.9E03
Breast 6.9E04 8.6E04 1.3E03 2.1E03 4.0E03
Gallbladder wall 1.4E03 1.8E03 3.3E03 4.3E03 6.5E03
Gastrointestinal tract
Stomach wall 1.2E03 1.4E03 2.4E03 3.6E03 6.4E03
Small intestine wall 2.2E03 2.8E03 4.3E03 6.1E03 9.3E03
Colon wall 2.7E03 3.4E03 5.2E03 7.2E03 1.0E02
(Upper large intestine wall 1.9E03 2.4E03 3.8E03 5.7E03 8.7E03)
(Lower large intestine wall 3.8E03 4.7E03 7.1E03 9.2E03 1.3E02)
Heart wall 1.2E03 1.5E03 2.2E03 3.3E03 5.9E03
Kidneys 7.2E03 8.7E03 1.2E02 1.8E02 3.1E02
Liver 1.2E03 1.6E03 2.4E03 3.6E03 6.4E03
Lungs 1.2E03 1.6E03 2.3E03 3.5E03 6.7E03
Muscles 1.8E03 2.2E03 3.3E03 4.7E03 7.7E03
Oesophagus 1.0E03 1.3E03 1.9E03 2.9E03 5.1E03
Ovaries 3.6E03 4.5E03 6.5E03 8.6E03 1.2E02
Pancreas 1.6E03 2.0E03 3.0E03 4.5E03 7.9E03
Red marrow 5.9E03 5.4E03 8.8E03 1.7E02 3.6E02
Skin 9.9E04 1.3E03 1.9E03 3.0E03 5.3E03
Spleen 1.4E03 1.8E03 2.7E03 4.4E03 7.7E03
Testes 2.4E03 3.3E03 5.4E03 7.5E03 1.0E02
Thymus 1.0E03 1.3E03 1.9E03 2.9E03 5.1E03
Thyroid 1.3E03 1.5E03 2.2E03 3.4E03 5.4E03
Urinary bladder wall 4.7E02 5.9E02 8.7E02 1.1E01 1.3E01
Uterus 6.2E03 7.5E03 1.1E02 1.4E02 1.8E02
Remaining organs 1.9E03 2.3E03 3.4E03 5.0E03 7.7E03

Effective dose (mSv MBq1) 4.9E03 5.7E03 8.6E03 1.2E02 1.8E02

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 Radiation dose to patients from radiopharmaceuticals

Table C.89. (continued)

Absorbed dose per unit activity administered (mGy MBq1)

Organ
Adult 15 years 10 years 5 years 1 year

High bone uptake and/or severely impaired kidney function

Adrenals 4.0E3 5.0E3 7.2E3 1.1E2 2.1E2
Bone surfaces 6.5E2 3.0E2 4.5E2 7.4E2 1.6E1
Brain 3.7E3 4.5E3 6.3E3 9.6E3 1.4E2
Breast 1.7E3 2.1E3 3.2E3 5.0E3 9.6E3
Gallbladder wall 2.8E3 3.6E3 5.9E3 8.5E3 1.3E2
Gastrointestinal tract
Stomach wall 2.5E3 3.2E3 5.1E3 7.3E3 1.4E2
Small intestine wall 3.0E3 3.8E3 5.6E3 8.5E3 1.5E2
Colon wall 3.0E3 3.8E3 5.8E3 9.1E3 1.6E2
(Upper large intestine wall 2.8E3 3.6E3 5.3E3 8.6E3 1.5E2)
(Lower large intestine wall 3.3E3 4.2E3 6.5E3 9.8E3 1.8E2)
Heart wall 2.9E3 3.6E3 5.2E3 7.7E3 1.4E2
Kidneys 2.9E3 3.7E3 5.6E3 8.7E3 1.6E2
Liver 2.6E3 3.3E3 4.9E3 7.4E3 1.4E2
Lungs 2.9E3 3.7E3 5.4E3 8.1E3 1.5E2
Muscles 2.9E3 3.6E3 5.3E3 8.0E3 1.5E2
Oesophagus 2.5E3 3.1E3 4.5E3 7.0E3 1.2E2
Ovaries 3.2E3 4.1E3 5.8E3 8.8E3 1.6E2
Pancreas 3.2E3 4.0E3 5.8E3 8.8E3 1.6E2
Red marrow 1.1E2 1.0E2 1.7E2 3.2E2 7.1E2
Skin 1.9E3 2.4E3 3.7E3 6.0E3 1.1E2
Spleen 2.6E3 3.4E3 5.1E3 8.4E3 1.5E2
Testes 2.2E3 2.7E3 3.8E3 6.0E3 1.1E2
Thymus 2.5E3 3.1E3 4.5E3 7.0E3 1.2E2
Thyroid 3.1E3 3.7E3 5.3E3 8.2E3 1.4E2
Urinary bladder wall 2.6E3 3.5E3 5.4E3 7.3E3 1.5E2
Uterus 2.9E3 3.7E3 5.3E3 8.1E3 1.5E2
Remaining organs 3.0E3 3.7E3 5.5E3 8.6E3 1.5E2

Effective dose (mSv MBq1) 4.3E3 4.5E3 6.8E3 1.1E2 2.2E2

99m
The physical half-life of Tc is 6.01 h.

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 99m
C.45. Tc-labelled erythrocytes
C.45.1. Biokinetic model

(C139) Erythrocytes can be labelled with 99mTc in vitro, in vivo, or with a com-
bined in-vitro/in-vivo method (Callahan et al., 1982). Several studies have demon-
strated some elution of technetium from the circulating cells, with half-times of 40
and 80 h 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). The reader is referred to Dahlström et al. (1979), Larson et al. (1978), and
Ryo and Pinsky (1976) for further information.
(C140) In the model chosen, the activity is assumed to be distributed in the blood,
being removed with a half-time of 60 h 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 con-
tribution from free pertechnetate has to be taken into account.

99m
C.45.2. References for Tc-labelled erythrocytes
Callahan, R.J., Froelich, J.W., McKusick, K.A., Leppo, J., Strauss, W.H., 1982. A modified
method for the in vivo labeling of red blood cells with Tc-99m: concise communication.
J. Nucl. Med. 23, 315–318.
Dahlström, J.A., Carlsson, S., Lilja, B., Mattsson, S., Pettersson, C., 1979. Cardiac blood pool
imaging–a clinical comparison between red blood cells labeled with 99mTc in vivo and
in vitro and 99mTc-labeled human serum albumin. Nuklearmedizin 18, 271–273.
Larson, S.M., Hamilton, G.W., Richards, P., Ritchie, J.L., 1978. Kit-labeled technetium-99m
red blood cells (Tc-99m-RBC’s) for clinical cardiac chamber imaging. Eur. J. Nucl. Med. 3,
227–231.
Porter, W.C., Dees, S.M., Freitas, J.E., Dworkin, H.J., 1983. Acid-citrate-dextrose compared
with heparin in the preparation of in vivo/in vitro technetium-99m red blood cells. J. Nucl.
Med. 24, 383–387.
Ryo, U.Y., Pinsky, S.M., 1976. Radionuclide angiography with 99m technetium-RBC’s. Crit.
Rev. Clin. Radiol. Nucl. Med. 8, 107–128.

99m
Table C.90. Biokinetic data for Tc-labelled erythrocytes.

Organ (S) Fs T (h) a Ãs/A0 (h)

Blood 1.0 60 1.0 7.9

Kidneys 1.0 0.043
Urinary bladder contents 1.0
Adult, 15 years, 10 years 0.15
5 years 0.13
1 year 0.87

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99m
Table C.91. Absorbed doses for Tc-labelled erythrocytes.

Absorbed dose per unit activity administered (mGy MBq1)

Organ Adult 15 years 10 years 5 years 1 year

Adrenals 9.9E03 1.2E02 2.0E02 3.0E02 5.6E02

Bone surfaces 7.4E03 1.2E02 1.9E02 3.6E02 7.4E02
Brain 3.6E03 4.6E03 7.5E03 1.2E02 2.2E02
Breast 3.5E03 4.1E03 7.0E03 1.1E02 1.9E02
Gallbladder wall 6.5E03 8.1E03 1.3E02 2.0E02 3.0E02
Gastrointestinal tract
Stomach wall 4.6E03 5.9E03 9.7E03 1.4E02 2.5E02
Small intestine wall 3.9E03 4.9E03 7.8E03 1.2E02 2.1E02
Colon wall 3.7E03 4.8E03 7.5E03 1.2E02 2.0E02
(Upper large intestine wall 4.0E03 5.1E03 8.0E03 1.3E02 2.2E02)
(Lower large intestine wall 3.4E03 4.4E03 6.9E03 1.0E02 1.8E02)
Heart wall 2.3E02 2.9E02 4.3E02 6.6E02 1.1E01
Kidneys 1.8E02 2.2E02 3.6E02 5.7E02 1.1E01
Liver 1.3E02 1.7E02 2.6E02 4.0E02 7.2E02
Lungs 1.8E02 2.2E02 3.5E02 5.6E02 1.1E01
Muscles 3.3E03 4.0E03 6.1E03 9.4E03 1.7E02
Oesophagus 6.1E03 7.0E03 9.8E03 1.5E02 2.3E02
Ovaries 3.7E03 4.8E03 7.0E03 1.1E02 1.9E02
Pancreas 6.6E03 8.1E03 1.3E02 1.9E02 3.3E02
Red marrow 6.1E03 7.6E03 1.2E02 2.0E02 3.7E02
Skin 2.0E03 2.4E03 3.8E03 6.2E03 1.2E02
Spleen 1.4E02 1.7E02 2.7E02 4.3E02 8.1E02
Testes 2.3E03 3.0E03 4.4E03 6.9E03 1.3E02
Thymus 6.1E03 7.0E03 9.8E03 1.5E02 2.3E02
Thyroid 5.7E03 7.1E03 1.2E02 1.9E02 3.6E02
Urinary bladder wall 8.5E03 1.1E02 1.4E02 1.7E02 3.1E02
Uterus 3.9E03 4.9E03 7.4E03 1.1E02 1.9E02
Remaining organs 3.5E03 4.5E03 7.3E03 1.3E02 2.3E02

Effective dose (mSv MBq1) 7.0E03 8.9E03 1.4E02 2.1E02 3.9E02

99m
The physical half-life of Tc is 6.01 h.

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 99m
C.46. Tc-Technegas
C.46.1. Biokinetic model

(C141) Technegas is used for ventilation lung scintigraphy. It is an aerosol incor-

porating 99mTc atoms that is prepared by evaporating sodium 99mTc-pertechnetate in
normal saline to dryness in a graphite crucible. The crucible is then heated at 2500 C
for 15 s in an atmosphere of pure argon (Burch et al., 1986). Technegas appears to
consist of 99mTc atoms attached to carbon particles with a median diameter of 140–
160 nm (Strong and Agnew, 1989; Lloyd et al., 1995; Isawa et al., 1996). Following
inhalation, Technegas shows good penetration to the lung periphery, and the mate-
rial is deposited on the lung parenchyma, where it is retained with a half-time that is
long compared with the physical half-life of 99mTc (Burch et al., 1986; Isawa et al.,
1991). The observed deposition of Technegas in the bronchial airways is approxi-
mately 5% (Lloyd et al., 1995), and the biological retention in the pulmonary tissue
amounts to 85% at 24 h (Isawa et al., 1991).
(C142) The biokinetic model for Technegas assumes that 95% of the inhaled
material is deposited in the lungs, with 5% in the main bronchial airways. The
inhaled material is assumed to be lost from the pulmonary tissue with a biological
half-time of 4 days. The material deposited in the bronchii is assumed to be elevated
by the ciliary escalator and swallowed. The material absorbed from the gastrointest-
inal tract is assumed to behave as orally administered 99mTc-pertechnetate (ICRP,
1987).

99m
C.46.2. References for Tc-Technegas
Burch, W.M., Sullivan, P.J., McLaren, C.J., 1986. Technegas – a new ventilation agent for
lung scanning. Nucl. Med. Commun. 7, 865–871.
ICRP, 1987. Radiation dose to patients from radiopharmaceuticals. ICRP Publication 53.
Ann. ICRP 18(1–4).
Isawa, T., Teshima, T., Anazawa, Y., et al., 1991. Technegas for inhalation lung imaging.
Nucl. Med. Commun. 12, 47–55.
Isawa, T., Lee, B.T., Hiraga, K., 1996. High-resolution electron microscopy of Technegas and
Pertechnegas. Nucl. Med. Commun. 17, 147–152.
Lloyd, J.J., Shields, R.A., Taylor, C.J., et al., 1995. Technegas and Pertechnegas particle size
distribution. Eur. J. Nucl. Med. 22, 473–476.
Strong, J.C., Agnew, J.E., 1989. The particle size distribution of Technegas and its influence
on regional lung deposition. Nucl. Med. Comm. 10, 425–430.

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99m
Table C.92. Biokinetic data for Tc-Technegas.

Organ (S) Fs T (h) a Ãs/A0 (h)

Lungs 1.0 8.0 0.05 8.0

96 0.95
99m
Tc pertechnetate to gastrointestinal tract 0.05
Thyroid 0.00061
Salivary glands 0.00089
Stomach contents 0.019
Stomach wall 0.0039
Small intestine contents 0.016
Upper large intestine contents 0.024
Upper large intestine wall 0.0086
Lower large intestine contents 0.012
Other organs and tissues 0.070
Urinary bladder contents
Adult, 15 years 0.0047
10 years 0.0042
5 years, 1 year 0.0028

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99m
Table C.93. Absorbed doses for Tc-Technegas.

Absorbed dose per unit activity administered (mGy MBq1)

Organ Adult 15 years 10 years 5 years 1 year

Inhalation
Adrenals 6.8E03 9.1E03 1.3E02 2.0E02 3.4E02
Bone surfaces 4.9E03 6.3E03 8.8E03 1.4E02 2.6E02
Brain 2.5E04 3.3E04 5.8E04 9.4E04 1.5E03
Breast 6.7E03 7.3E03 1.3E02 1.9E02 2.7E02
Gallbladder wall 2.3E03 3.2E03 5.5E03 8.4E03 1.1E02
Gastrointestinal tract
Stomach wall 4.4E03 6.2E03 8.8E03 1.3E02 2.2E02
Small intestine wall 8.7E04 1.3E03 2.2E03 3.9E03 7.8E03
Colon wall 1.4E03 1.9E03 3.4E03 5.9E03 1.2E02
(Upper large intestine wall 1.9E03 2.5E03 4.6E03 7.7E03 1.5E02)
(Lower large intestine wall 7.4E04 1.0E03 1.8E03 3.4E03 7.0E03)
Heart wall 1.3E02 1.7E02 2.3E02 3.2E02 4.8E02
Kidneys 2.0E03 3.0E03 4.6E03 7.2E03 1.3E02
Liver 5.7E03 7.8E03 1.0E02 1.5E02 2.5E02
Lungs 1.1E01 1.6E01 2.2E01 3.3E01 6.3E01
Muscles 2.8E03 3.6E03 4.9E03 7.3E03 1.3E02
Oesophagus 8.2E03 1.0E02 1.5E02 1.9E02 2.7E02
Ovaries 4.1E04 5.5E04 1.1E03 2.0E03 4.2E03
Pancreas 5.2E03 7.3E03 1.0E02 1.6E02 2.8E02
Red marrow 3.3E03 3.8E03 5.0E03 6.6E03 1.1E02
Salivary glands 2.8E03 3.6E03 6.3E03 9.8E03 1.8E02
Skin 1.2E03 1.3E03 2.2E03 3.3E03 5.9E03
Spleen 4.8E03 6.3E03 9.3E03 1.5E02 2.5E02
Testes 6.1E05 9.1E05 2.0E04 3.3E04 1.1E03
Thymus 8.2E03 1.0E02 1.5E02 1.9E02 2.7E02
Thyroid 2.9E03 3.9E03 6.9E03 1.1E02 2.0E02
Urinary bladder wall 3.2E04 4.5E04 7.4E04 1.2E03 2.8E03
Uterus 3.0E04 4.6E04 8.3E04 1.6E03 3.6E03
Remaining organs 2.7E03 3.5E03 4.7E03 6.8E03 1.2E02

Effective dose (mSv MBq1) 1.5E02 2.2E02 3.1E02 4.7E02 8.7E02

99m
The physical half-life of Tc is 6.01 h.

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 99m
C.47. Tc-labelled tetrofosmin
C.47.1. Biokinetic model

(C143) Technetium-99m-1,2-bis[bis(2-ethoxyethyl)phosphino]ethane is a lipophilic

technetium phosphine dioxo cation {[99mTc-(tetrofosmin)2 O2]+} prepared from a
freeze-dried kit (Myoview). It is used for studies of myocardial perfusion.
(C144) 99mTc-tetrofosmin accumulates in viable myocardial tissue in proportion to
regional blood flow in a manner similar to thallous chloride. After intravenous
injection, the substance is cleared rapidly from the blood (<5% left by 10 min)
and taken up predominantly in muscular tissues (including heart), liver, kidneys,
and salivary glands, with a smaller amount in the thyroid. Biodistribution is gener-
ally similar to that of 99mTc-MIBI (Cardiolite) [Publication 62 (ICRP, 1991)], but
there are some differences that have a bearing on diagnostic technique. 99mTc-tetro-
fosmin shows heart uptake of 1.2%, and is cleared very rapidly from the liver
(<4.5% left by 1 h) and lungs. More than 80% of the substance is excreted in
48 h, and the faecal:urinary excretion ratio is 54:46. When the substance is injected
in conjunction with an exercise stress test, there is a considerable increase in uptake
in skeletal muscle but little change in heart uptake. Initial rates of urinary and faecal
clearance are lower than at rest, and the faecal:urinary excretion ratio is 46:54.
(C145) The quantitative figures for uptake and excretion in man, presented in
Table C.94, are based on reports by Smith et al. (1992) and Higley et al. (1993).
Substance excreted by the hepatobiliary system is assumed to leave the body via the
intestinal tract according to the Publication 30 gastrointestinal tract model (ICRP,
1979). The kidney–bladder model presented in Publication 53 (ICRP, 1987) is used
for substance excreted in urine.

99m
C.47.2. References for Tc-labelled tetrofosmin
Higley, B., Smith, F.W., Smith, T., et al., 1993. Technetium-99m-1,2-bis(bis(2-ethoxyethyl)
phosphino)ethane: human biodistribution, dosimetry and safety of a new myocardial per-
fusion imaging agent. J. Nucl. Med. 34, 30–38.
ICRP, 1979. Limits for intakes of radionuclides by workers. ICRP Publication 30, Part 1.
Ann. ICRP 2(3/4).
ICRP, 1987. Radiation dose to patients from radiopharmaceuticals. ICRP Publication 53.
Ann. ICRP 18(1–4).
ICRP, 1991. Radiation dose to patients from radiopharmaceuticals. Addendum 1 to
Publication 53. ICRP Publication 62. Ann. ICRP 22(3).
Smith, T., Lahiri, A., Gemmell, H.G., et al., 1992. Dosimetry of 99mTc-P53, a new myocardial
perfusion imaging agent. In: S-Stelson, A., Watson, E.E. (Eds.), Fifth International
Radiopharmaceutical Dosimetry Symposium, Oak Ridge, TN, USA, May 7–10, 1992.
CONF-910529. Oak Ridge Associated Universities, Oak Ridge, TN, USA, pp. 467–481.

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99m
Table C.94. Biokinetic data for Tc-labelled tetrofosmin.
Organ (S) Fs T (h) a Ãs/A0 (h)

Resting subject
Thyroid 0.003 2.0 1.00 0.0064
Salivary glands 0.15 24 1.00 0.10
Heart wall 0.012 4.0 0.67 0.055
24 0.33
Kidneys 0.07 1.0 0.70 0.21
24 0.30
Liver 0.10 0.50 0.85 0.088
2.0 0.15
Other organs and tissues 0.80 0.33 0.15 4.8
24 0.85
Gallbladder contents 0.18 0.24
Gastrointestinal contents
Small intestine 0.54 0.51
Upper large intestine 0.54 0.67
Lower large intestine 0.54 0.33
Urinary bladder contents 0.46
Adult, 15 years 0.33
10 years 0.28
5 years, 1 year 0.18

Exercise
Thyroid 0.002 2.0 1.00 0.0044
Salivary glands 0.01 24 1.00 0.070
Heart wall 0.013 4.0 0.67 0.060
24 0.33
Kidneys 0.05 1.0 0.70 0.15
24 0.30
Liver 0.05 0.50 0.85 0.045
2.0 0.15
Other organs and tissues 0.875 0.33 0.05 5.8
24 0.95
Gallbladder contents 0.153 0.18
Gastrointestinal contents
Small intestine 0.46 0.36
Upper large intestine 0.46 0.46
Lower large intestine 0.46 0.23
Urinary bladder contents 0.54
Adult, 15 years 0.25
10 years 0.22
5 years, 1 year 0.14

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99m
Table C.95. Absorbed doses for Tc-labelled tetrofosmin.

Absorbed dose per unit activity administered (mGy MBq1)

Organ Adult 15 years 10 years 5 years 1 year

Resting subject
Adrenals 4.2E03 5.3E03 8.1E03 1.2E02 2.2E02
Bone surfaces 5.8E03 6.9E03 1.0E02 1.5E02 2.7E02
Brain 2.3E03 2.9E03 4.6E03 7.4E03 1.3E02
Breast 2.0E03 2.5E03 3.7E03 6.1E03 1.2E02
Gallbladder wall 3.6E02 4.1E02 5.3E02 9.3E02 3.0E01
Gastrointestinal tract contents
Stomach wall 4.5E03 6.0E03 9.7E03 1.4E02 2.4E02
Small intestine wall 1.5E02 1.8E02 2.9E02 4.6E02 8.1E02
Colon wall 2.4E02 3.1E02 5.0E02 7.9E02 1.5E01
(Upper large intestine wall 2.7E02 3.5E02 5.6E02 8.9E02 1.6E01)
(Lower large intestine wall 2.0E02 2.6E02 4.2E02 6.6E02 1.2E01)
Heart wall 4.7E03 5.9E03 8.9E03 1.3E02 2.3E02
Kidneys 1.3E02 1.6E02 2.2E02 3.2E02 5.5E02
Liver 4.0E03 5.0E03 7.7E03 1.1E02 2.0E02
Lungs 2.8E03 3.7E03 5.5E03 8.5E03 1.6E02
Muscles 3.3E03 4.1E03 6.2E03 9.4E03 1.7E02
Oesophagus 2.8E03 3.6E03 5.4E03 8.5E03 1.6E02
Ovaries 8.8E03 1.1E02 1.6E02 2.4E02 4.0E02
Pancreas 4.9E03 6.2E03 1.0E02 1.5E02 2.5E02
Red marrow 3.8E03 4.6E03 6.8E03 9.5E03 1.6E02
Skin 2.0E03 2.4E03 3.8E03 6.0E03 1.1E02
Spleen 3.9E03 5.0E03 7.8E03 1.2E02 2.1E02
Testes 3.1E03 3.9E03 6.2E03 9.6E03 1.7E02
Thymus 2.8E03 3.6E03 5.4E03 8.5E03 1.6E02
Thyroid 5.5E03 8.2E03 1.3E02 2.6E02 4.7E02
Urinary bladder wall 1.7E02 2.2E02 3.2E02 4.2E02 5.6E02
Uterus 7.8E03 9.7E03 1.5E02 2.2E02 3.5E02
Remaining organs 3.8E03 4.9E03 7.6E03 1.2E02 2.0E02

Effective dose (mSv MBq1) 8.0E03 1.0E02 1.5E02 2.4E02 4.6E02

(continued on next page)

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 ICRP Publication 128

Table C.95. (continued)

Absorbed dose per unit activity administered (mGy MBq1)

Organ Adult 15 years 10 years 5 years 1 year

Exercise
Adrenals 4.4E03 5.5E03 8.3E03 1.2E02 2.2E02
Bone surfaces 6.3E03 7.5E03 1.1E02 1.6E02 3.0E02
Brain 2.7E03 3.4E03 5.5E03 8.9E03 1.6E02
Breast 2.3E03 2.9E03 4.3E03 6.9E03 1.3E02
Gallbladder wall 2.7E02 3.2E02 4.2E02 7.3E02 2.3E01
Gastrointestinal tract
Stomach wall 4.6E03 6.1E03 9.8E03 1.4E02 2.4E02
Small intestine wall 1.1E02 1.4E02 2.2E02 3.4E02 6.1E02
Colon wall 1.8E02 2.2E02 3.7E02 5.8E02 1.1E01
(Upper large intestine wall 2.0E02 2.5E02 4.1E02 6.5E02 1.2E01)
(Lower large intestine wall 1.5E02 1.9E02 3.2E02 4.9E02 9.2E02)
Heart wall 5.2E03 6.5E03 9.7E03 1.5E02 2.5E02
Kidneys 1.0E02 1.2E02 1.7E02 2.5E02 4.3E02
Liver 3.3E03 4.1E03 6.3E03 9.2E03 1.6E02
Lungs 3.2E03 4.2E03 6.3E03 9.6E03 1.7E02
Muscles 3.5E03 4.3E03 6.5E03 9.9E03 1.8E02
Oesophagus 3.3E03 4.2E03 6.2E03 9.6E03 1.7E02
Ovaries 7.7E03 9.6E03 1.4E02 2.1E02 3.6E02
Pancreas 5.0E03 6.3E03 9.8E03 1.5E02 2.5E02
Red marrow 3.9E03 4.7E03 7.1E03 1.0E02 1.7E02
Skin 2.2E03 2.7E03 4.3E03 6.8E03 1.3E02
Spleen 4.1E03 5.2E03 8.2E03 1.2E02 2.2E02
Testes 3.4E03 4.3E03 6.6E03 1.0E02 1.8E02
Thymus 3.3E03 4.2E03 6.2E03 9.6E03 1.7E02
Thyroid 4.7E03 6.8E03 1.1E02 2.0E02 3.7E02
Urinary bladder wall 1.4E02 1.8E02 2.7E02 3.5E02 4.9E02
Uterus 7.0E03 8.7E03 1.3E02 2.0E02 3.2E02
Remaining organs 3.8E03 4.9E03 7.5E03 1.2E02 2.0E02

Effective dose (mSv MBq1) 6.9E03 8.8E03 1.3E02 2.1E02 3.9E02

99m
The physical half-life of Tc is 6.01 h.

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 99m
C.48. Tc-labelled leukocytes
C.48.1. Biokinetic model

(C146) The same model is used as for indium-labelled leukocytes [see p. 255 in
Publication 53 (ICRP, 1987)], with the exception that, in view of the short physical
half-life, the retention half-times are set to infinity. For further information, the
reader is referred to Hanna et al. (1984), Kelbaek et al. (1985), and Schroth et al.
(1981).

99m
C.48.2. References for Tc-labelled leukocytes
Hanna, R., Braun, T., Levendel, A., Lomas, F., 1984. Radiochemistry and biostability of
autologous leukocytes labelled with 99mTc-stannous colloid in whole blood. Eur. J. Nucl.
Med. 9, 216–219.
ICRP, 1987. Radiation dose to patients from radiopharmaceuticals. ICRP Publication 53.
Ann. ICRP 18(1–4).
Kelbaek, H., Fogh, J., Gjorup, T., Bülow, K., Vestergaard, B., 1985. Scintigraphic demon-
stration of subcutaneous abscesses with 99mTc-labeled leukocytes. Eur. J. Nucl. Med. 10,
302–303.
Schroth, H.J., Oberhausen, E., Berberich, R., 1981. Cell labelling with colloidal substances in
whole blood. Eur. J. Nucl. Med. 6, 469–472.

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99m
Table C.96. Biokinetic data for Tc-labelled leukocytes.

Organ (S) Fs T (h) a Ãs/A0 (h)

Blood 1.0 0 0.60 1.9

7.0 0.40
Liver 0.20 0 0.60 1.4
7.0 0.40
1 1.0
Red marrow 0.30 0 0.60 2.1
7.0 0.40
1 1.0
Spleen 0.25 0 0.60 1.7
7.0 0.40
1 1.0
Other organs and tissues 0.25 0 0.60 1.7
7.0 0.40
1 1.0

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 Radiation dose to patients from radiopharmaceuticals

99m
Table C.97. Absorbed doses for Tc-labelled leukocytes.

Absorbed dose per unit activity administered (mGy MBq1)

Organ Adult 15 years 10 years 5 years 1 year

Adrenals 1.2E02 1.2E02 1.8E02 2.6E02 4.3E02

Bone surfaces 1.6E02 2.1E02 3.4E02 6.1E02 1.5E01
Brain 2.3E03 2.9E03 4.4E03 7.0E03 1.3E02
Breast 2.4E03 2.9E03 4.9E03 7.6E03 1.3E02
Gallbladder wall 8.4E03 1.0E02 1.6E02 2.5E02 3.6E02
Gastrointestinal tract
Stomach wall 8.1E03 9.6E03 1.4E02 2.0E02 3.2E02
Small intestine wall 4.6E03 5.7E03 8.7E03 1.3E02 2.1E02
Colon wall 4.3E03 5.4E03 8.4E03 1.2E02 2.1E02
(Upper large intestine wall 4.7E03 5.9E03 9.3E03 1.4E02 2.3E02)
(Lower large intestine wall 3.7E03 4.8E03 7.3E03 1.0E02 1.8E02)
Heart wall 9.4E03 1.2E02 1.7E02 2.5E02 4.4E02
Kidneys 1.2E02 1.4E02 2.2E02 3.2E02 5.4E02
Liver 2.0E02 2.6E02 3.8E02 5.4E02 9.7E02
Lungs 7.8E03 9.9E03 1.5E02 2.3E02 4.1E02
Muscles 3.3E03 4.1E03 6.0E03 8.9E03 1.6E02
Oesophagus 3.5E03 4.2E03 5.8E03 8.6E03 1.5E02
Ovaries 3.9E03 5.0E03 7.2E03 1.1E02 1.8E02
Pancreas 1.3E02 1.6E02 2.3E02 3.4E02 5.3E02
Red marrow 2.3E02 2.5E02 4.0E02 7.1E02 1.4E01
Skin 1.8E03 2.1E03 3.4E03 5.5E03 1.0E02
Spleen 1.5E01 2.1E01 3.1E01 4.8E01 8.5E01
Testes 1.6E03 2.1E03 3.2E03 5.1E03 9.2E03
Thymus 3.5E03 4.2E03 5.8E03 8.6E03 1.5E02
Thyroid 2.9E03 3.7E03 5.8E03 9.3E03 1.7E02
Urinary bladder wall 2.6E03 3.5E03 5.2E03 7.8E03 1.4E02
Uterus 3.4E03 4.3E03 6.5E03 9.7E03 1.6E02
Remaining organs 3.4E03 4.2E03 6.3E03 9.5E03 1.6E02

Effective dose (mSv MBq1) 1.1E02 1.4E02 2.2E02 3.4E02 6.2E02

99m
The physical half-life of Tc is 6.01 h.

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 111
C.49. In-labelled human immunoglobulin (HIG)
C.49.1. Biokinetic model

(C147) 111In-labelled human immunoglobulin (HIG) behaves in principle in the

same way as described in the biokinetic model for technetium-labelled HIG, i.e. an
initial blood pool distribution, followed by some active accumulation in liver and
kidneys, some additional uptake in spleen, and some direct excretion of radioactivity
in the urine. The model has been constructed based on data in the literature (Buijs et
al., 1990; Claessens et al., 1994; Datz et al., 1995; Fishman et al., 1988; Morrel et al.,
1989; Oyen et al., 1990). Compared with the technetium-labelled substance, blood
clearance is slower (T1/2 ¼ 24 h for the main part), liver and spleen uptake is some-
what higher, and kidney uptake and urinary excretion are somewhat lower. Early
excretion in urine is set to 20%, and it is assumed that there is slow excretion of
remaining activity in the body with the same half-time as found for indium in ionic
form (i.e. 70 days).

111
C.49.2. References for In-labelled human immunoglobulin
Buijs, W.C.A.M., Oyen, W.J.G., Dams, E.T., et al., 1990. Dynamic distribution and dosi-
metric evaluation of human non-specific immunoglobulin G labelled with 111In or 99mTc.
Nucl. Med. Commun. 19, 743–751.
Claessens, R.A.M.J., Koenders, E.B., Solomon, H.F., et al., 1994. Pharmacokinetics of
111
In-14C-DTPA-IgG-123I in rats with a focal infection. Eur. J. Nucl. Med. 21, 832.
Datz, F.L., Castronovo, F.P., Christian, P.E., et al., 1995. Biodistribution and dosimetry of
indium-111-polyclonal IgG in normal subjects. J. Nucl. Med. 36, 2372–2379.
Fischman, A.J., Rubin, R.H., Khaw, B.A., et al., 1988. Detection of acute inflammation with
111In-labeled non-specific polyclonal IgG. Sem. Nucl. Med. 18, 335–344.
Morrel, E.M., Tompkins, R.G., Fischman, A.J., et al., 1989. Autoradiographic method for
quantitation of radiolabelled proteins in tissues using indium-111. J. Nucl. Med. 30,
1538–1545.
Oyen, W.J.G., Claessens, R.A.M.J., van Horn, J.R., et al., 1990. Scintigraphic detection of
bone and joint infections with indium-111-labelled non-specific polyclonal human immu-
noglobulin G. J. Nucl. Med. 31, 403–412.

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111
Table C.98. Biokinetic data for In-labelled human immunoglobulin.

Organ (S) Fs T (h) a Ãs/A0 (h)

Blood 1.00 1.0 0.15 22

24 0.85
Liver 0.08 1.0 1.00 7.4
1700 1.00
Kidneys 0.05 1.0 1.00 0.39
6.0 1.00
Spleen 0.02 1.0 1.00 1.9
1700 1.00
Testes 0.003 1.0 1.00 0.075
24 1.00
Other organs and tissues 0.70 24 1.00 2.0
1700 1.00
Urinary bladder contents 1.0
From activity accumulated in kidneys (0.05)
Excreted directly from blood (0.15)
Slow excretion from organ and tissues (0.80)
Adult, 15 years 0.32
10 years 0.27
5 years, 1 year 0.18

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Table C.99. Absorbed doses for In-labelled human immunoglobulin.

Absorbed dose per unit activity administered (mGy MBq1)

Organ Adult 15 years 10 years 5 years 1 year

Adrenals 2.1E01 2.5E01 3.8E01 5.8E01 1.0E+00

Bone surfaces 1.8E01 2.3E01 3.5E01 5.5E01 1.1E+00
Brain 9.8E02 1.2E01 2.0E01 3.3E01 5.8E01
Breast 9.1E02 1.1E01 1.7E01 2.7E01 5.0E01
Gallbladder wall 2.1E01 2.6E01 3.9E01 5.8E01 8.8E01
Gastrointestinal tract
Stomach wall 1.5E01 1.9E01 2.9E01 4.4E01 7.6E01
Small intestine wall 1.4E01 1.7E01 2.7E01 4.2E01 7.4E01
Colon wall 1.4E01 1.7E01 2.6E01 4.1E01 7.0E01
(Upper large intestine wall 1.4E01 1.8E01 2.7E01 4.4E01 7.4E01)
(Lower large intestine wall 1.3E01 1.5E01 2.4E01 3.6E01 6.5E01)
Heart wall 2.9E01 3.6E01 5.4E01 8.1E01 1.4E+00
Kidneys 2.3E01 2.8E01 4.2E01 6.4E01 1.1E+00
Liver 3.9E01 5.0E01 7.5E01 1.1E+00 1.9E+00
Lungs 2.3E01 2.9E01 4.5E01 6.9E01 1.3E+00
Muscles 1.1E01 1.3E01 2.0E01 3.1E01 5.8E01
Oesophagus 1.4E01 1.7E01 2.4E01 3.7E01 6.5E01
Ovaries 1.3E01 1.7E01 2.5E01 3.8E01 6.9E01
Pancreas 2.0E01 2.5E01 3.8E01 5.8E01 1.0E+00
Red marrow 1.3E01 1.6E01 2.5E01 3.7E01 6.7E01
Skin 7.0E02 8.3E02 1.3E01 2.1E01 3.9E01
Spleen 6.0E01 8.1E01 1.2E+00 1.9E+00 3.3E+00
Testes 1.3E01 2.2E01 1.1E+00 1.3E+00 1.8E+00
Thymus 1.4E01 1.7E01 2.4E01 3.7E01 6.5E01
Thyroid 1.3E01 1.6E01 2.5E01 4.1E01 7.6E01
Urinary bladder wall 1.3E01 1.8E01 2.4E01 3.3E01 5.8E01
Uterus 1.3E01 1.7E01 2.6E01 3.9E01 6.9E01
Remaining organs 1.1E01 1.4E01 2.1E01 3.4E01 6.1E01

Effective dose (mSv MBq1) 1.7E01 2.2E01 4.1E01 5.8E01 9.9E01

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The physical half-life of In is 67.9 h.

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 111
C.50. In-labelled monoclonal tumour-associated antibodies
C.50.1. Biokinetic model

(C148) The models for indium-labelled monoclonal tumour-associated antibodies

and fragments are the same as those used for the corresponding technetium-labelled
substances, with the modification that released indium is handled by the body
according to the model for ionic indium (Bischof Delaloye and Delaloye, 1995;
Britton and Granowska, 1987; Fishman et al., 1989; ICRP, 1987). This biokinetic
model is not intended to apply to therapeutic use of the substance.

111
C.50.2. References for In-labelled monoclonal tumour-associated antibodies
Bischof Delaloye, A., Delaloye, B., 1995. Radiolabelled monoclonal antibodies in tumour
imaging and therapy: out of fashion? Eur. J. Nucl. Med. 22, 571–580.
Britton, K.E., Granowska, M., 1987. Radioimmunoscintigraphy in tumour identification.
Cancer Surv. 6, 247–267.
Fishman, A.J., Khaw, B.A., Strauss, H.N., 1989. Quo vadis radioimmune imaging. J. Nucl.
Med. 20, 1911–1915.
ICRP, 1987. Radiation dose to patients from radiopharmaceuticals. ICRP Publication 53.
Ann. ICRP 18(1–4).

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111
Table C.100. Biokinetic data for In-labelled monoclonal tumour-associated antibodies.

Organ (S) Fs T (h) a Ãs/A0 (h)

Intact antibody
Kidneys 0.03 24 0.5 1.2
96 0.5
Liver 0.50 24 0.5 21
96 0.5
Spleen 0.09 24 0.5 3.7
96 0.5
Red marrow 0.20 24 0.5 8.3
96 0.5
Other organs and tissues 0.18 24 0.5 7.5
96 0.5
*
Released indium 1.0 24 0.5
96 0.5
F(ab’)2 fragments
Kidneys 0.20 12 1.0 2.9
Liver 0.30 12 1.0 4.4
Spleen 0.06 12 1.0 0.88
Red marrow 0.10 12 1.0 1.5
Other organs and tissues 0.34 12 1.0 5.0
y
Released indium 1.0 12 1.0
F(ab’) fragments
Kidneys 0.40 6.0 1.0 3.2
Liver 0.10 6.0 1.0 0.80
Spleen 0.02 6.0 1.0 0.16
Red marrow 0.03 6.0 1.0 0.24
Other organs and tissues 0.45 6.0 1.0 3.6
z
Released indium 1.0 6.0 1.0
*To obtain the contribution from released indium, the cumulated activities given in the model for ionic
indium (ICRP, 1987) should be multiplied by 0.58.
y
To obtain the contribution from released indium, the cumulated activities given in the model for ionic
indium (ICRP, 1987) should be multiplied by 0.88.
z
To obtain the contribution from released indium, the cumulated activities given in the model for ionic
indium (ICRP, 1987) should be multiplied by 0.92.

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111
Table C.101. Absorbed doses for In-labelled monoclonal tumour-associated antibodies.

Absorbed dose per unit activity administered (mGy MBq1)

Organ Adult 15 years 10 years 5 years 1 year

Intact antibody
Adrenals 3.1E01 3.7E01 5.3E01 7.2E01 1.2E+00
Bone surfaces 3.2E01 3.6E01 5.7E01 9.4E01 1.6E+00
Brain 5.7E02 7.3E02 1.1E01 1.8E01 3.3E01
Breast 6.9E02 8.5E02 1.4E01 2.1E01 3.8E01
Gallbladder wall 3.8E01 4.3E01 6.0E01 9.2E01 1.6E+00
Gastrointestinal tract
Stomach wall 1.6E01 2.0E01 3.1E01 4.8E01 8.3E01
Small intestine wall 1.5E01 1.8E01 2.8E01 4.3E01 7.1E01
Colon wall 1.4E01 1.7E01 2.7E01 4.2E01 6.9E01
(Upper large intestine wall 1.6E01 2.0E01 3.2E01 5.1E01 8.4E01)
(Lower large intestine wall 1.1E01 1.4E01 2.1E01 3.0E01 4.9E01)
Heart wall 1.6E01 2.0E01 2.9E01 4.1E01 7.3E01
Kidneys 8.0E01 9.5E01 1.3E+00 1.9E+00 3.1E+00
Liver 1.1E+00 1.4E+00 2.0E+00 2.8E+00 4.8E+00
Lungs 1.4E01 1.8E01 2.6E01 3.8E01 6.7E01
Muscles 9.6E02 1.2E01 1.8E01 2.6E01 4.8E01
Oesophagus 8.6E02 1.0E01 1.5E01 2.2E01 3.8E01
Ovaries 1.2E01 1.5E01 2.2E01 3.3E01 5.5E01
Pancreas 2.9E01 3.5E01 5.3E01 8.0E01 1.3E+00
Red marrow 4.1E01 4.6E01 6.9E01 1.2E+00 2.8E+00
Skin 5.4E02 6.5E02 1.0E01 1.6E01 3.1E01
Spleen 1.1E+00 1.5E+00 2.2E+00 3.4E+00 5.9E+00
Testes 4.8E02 6.2E02 9.5E02 1.5E01 2.7E01
Thymus 8.6E02 1.0E01 1.5E01 2.2E01 3.8E01
Thyroid 6.6E02 8.2E02 1.2E01 2.0E01 3.6E01
Urinary bladder wall 7.8E02 9.9E02 1.6E01 2.4E01 4.1E01
Uterus 1.1E01 1.3E01 2.0E01 3.0E01 5.0E01
Remaining organs 1.0E01 1.3E01 2.0E01 3.0E01 5.1E01

Effective dose (mSv MBq1) 2.2E01 2.7E01 4.1E01 6.4E01 1.2E+00

(continued on next page)

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 ICRP Publication 128

Table C.101. (continued)

Absorbed dose per unit activity administered (mGy MBq1)

Organ Adult 15 years 10 years 5 years 1 year

F(ab’)2 fragments
Adrenals 2.7E01 3.3E01 4.7E01 6.6E01 1.1E+00
Bone surfaces 3.2E01 3.6E01 5.7E01 9.3E01 1.6E+00
Brain 6.5E02 8.3E02 1.3E01 2.0E01 3.8E01
Breast 6.6E02 8.2E02 1.3E01 1.9E01 3.5E01
Gallbladder wall 2.9E01 3.3E01 4.6E01 7.0E01 1.1E+00
Gastrointestinal tract
Stomach wall 1.4E01 1.7E01 2.7E01 4.0E01 6.8E01
Small intestine wall 1.5E01 1.8E01 2.8E01 4.1E01 6.7E01
Colon wall 1.4E01 1.7E01 2.6E01 3.9E01 6.4E01
(Upper large intestine wall 1.5E01 1.9E01 2.9E01 4.5E01 7.3E01)
(Lower large intestine wall 1.2E01 1.5E01 2.2E01 3.2E01 5.2E01)
Heart wall 1.4E01 1.7E01 2.5E01 3.5E01 6.2E01
Kidneys 1.2E+00 1.4E+00 1.9E+00 2.7E+00 4.6E+00
Liver 6.7E01 8.6E01 1.3E+00 1.7E+00 3.0E+00
Lungs 1.2E01 1.6E01 2.3E01 3.3E01 5.9E01
Muscles 9.5E02 1.2E01 1.8E01 2.6E01 4.7E01
Oesophagus 8.7E02 1.1E01 1.5E01 2.3E01 4.0E01
Ovaries 1.3E01 1.6E01 2.3E01 3.4E01 5.7E01
Pancreas 2.3E01 2.8E01 4.1E01 6.2E01 1.0E+00
Red marrow 4.0E01 4.5E01 6.8E01 1.2E+00 2.7E+00
Skin 5.6E02 6.7E02 1.1E01 1.7E01 3.1E01
Spleen 4.9E01 6.7E01 1.0E+00 1.5E+00 2.6E+00
Testes 5.7E02 7.3E02 1.1E01 1.7E01 3.1E01
Thymus 8.7E02 1.1E01 1.5E01 2.3E01 4.0E01
Thyroid 7.5E02 9.3E02 1.4E01 2.2E01 4.0E01
Urinary bladder wall 8.8E02 1.1E01 1.7E01 2.6E01 4.4E01
Uterus 1.2E01 1.4E01 2.1E01 3.2E01 5.2E01
Remaining organs 9.9E02 1.2E01 1.8E01 2.7E01 4.8E01

Effective dose (mSv MBq1) 2.0E01 2.4E01 3.6E01 5.5E01 1.0E+00

(continued on next page)

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 Radiation dose to patients from radiopharmaceuticals

Table C.101. (continued)

Absorbed dose per unit activity administered (mGy MBq1)

Organ Adult 15 years 10 years 5 years 1 year

F(ab’) fragments
Adrenals 2.6E01 3.2E01 4.6E01 6.4E01 1.1E+00
Bone surfaces 3.2E01 3.6E01 5.7E01 9.4E01 1.6E+00
Brain 6.7E02 8.5E02 1.3E01 2.1E01 3.9E01
Breast 6.5E02 8.0E02 1.2E01 1.9E01 3.4E01
Gallbladder wall 2.7E01 3.0E01 4.3E01 6.5E01 1.0E+00
Gastrointestinal tract
Stomach wall 1.3E01 1.6E01 2.5E01 3.8E01 6.4E01
Small intestine wall 1.5E01 1.8E01 2.7E01 4.0E01 6.6E01
Colon wall 1.4E01 1.7E01 2.5E01 3.9E01 6.2E01
(Upper large intestine wall 1.5E01 1.8E01 2.8E01 4.4E01 7.0E01)
(Lower large intestine wall 1.2E01 1.5E01 2.2E01 3.2E01 5.2E01)
Heart wall 1.3E01 1.6E01 2.4E01 3.4E01 5.9E01
Kidneys 1.3E+00 1.5E+00 2.0E+00 2.9E+00 4.9E+00
Liver 5.9E01 7.5E01 1.1E+00 1.5E+00 2.6E+00
Lungs 1.2E01 1.5E01 2.2E01 3.2E01 5.7E01
Muscles 9.5E02 1.2E01 1.7E01 2.6E01 4.7E01
Oesophagus 8.7E02 1.1E01 1.5E01 2.3E01 4.0E01
Ovaries 1.3E01 1.6E01 2.3E01 3.5E01 5.7E01
Pancreas 2.2E01 2.6E01 3.9E01 5.8E01 9.4E01
Red marrow 4.0E01 4.5E01 6.9E01 1.2E+00 2.8E+00
Skin 5.6E02 6.7E02 1.1E01 1.7E01 3.1E01
Spleen 3.4E01 4.5E01 6.8E01 1.0E+00 1.7E+00
Testes 5.9E02 7.5E02 1.1E01 1.8E01 3.1E01
Thymus 8.7E02 1.1E01 1.5E01 2.3E01 4.0E01
Thyroid 7.6E02 9.5E02 1.4E01 2.3E01 4.0E01
Urinary bladder wall 9.0E02 1.1E01 1.7E01 2.6E01 4.4E01
Uterus 1.2E01 1.4E01 2.1E01 3.2E01 5.2E01
Remaining organs 9.7E02 1.2E01 1.8E01 2.7E01 4.7E01

Effective dose (mSv MBq1) 2.0E01 2.4E01 3.5E01 5.4E01 1.0E+00

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The physical half-life of In is 67.9 h.

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 111
C.51. In-labelled octreotide
C.51.1. Biokinetic model

(C149) 111In-DTPA-D-Phe-1-octreotide (pentatreotide) is a peptide composed of

eight amino acids, and is an analogue of the active part of the peptide hormone
somatostatin. Somatostatin is present in many neurons and endocrine cells, mainly in
the brain and in the gastrointestinal tract, and has an inhibitory effect on growth
hormone secretion. 111In-DTPA-D-Phe-1-octreotide may be used for visualising
somatostatin-receptor-containing tumours including neuroblastoma, some types of
endocrine gastroenteropancreatic tumours, small cell lung cancer, and breast cancer.
(C150) The biokinetic model is based on scintigraphic studies of a total of 24
humans by Krenning et al. (1992), Forssell Aronsson et al. (1995, 1999), and
Leide-Svegborn et al. (1996). Tissue samples have been analysed by Forssell
Aronsson et al. (1995). These studies have demonstrated uptake in liver, spleen,
kidneys, and thyroid. In some patients, there may also be uptake in the pituitary
gland. For further information, the reader is referred to Bajc et al. (1994), Krenning
et al. (1993), and Stabin et al. (1997). There is wide variation in uptake values
between the subjects. The main route of excretion is via the kidneys, and less than
2% is excreted in faeces. Although some degradation seems to occur, the great
majority of activity excreted in urine is still peptide bound, even after 48 h. The
biokinetic data come from patients with carcinoid tumours and neuroendocrine
tumours in the gastrointestinal tract. Uptake in tumour tissue present in any given
organ may therefore be included in the published organ uptake values.
(C151) Intravenously injected 111In-DTPA-D-Phe-1-octreotide is assumed to be
taken up immediately in liver, spleen, kidneys, and thyroid, while the rest is assumed
to be distributed homogeneously in the remainder of the body. Experimental reten-
tion data are best described by mono- or bi-exponential functions. The small amount
of excretion via the gastrointestinal tract is not included in the model because its
contribution to the absorbed dose in normal circumstances is negligible. According
to Claessens et al. (1995) and Koizumi et al. (1989), there is detachment of part of the
molecule, giving an 111In substance with long-term retention. For this long-term
retention, the same half-time as for In ions [Publication 53 (ICRP, 1987)] is assumed.
(C152) An observed excretion of 85% via urine after 24 h fits well with the model
proposed.

111
C.51.2. References for In-labelled octreotide
Bajc, M., Palmer, J., Ohlsson, T., et al., 1994. Distribution and dosimetry of 111In DTPA-D-
Phe-octreotide in man assessed by whole body scintigraphy. Acta Radiol. 35, 53–57.
Claessens, R.A.M.J., Koenders, E.B., Boerman, O.C., et al., 1995. Dissociation of indium
from indium-111 labelled triamine penta acetic acid conjugated with non-specific polyclo-
nal human immunoglobulin G in inflammatory foci. Eur. J. Nucl. Med. 22, 212–219.

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Forssell Aronsson, E., Fjälling, M., Nilsson, O., et al., 1995. 111In activity concentration in
human tissue samples after i.v. injection of 111In-DTPA-D-Phe-1-octreotide. J. Nucl. Med.
36, 7–12.
Forssell Aronsson, E., Lanhede, B., Fjälling, M., et al., 1999. Pharmacokinetics and dosimetry
of 111In-DTPA-D-Phe-1-octreotide in patients with neuroendocrine tumours. In: S-Stelson,
A.T., Stabin, M.G., Sparks, R.B. (Eds.), Proceedings of the Sixth International
Radiopharmaceutical Dosimetry Symposium, Gatlinburg, TN, USA, May 7–10, 1996.
Oak Ridge Associated Universities, Oak Ridge, TN, USA, pp. 643–655.
ICRP, 1987. Radiation dose to patients from radiopharmaceuticals. ICRP Publication 53.
Ann. ICRP 18(1–4).
Koizumi, M., Endo, K., Watanabe, Y., et al., 1989. Pharamcokinetics of internally labeled
monoclonal antibodies in osteogenic sarcoma xenografts in nude mice. Cancer Res. 49,
1752–1757.
Krenning, E.P., Bakker, W.H., Kooij, P.P.M., et al., 1992. Somatostatin receptor scintigraphy
with indium-111-DTPA-D-Phe-1-octreotide in man: metabolism, dosimetry and compar-
ison with iodine-123-Tyr-3-octreotide. J. Nucl. Med. 33, 652–658.
Krenning, E.P., Kwekkeboom, D.J., Bakker, W.H., et al., 1993. Somatostatin receptor scinti-
graphy with (111In-DTPA-D-Phe1)-and 123I-Tyr3)-octreotide: the Rotterdam experience
with more than 1000 patients. Eur. J. Nucl. Med. 20, 716–731.
Leide-Svegborn, S., Nosslin, B., Mattsson, S., 1996. Biokinetics and dosimetry of 111In-
DTPA-D-Phe-1-octreotide in patients. In: S-Stelson, A.T., Stabin, M.G., Sparks, R.B.
(Eds.), Proceedings of the Sixth International Radiopharmaceutical Dosimetry
Symposium, Gatlinburg, TN, USA, May 7–10, 1996. Oak Ridge Associated Universities,
Oak Ridge, TN, USA, pp. 631–642.
Stabin, M.G., Kooij, P.P.M., Bakker, W.H., et al., 1997. Radiation dosimetry for indium-111-
pentetreotide. J. Nucl. Med. 38, 1919–1922.

111
Table C.102. Biokinetic data for In-labelled octreotide.

Organ (S) Fs T (h) a Ãs/A0 (h)

Liver 0.06 2.0 0.40 2.6

60 0.30
1700 0.30
Spleen 0.05 60 1.00 2.3
Kidney 0.06 60 1.00 2.8
Thyroid 0.001 60 1.00 0.046
Other organs and tissues 0.829 3.0 0.90 6.9
60 0.10
Urinary bladder contents 1.00
Adult, 15 years 1.7
10 years 1.4
5 years, 1 year 0.91

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111
Table C.103. Absorbed doses for In-labelled octreotide.

Absorbed dose per unit activity administered (mGy MBq1)

Organ Adult 15 years 10 years 5 years 1 year

Adrenals 5.8E02 7.5E02 1.2E01 1.7E01 3.0E01

Bone surfaces 2.7E02 3.4E02 5.0E02 7.6E02 1.5E01
Brain 9.6E03 1.2E02 2.0E02 3.3E02 5.8E02
Breast 1.2E02 1.5E02 2.3E02 3.7E02 6.8E02
Gallbladder wall 5.2E02 6.3E02 9.2E02 1.4E01 2.2E01
Gastrointestinal tract
Stomach wall 4.3E02 5.0E02 7.8E02 1.1E01 1.8E01
Small intestine wall 2.9E02 3.8E02 5.9E02 9.1E02 1.6E01
Colon wall 2.9E02 3.6E02 5.5E02 8.9E02 1.5E02
(Upper large intestine wall 3.0E02 3.7E02 5.8E02 9.4E02 1.6E01)
(Lower large intestine wall 2.7E02 3.4E02 5.0E02 7.6E02 1.3E01)
Heart wall 2.5E02 3.2E02 4.9E02 7.1E02 1.3E01
Kidneys 4.1E01 4.9E01 6.7E01 9.6E01 1.6E+00
Liver 1.0E01 1.3E01 2.0E01 2.7E01 4.8E01
Lungs 2.3E02 3.0E02 4.4E02 6.8E02 1.2E01
Muscles 2.0E02 2.6E02 3.8E02 5.7E02 1.1E01
Oesophagus 1.4E02 1.9E02 2.8E02 4.4E02 7.8E02
Ovaries 2.7E02 3.5E02 5.1E02 8.1E02 1.4E01
Pancreas 7.2E02 8.8E02 1.3E01 2.0E01 3.2E01
Red marrow 2.2E02 2.7E02 3.9E02 5.3E02 8.7E02
Skin 1.1E02 1.3E02 2.1E02 3.3E02 6.2E02
Spleen 5.7E01 7.9E01 1.2E+00 1.8E+00 3.1E+00
Testes 1.7E02 2.3E02 3.5E02 5.5E02 1.0E01
Thymus 1.4E02 1.9E02 2.8E02 4.4E02 7.8E02
Thyroid 7.6E02 1.2E01 1.8E01 3.7E01 6.9E01
Urinary bladder wall 2.0E01 2.5E01 3.1E01 4.6E01 8.2E01
Uterus 3.9E02 4.9E02 7.1E02 1.1E01 1.9E01
Remaining organs 2.3E02 2.8E02 4.2E02 6.3E02 1.1E01

Effective dose (mSv MBq1) 5.4E02 7.1E02 1.0E01 1.6E01 2.8E01

111
The physical half-life of In is 67.9 h.

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 123 124 125 131
C.52. I, I, I, and I-iodide
C.52.1. Biokinetic model

(C153) The kinetic behaviour of iodide has been studied extensively, and several
biokinetic models have been suggested (Riggs, 1952; Berman et al., 1968; MIRD,
1975; Smith, 1988; Zanzonico, 2000; Johansson et al., 2003; Leggett, 2010). These
may be described either as compartment models or in terms of fractional uptakes and
half-times. The model presented in Publication 53 (ICRP, 1987) is a highly simplified
kinetic model presenting the absorbed dose for different thyroid uptakes, expressed
as the fractional distribution of iodide in the thyroid, Fs, in the range 0.05–0.55.
ICRP has published another model to be used for members of the public, including
occupational exposure to radioiodine, in Publications 56 and 67 (ICRP, 1990, 1993),
and this model is also a greatly simplified model, expressed as half-times and frac-
tional distributions. In addition to these models, Publication 88 (ICRP, 2001) pre-
sents a more complex compartment model for the biokinetics of iodine in a pregnant
mother and the fetus, with the aim of calculating the dose to the embryo and fetus.
(C154) The biokinetic model adopted for the present report was developed by
Leggett (2010). It is described as a compartment model including inorganic iodide
as well as organically bound iodine released to the body tissues following discharge
from the thyroid. For a more comprehensive discussion and description of the
model, the reader is referred to the original paper (Leggett, 2010). Applying the
transfer coefficients proposed by Leggett (Table C.104) results in 26% uptake of
131
I in the thyroid 24 h after administration. The same 24-h uptake is obtained
with the Publication 53 model if a fractional distribution in the thyroid, Fs, of 0.33
is used (ICRP, 1987). The adopted model is also well in accordance with the ICRP
model for occupational exposure (ICRP, 1990), where it is assumed that 0.3 of iodine
entering the blood is taken up by the thyroid.
(C155) The Leggett model, as presented in Fig. C.2, has, for the purpose of dose
calculations, been adjusted in order to be congruent with other radiopharmaceutical
models. The modifications are included in Table C.104.
. For the biokinetics of the gastrointestinal tract, the HAT model (ICRP, 2006)
has been used. The resulting cumulated activities in the different parts of the
colon have, for dose calculations thereafter, been redistributed to ULI and
LLI, as defined by the old gastrointestinal tract model (ICRP, 1979).
. An organ ‘kidneys 3’ has been introduced for the transfer of iodide to the
urinary bladder. The mean residence time in ‘kidneys 3’ is 5 min, which is in
accordance with other models for radiopharmaceutical dosimetry (ICRP,
1998).
(C156) The uptake of iodide in the normal thyroid depends on the dietary intake
of stable iodine (Stanbury et al., 1954; Zvonova, 1989) which varies in different
regions of the world. In order to take this variation into account, the Task Group
has chosen to include dose data for typical ‘low’ and ‘high’ thyroid uptake of iodide.
This has been accomplished by adjusting the transfer coefficient for thyroid uptake
(i.e. from blood to thyroid), aiming at 24-h uptake of 16% and 36%, respectively, for

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 ICRP Publication 128

131
I. For the Publication 53 model (ICRP, 1987), this is obtained if Fs is set to 0.20
and 0.45, respectively. All other transfer factors are independent of the uptake in
thyroid, including the release of organically bound iodine from the thyroid.

Blocked thyroid
(C157) In order to obtain the cumulated activities in different organs when the
thyroid has been blocked, the transfer between the compartments representing inor-
ganic iodide in the thyroid to the compartment for organically bound iodine is set to
zero. The dose to the thyroid in this case is thus only a result of uptake of iodide and
irradiation from other parts of the body. Incomplete blockage will, however, increase
the radiation dose to the thyroid; one may use dose data for the thyroid for different
uptakes to get some idea of the magnitude of this dose.

Age dependence
(C158) There is no significant age dependence of uptake in the thyroid after the
first few days after birth. However, for organically bound iodine, the biological half-
time of thyroid to blood shows distinct age dependence. The half-time in adults is 90
days, and 65, 50, 30, and 15 days for 15, 10, 5, and 1 year olds, respectively (Leggett,
2015). In general, the turnover rate of organically bound iodine, also between other
compartments, may be assumed to be faster (Leggett, 2015) with a transfer coefficient
approximately 50% larger for the youngest ages.

123 124 125 131

C.52.2. References for I, I, I, and I
Berman, M., Hoff, E., Barandes, M., et al., 1968. Iodine kinetics in man – a model. J. Clin.
Endocrinol. Metab. 28, 1–14.
ICRP, 1979. Limits for intakes of radionuclides by workers. ICRP Publication 30, Part 1.
Ann. ICRP 2(3/4).
ICRP, 1987. Radiation dose to patients from radiopharmaceuticals. ICRP Publication 53.
Ann. ICRP 18(1–4).
ICRP, 1990. Age-dependent doses to members of the public from intake of radionuclides. Part
1. ICRP Publication 56. Ann. ICRP 20(2).
ICRP, 1993. Age-dependent doses to members of the public from intake of radionuclides. Part
2. Ingestion dose coefficients. ICRP Publication 67. Ann. ICRP 23(3/4).
ICRP, 1998. Radiation dose to patients from radiopharmaceuticals. Addendum 2 to ICRP
Publication 53. ICRP Publication 80. Ann. ICRP 28(3).
ICRP, 2001. Doses to the embryo and fetus from intakes of radionuclides by the mother.
Corrected version May 2002. ICRP Publication 88, Part 1. Ann. ICRP 31(1–3).
ICRP, 2006. Human alimentary tract model for radiological protection. ICRP Publication
100. Ann. ICRP 36(3).
ICRP, 2008. Radiation dose to patients from radiopharmaceuticals. Addendum 3 to ICRP
Publication 53. ICRP Publication 106. Ann. ICRP 38(1/2).
Johansson, L., Leide-Svegborn, S., Mattsson, S., et al., 2003. Biokinetics of iodide in man:
refinement of current ICRP dosimetry models. Cancer Biother. Radiopharm. 18, 445–450.

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 Radiation dose to patients from radiopharmaceuticals

Leggett, R.W., 2010. A physiological systems model for iodine for use in radiation protection.
Radiat. Res. 174, 496–516.
Leggett, R.W., 2015. An age-specific biokinetic model for iodine. To be published.
MIRD, 1975. MIRD/Dose Estimate Report No. 7. Summary of current radiation dose esti-
mates to humans from 123I, 124I, 126I, 130I, and 131I as sodium rose bengal. J. Nucl.
Med. 16, 1214–1217.
Riggs, D.S., 1952. Quantitative aspects of iodine metabolism in man. Pharmacol. Rev. 4,
284–370.
Smith, T., 1988. A simplified recycling model for the dosimetry of radioiodide. Phys. Med.
Biol. 33, 1141–1157.
Stanbury, J.B., Brownell, G.L., Riggs, D.L., et al., 1954. Endemic Goiter. The Adaption of
Man to Iodide Deficiency. Harvard University Press, Cambridge, MA.
Zanzonico, P.B., 2000. Age-dependent thyroid absorbed doses for radiobiologically significant
radioisotopes of iodine. Health Phys. 78, 60–67.
Zvonova, I.A., 1989. Dietary intake of stable I and some aspects of radioiodine dosimetry.
Health Phys. 78, 471–475.

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Fig. C.2. Compartment model used to describe the kinetics of iodine (Leggett, 2010).

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Table C.104. Transfer coefficients (h1) for the compartment model.

Pathway Adults 15 years 10 years 5 years 1 year

Blood iodide to thyroid 3.03E01 3.03E01 3.03E01 3.03E01 3.03E01

1 (medium uptake)
Blood iodide to salivary 2.15E01 2.15E01 2.15E01 2.15E01 2.15E01
glands
Blood iodide to stomach 3.58E01 3.58E01 3.58E01 3.58E01 3.58E01
wall
Blood iodide to other 1 2.50E+01 2.50E+01 2.50E+01 2.50E+01 2.50E+01
Blood iodide to kidneys 1 1.04E+00 1.04E+00 1.04E+00 1.04E+00 1.04E+00
Blood iodide to liver 1 6.25E01 6.25E01 6.25E01 6.25E01 6.25E01
Salivary glands to stom- 2.08E+00 2.08E+00 2.08E+00 2.08E+00 2.08E+00
ach contents
Stomach wall to stom- 2.08E+00 2.08E+00 2.08E+00 2.08E+00 2.08E+00
ach contents
Thyroid 1 to thyroid 2 3.96E+00 3.96E+00 3.96E+00 3.96E+00 3.96E+00
Thyroid 1 to blood 1.50E+00 1.50E+00 1.50E+00 1.50E+00 1.50E+00
iodide
Thyroid 2 to blood 3.21E04 4.46E04 5.79E04 9.63E04 1.93E03
organic
Other 1 to blood iodide 1.38E+01 1.38E+01 1.38E+01 1.38E+01 1.38E+01
Other 1 to other 2 1.46E+00 1.46E+00 1.46E+00 1.46E+00 1.46E+00
Other 2 to other 1 2.33E+00 2.33E+00 2.33E+00 2.33E+00 2.33E+00
Kidneys 1 to blood 4.17E+00 4.17E+00 4.17E+00 4.17E+00 4.17E+00
iodide
Liver 1 to blood iodide 4.17E+00 4.17E+00 4.17E+00 4.17E+00 4.17E+00
Blood organic to other 3 6.25E01 7.29E01 7.96E01 8.75E01 9.71E01
Other 3 to blood organic 8.75E01 1.02E+00 1.11E+00 1.23E+00 1.36E+00
Other 3 to other 4 5.00E02 5.83E02 6.38E02 7.00E02 7.79E02
Other 4 to other 3 2.58E02 3.01E02 3.29E02 3.62E02 4.02E02
Other 4 to blood iodide 5.83E03 6.79E03 7.42E03 8.17E03 9.08E03
Blood organic to kidneys 2 1.50E01 1.75E01 1.91E01 2.10E01 2.33E01
Kidneys 2 to blood 8.75E01 1.02E+00 1.11E+00 1.23E+00 1.36E+00
organic
Kidneys 2 to blood 5.83E03 6.79E03 7.42E03 8.17E03 9.08E03
iodide
Blood iodide to kidneys 3 4.93E01 4.93E01 4.93E01 4.93E01 4.93E01
Kidneys 3 to bladder 1.20E+01 1.20E+01 1.20E+01 1.20E+01 1.20E+01
contents
Blood organic to liver 2 8.75E01 1.02E+00 1.11E+00 1.23E+00 1.36E+00
(continued on next page)

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 ICRP Publication 128

Table C.104. (continued)

Pathway Adults 15 years 10 years 5 years 1 year

Liver 2 to blood organic 8.75E01 1.02E+00 1.11E+00 1.23E+00 1.36E+00

Liver 2 to blood iodide 5.83E03 6.79E03 7.42E03 8.17E03 9.08E03
Liver 2 to right colon 3.33E03 3.89E03 4.25E03 4.67E03 5.17E03
contents
Stomach contents to 8.57E01 8.57E01 8.57E01 8.57E01 8.57E01
small intestine contents
Small intestine contents 2.50E01 2.50E01 2.50E01 2.50E01 2.50E01
to right colon contents
Right colon to left colon 8.33E02 9.09E02 9.09E02 9.09E02 1.00E01
Left colon to 8.33E02 9.09E02 9.09E02 9.09E02 1.00E01
sigmoideum
Sigmoideum to faeces 8.33E02 8.33E02 8.33E02 8.33E02 8.33E02
Small intestine contents 2.48E+01 2.48E+01 2.48E+01 2.48E+01 2.48E+01
to blood iodide
Blood iodide to thyroid 1.70E01 1.70E01 1.70E01 1.70E01 1.70E01
1 (low)
Blood iodide to thyroid 4.80E01 4.80E01 4.80E01 4.80E01 4.80E01
1 (high)
See text for explanation of organs not illustrated in Fig. C.2.

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123 124 125 131

Table C.105. Biokinetic data for I, I, I, and I.
Adult Ã/A0 (h)

Oral administration Intravenous administration

123 124 125 131 123 124
Organ (S) I I I I I I

Thyroid blocked, uptake 0%

Blood 1.2 1.8 2.0 1.9 1.3 1.9
Kidneys 0.34 0.53 0.57 0.55 0.37 0.54
Liver 0.18 0.27 0.30 0.28 0.19 0.28
Salivary glands 0.12 0.19 0.20 0.20 0.13 0.19
Stomach wall 0.20 0.31 0.34 0.33 0.21 0.32
Thyroid 0.23 0.37 0.40 0.38 0.25 0.37
Gastrointestinal tract
Stomach contents 1.8 2.4 2.5 2.4 0.79 1.2
Small intestine contents 0.063 0.081 0.085 0.083 0.027 0.042
Upper large intestine contents 0.15 0.32 0.37 0.35 0.064 0.17
Lower large intestine contents 0.081 0.30 0.38 0.34 0.035 0.16
Other organs and tissues 3.5 5.4 5.8 5.6 3.7 5.5
Urinary bladder contents 0.98 1.6 1.7 1.7 1.1 1.7
Thyroid, low uptake
Blood 1.0 1.7 6.1 2.1 1.1 1.7
Kidneys 0.30 0.47 1.2 0.54 0.32 0.48
Liver 0.16 0.42 4.7 0.75 0.17 0.43
Salivary glands 0.10 0.15 0.17 0.16 0.11 0.16
Stomach wall 0.17 0.26 0.29 0.27 0.19 0.26
Thyroid 2.5 25 260 49 2.6 26
Gastrointestinal tract
Stomach contents 1.7 2.1 2.3 2.2 0.69 1.0
Small intestine contents 0.059 0.073 0.078 0.075 0.023 0.034
Upper large intestine contents 0.14 0.30 0.60 0.34 0.056 0.15
Lower large intestine contents 0.077 0.28 0.62 0.33 0.030 0.14
Other organs and tissues 3.0 4.7 13 5.5 3.3 4.8
Urinary bladder contents 0.86 1.3 1.5 1.3 1.0 1.4
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 ICRP Publication 128

Table C.105. (continued)

Adult Ã/A0 (h)

Oral administration Intravenous administration

123 124 125 131 123 124
Organ (S) I I I I I I

Thyroid, medium uptake

Blood 0.95 1.6 8.6 2.2 1.0 1.6
Kidneys 0.27 0.43 1.6 0.53 0.29 0.44
Liver 0.15 0.50 7.3 1.0 0.16 0.51
Salivary glands 0.095 0.13 0.16 0.14 0.10 0.14
Stomach wall 0.16 0.22 0.26 0.23 0.17 0.23
Thyroid 3.9 40 410 76 4.2 40
Gastrointestinal tract
Stomach contents 1.7 2.0 2.2 2.1 0.62 0.88
Small intestine contents 0.057 0.069 0.074 0.070 0.021 0.030
Upper large intestine contents 0.14 0.29 0.74 0.34 0.051 0.14
Lower large intestine contents 0.074 0.27 0.76 0.33 0.027 0.13
Other organs and tissues 2.7 4.3 17 5.4 2.9 4.4
Urinary bladder contents 0.78 1.1 1.3 1.2 0.93 1.3
Thyroid, high uptake
Blood 0.84 1.5 11 2.3 0.90 1.6
Kidneys 0.24 0.40 2.1 0.52 0.26 0.40
Liver 0.13 0.58 10 1.3 0.14 0.59
Salivary glands 0.084 0.11 0.14 0.12 0.090 0.12
Stomach wall 0.14 0.19 0.23 0.20 0.15 0.19
Thyroid 5.5 54 570 100 5.9 55
Gastrointestinal tract
Stomach contents 1.6 1.9 2.0 1.9 0.55 0.75
Small intestine contents 0.055 0.065 0.070 0.066 0.019 0.026
Upper large intestine contents 0.13 0.28 0.88 0.34 0.045 0.13
Lower large intestine contents 0.071 0.26 0.90 0.33 0.024 0.12
Other organs and tissues 2.4 4.0 22 5.3 2.6 4.0
Urinary bladder contents 0.69 0.98 1.2 1.0 0.83 1.1

Ãs/A0, time-integrated activity (cumulated activity) in organ S for adults. (continued on next page)

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Table C.105.(continued)
15 years Ã/A0 (h)

Oral administration Intravenous administration

123 124 125 131 123 124
Organ (S) I I I I I I

Thyroid blocked, uptake 0%

Blood 1.2 1.8 2.0 1.9 1.3 1.9
Kidneys 0.34 0.53 0.57 0.55 0.37 0.54
Liver 0.18 0.27 0.30 0.28 0.19 0.28
Salivary glands 0.12 0.19 0.20 0.20 0.13 0.19
Stomach wall 0.20 0.31 0.34 0.33 0.21 0.32
Thyroid 0.23 0.37 0.40 0.38 2.5 0.37
Gastrointestinal tract
Stomach contents 1.8 2.4 2.5 2.4 0.79 1.2
Small intestine contents 0.063 0.081 0.085 0.083 0.027 0.042
Upper large intestine contents 0.14 0.30 0.34 0.32 0.061 0.16
Lower large intestine contents 0.083 0.29 0.37 0.33 0.036 0.15
Other organs and tissues 3.5 5.4 5.8 5.6 3.7 5.5
Urinary bladder contents 0.98 1.6 1.7 1.7 1.1 1.7
Thyroid, low uptake
Blood 1.0 1.7 6.4 2.2 1.1 1.8
Kidneys 0.30 0.48 1.3 0.56 0.32 0.49
Liver 0.16 0.47 4.9 0.87 0.17 0.48
Salivary glands 0.10 0.15 0.18 0.16 0.11 0.16
Stomach wall 0.17 0.26 0.29 0.27 0.19 0.26
Thyroid 2.4 25 220 47 2.6 26
Gastrointestinal tract
Stomach contents 1.7 2.1 2.3 2.2 0.69 1.0
Small intestine contents 0.059 0.073 0.079 0.075 0.023 0.034
Upper large intestine contents 0.14 0.29 0.61 0.33 0.054 0.14
Lower large intestine contents 0.079 0.28 0.66 0.34 0.031 0.14
Other organs and tissues 3.0 4.8 14 5.4 3.3 4.9
Urinary bladder contents 0.86 1.3 1.5 1.4 1.0 1.4
(continued on next page)

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 ICRP Publication 128

Table C.105. (continued)

15 years Ã/A0 (h)

Oral administration Intravenous administration

123 124 125 131 123 124
Organ (S) I I I I I I

Thyroid, medium uptake

Blood 0.95 1.7 9.2 2.4 1.0 1.7
Kidneys 0.27 0.45 1.7 0.57 0.29 0.45
Liver 0.15 0.58 7.8 1.2 0.16 0.59
Salivary glands 0.095 0.13 0.16 0.14 0.10 0.14
Stomach wall 0.16 0.22 0.26 0.23 0.17 0.23
Thyroid 3.9 39 360 74 4.2 40
Gastrointestinal tract
Stomach contents 1.7 2.0 2.2 2.1 0.62 0.88
Small intestine contents 0.057 0.069 0.075 0.071 0.021 0.030
Upper large intestine contents 0.13 0.28 0.78 0.33 0.049 0.13
Lower large intestine contents 0.076 0.27 0.84 0.34 0.028 0.13
Other organs and tissues 2.7 4.5 18 5.7 2.9 4.6
Urinary bladder contents 0.78 1.1 1.3 1.2 0.93 1.3
Thyroid, high uptake
Blood 0.84 1.7 12 2.5 0.91 1.7
Kidneys 0.24 0.42 2.2 0.57 0.26 0.42
Liver 0.14 0.69 11 1.5 0.15 0.71
Salivary glands 0.084 0.12 0.14 0.12 0.090 0.12
Stomach wall 0.14 0.19 0.23 0.20 0.15 0.20
Thyroid 5.5 53 510 100 5.9 54
Gastrointestinal tract
Stomach contents 1.6 1.9 2.1 1.9 0.55 0.75
Small intestine contents 0.055 0.065 0.071 0.066 0.019 0.026
Upper large intestine contents 0.13 0.27 0.95 0.34 0.043 0.13
Lower large intestine contents 0.073 0.27 1.0 0.35 0.025 0.12
Other organs and tissues 2.4 4.2 23 5.8 2.6 4.2
Urinary bladder contents 0.69 0.98 1.2 1.0 0.83 1.1
(continued on next page)

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Table C.105.(continued)

10 years Ã/A0 (h)

Oral administration Intravenous administration

123 124 125 131 123 124
Organ (S) I I I I I I

Thyroid blocked, uptake 0%

Blood 1.2 1.8 2.0 1.9 1.3 1.9
Kidneys 0.34 0.53 0.57 0.55 0.37 0.54
Liver 0.18 0.27 0.30 0.28 0.19 0.28
Salivary glands 0.12 0.19 0.20 0.20 0.13 0.19
Stomach wall 0.20 0.31 0.34 0.33 0.21 0.32
Thyroid 0.23 0.37 0.40 0.38 2.5 0.37
Gastrointestinal tract
Stomach contents 1.8 2.4 2.5 2.4 0.79 1.2
Small intestine contents 0.063 0.081 0.085 0.083 0.027 0.042
Upper large intestine contents 0.14 0.30 0.34 0.32 0.061 0.16
Lower large intestine contents 0.083 0.29 0.37 0.33 0.036 0.15
Other organs and tissues 3.5 5.4 5.8 5.6 3.7 5.5
Urinary bladder contents 0.98 1.6 1.7 1.7 1.1 1.7
Thyroid, low uptake
Blood 1.0 1.8 6.7 2.3 1.1 1.8
Kidneys 0.30 0.49 1.4 0.58 0.32 0.50
Liver 0.16 0.53 5.2 1.0 0.17 0.54
Salivary glands 0.10 0.15 0.18 0.16 0.11 0.16
Stomach wall 0.17 0.26 0.30 0.27 0.19 0.26
Thyroid 2.4 25 200 46 2.6 25
Gastrointestinal tract
Stomach contents 1.7 2.1 2.3 2.2 0.69 1.0
Small intestine contents 0.059 0.073 0.079 0.075 0.023 0.034
Upper large intestine contents 0.14 0.29 0.66 0.34 0.054 0.15
Lower large intestine contents 0.079 0.29 0.71 0.35 0.031 0.14
Other organs and tissues 3.0 4.9 14 5.9 3.3 5.0
Urinary bladder contents 0.86 1.3 1.5 1.4 1.0 1.4
(continued on next page)

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Table C.105.(continued)

10 years Ã/A0 (h) (as for Adult and 15 year above and as for 5 years and 1 year below)

Oral administration Intravenous administration

123 124 125 131 123 124
Organ (S) I I I I I I

Thyroid, medium uptake

Blood 0.95 1.8 9.7 2.6 1.0 1.8
Kidneys 0.27 0.46 1.8 0.60 0.29 0.47
Liver 0.15 0.67 8.3 1.4 0.16 0.68
Salivary glands 0.095 0.13 0.16 0.14 0.10 0.14
Stomach wall 0.16 0.22 0.27 0.23 0.17 0.23
Thyroid 3.9 38 320 72 4.2 39
Gastrointestinal tract
Stomach contents 1.7 2.0 2.2 2.1 0.62 0.88
Small intestine contents 0.057 0.069 0.076 0.071 0.021 0.030
Upper large intestine contents 0.13 0.29 0.86 0.35 0.049 0.14
Lower large intestine contents 0.076 0.28 0.93 0.36 0.028 0.14
Other organs and tissues 2.8 4.7 19 6.1 3.0 4.7
Urinary bladder contents 0.78 1.1 1.4 1.2 0.93 1.3
Thyroid, high uptake
Blood 0.85 1.8 13 2.8 0.91 1.8
Kidneys 0.24 0.44 2.4 0.62 0.26 0.45
Liver 0.14 0.81 12 1.8 0.15 0.83
Salivary glands 0.084 0.12 0.14 0.12 0.090 0.12
Stomach wall 0.14 0.19 0.24 0.20 0.15 0.20
Thyroid 5.5 52 450 97 5.9 53
Gastrointestinal tract
Stomach contents 1.6 1.9 2.1 1.9 0.55 0.76
Small intestine contents 0.055 0.065 0.071 0.066 0.019 0.026
Upper large intestine contents 0.13 0.28 1.1 0.36 0.043 0.14
Lower large intestine contents 0.073 0.28 1.2 0.37 0.025 0.13
Other organs and tissues 2.4 4.4 25 6.3 2.6 4.5
Urinary bladder contents 0.69 0.98 1.2 1.0 0.83 1.1
Ãs/A0, time-integrated activity (cumulated activity) in organ S for 10 years. (continued on next page)

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 Radiation dose to patients from radiopharmaceuticals

Table C.105.(continued)

5 years Ã/A0 (h)

Oral administration Intravenous administration

123 124 125 131 123 124
Organ (S) I I I I I I

Thyroid blocked, uptake 0%

Blood 1.2 1.8 2.0 1.9 1.3 1.9
Kidneys 0.34 0.53 0.57 0.55 0.37 0.54
Liver 0.18 0.27 0.30 0.28 0.19 0.28
Salivary glands 0.12 0.19 0.20 0.20 0.13 0.19
Stomach wall 0.20 0.31 0.34 0.33 0.21 0.32
Thyroid 0.23 0.37 0.40 0.38 2.5 0.37
Gastrointestinal tract
Stomach contents 1.8 2.4 2.5 2.4 0.79 1.2
Small intestine contents 0.063 0.081 0.085 0.083 0.027 0.042
Upper large intestine contents 0.14 0.30 0.34 0.32 0.061 0.16
Lower large intestine contents 0.083 0.29 0.37 0.33 0.036 0.15
Other organs and tissues 3.5 5.4 5.8 5.6 3.7 5.5
Urinary bladder contents 0.85 1.4 1.5 1.4 0.98 1.5
Thyroid, low uptake
Blood 1.1 2.0 7.5 2.7 1.1 2.0
Kidneys 0.30 0.52 1.5 0.65 0.32 0.53
Liver 0.17 0.69 5.9 1.3 0.18 0.70
Salivary glands 0.10 0.15 0.18 0.16 0.11 0.16
Stomach wall 0.17 0.26 0.30 0.27 0.19 0.26
Thyroid 2.4 24 150 42 2.6 24
Gastrointestinal tract
Stomach contents 1.7 2.2 2.3 2.2 0.69 1.0
Small intestine contents 0.059 0.074 0.080 0.075 0.023 0.035
Upper large intestine contents 0.14 0.30 0.75 0.37 0.054 0.16
Lower large intestine contents 0.079 0.30 0.81 0.38 0.031 0.16
Other organs and tissues 3.0 5.2 16 6.6 3.3 5.3
Urinary bladder contents 0.74 1.1 1.3 1.2 0.87 1.2
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 ICRP Publication 128

Table C.105. (continued)

5 years Ã/A0 (h)

Oral administration Intravenous administration

123 124 125 131 123 124
Organ (S) I I I I I I

Thyroid, medium uptake

Blood 0.96 2.0 11 3.1 1.0 2.1
Kidneys 0.27 0.51 2.1 0.70 0.29 0.52
Liver 0.16 0.92 9.5 1.9 0.17 0.93
Salivary glands 0.095 0.14 0.17 0.14 0.10 0.14
Stomach wall 0.16 0.23 0.28 0.24 0.17 0.23
Thyroid 3.9 37 240 66 4.2 37
Gastrointestinal tract
Stomach contents 1.7 2.0 2.2 2.1 0.62 0.89
Small intestine contents 0.057 0.069 0.077 0.071 0.021 0.030
Upper large intestine contents 0.13 0.31 1.0 0.40 0.049 0.16
Lower large intestine contents 0.076 0.30 1.1 0.41 0.029 0.16
Other organs and tissues 2.8 5.1 22 7.1 3.0 5.2
Urinary bladder contents 0.67 0.98 1.2 1.0 0.79 1.1
Thyroid, high uptake
Blood 0.86 2.1 15 3.6 0.92 2.2
Kidneys 0.24 0.50 2.7 0.75 0.26 0.51
Liver 0.15 1.2 14 2.5 0.16 1.2
Salivary glands 0.084 0.12 0.15 0.12 0.090 0.12
Stomach wall 0.14 0.19 0.25 0.20 0.15 0.20
Thyroid 5.5 50 350 91 5.9 51
Gastrointestinal tract
Stomach contents 1.6 1.9 2.1 2.0 0.55 0.76
Small intestine contents 0.055 0.065 0.073 0.067 0.019 0.026
Upper large intestine contents 0.13 0.31 1.3 0.43 0.044 0.17
Lower large intestine contents 0.073 0.30 1.4 0.44 0.026 0.16
Other organs and tissues 2.5 5.0 29 7.6 2.6 5.1
Urinary bladder contents 0.59 0.84 1.1 0.89 0.71 0.94
Ãs/A0, time-integrated activity (cumulated activity) in organ S for 5 years. (continued on next page)

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 Radiation dose to patients from radiopharmaceuticals

Table C.105.(continued)

1 year Ã/A0 (h)

Oral administration Intravenous administration

123 124 125 131 123 124
Organ (S) I I I I I I

Blood 1.2 1.8 2.0 1.9 1.3 1.9

Kidneys 0.34 0.53 0.57 0.55 0.37 0.54
Liver 0.18 0.27 0.30 0.28 0.19 0.28
Salivary glands 0.12 0.19 0.20 0.20 0.13 0.19
Stomach wall 0.20 0.31 0.34 0.33 0.21 0.32
Thyroid 0.23 0.37 0.40 0.38 2.5 0.37
Gastrointestinal tract
Stomach contents 1.8 2.4 2.5 2.4 0.79 1.2
Small intestine contents 0.063 0.081 0.085 0.083 0.027 0.042
Upper large intestine contents 0.14 0.27 0.31 0.29 0.058 0.14
Lower large intestine contents 0.085 0.29 0.36 0.32 0.037 0.15
Other organs and tissues 3.5 5.4 5.8 5.6 3.7 5.5
Urinary bladder contents 0.57 0.90 0.98 0.94 0.65 0.96
Thyroid, low uptake
Blood 1.1 2.3 8.1 3.3 1.1 2.4
Kidneys 0.30 0.58 1.6 0.76 0.33 0.59
Liver 0.18 1.0 6.6 2.0 0.19 1.0
Salivary glands 0.10 0.16 0.19 0.16 0.11 0.16
Stomach wall 0.17 0.26 0.31 0.27 0.19 0.26
Thyroid 2.4 21 92 36 2.6 22
Gastrointestinal tract
Stomach contents 1.7 2.2 2.4 2.2 0.69 1.0
Small intestine contents 0.059 0.074 0.081 0.076 0.023 0.035
Upper large intestine contents 0.13 0.30 0.78 0.39 0.052 0.17
Lower large intestine contents 0.081 0.32 0.90 0.43 0.033 0.18
Other organs and tissues 3.1 5.8 17 7.7 3.3 5.9
Urinary bladder contents 0.50 0.74 0.89 0.79 0.57 0.80
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 ICRP Publication 128

Table C.105. (continued)

1 year Ã/A0 (h)

Oral administration Intravenous administration

123 124 125 131 123 124
Organ (S) I I I I I I

Thyroid, medium uptake

Blood 0.98 2.6 12 4.2 1.0 2.6
Kidneys 0.28 0.60 2.3 0.88 0.30 0.61
Liver 0.18 1.4 11 2.9 0.19 1.5
Salivary glands 0.095 0.14 0.17 0.15 0.10 0.14
Stomach wall 0.16 0.23 0.29 0.24 0.17 0.23
Thyroid 3.8 33 150 56 4.1 34
Gastrointestinal tract
Stomach contents 1.7 2.0 2.3 2.1 0.62 0.90
Small intestine contents 0.057 0.070 0.078 0.072 0.021 0.031
Upper large intestine contents 0.13 0.32 1.1 0.45 0.048 0.19
Lower large intestine contents 0.079 0.34 1.3 0.50 0.030 0.20
Other organs and tissues 2.8 6.0 24 9.0 3.0 6.1
Urinary bladder contents 0.45 0.66 0.83 0.70 0.52 0.71
Thyroid, high uptake
Blood 0.89 2.9 17 5.0 0.95 2.9
Kidneys 0.25 0.62 3.1 1.0 0.27 0.63
Liver 0.17 1.9 16 3.9 0.19 1.9
Salivary glands 0.084 0.12 0.16 0.13 0.090 0.12
Stomach wall 0.14 0.20 0.26 0.21 0.15 0.20
Thyroid 5.4 45 220 77 5.8 46
Gastrointestinal tract
Stomach contents 1.6 1.9 2.2 2.0 0.55 0.77
Small intestine contents 0.055 0.066 0.075 0.068 0.019 0.026
Upper large intestine contents 0.12 0.34 1.4 0.51 0.043 0.21
Lower large intestine contents 0.076 0.36 1.7 0.57 0.027 0.22
Other organs and tissues 2.5 6.2 33 10 2.7 6.4
Urinary bladder contents 0.40 0.57 0.76 0.61 0.47 0.62
Ãs/A0, time-integrated activity (cumulated activity) in organ S for 1 year.

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 Radiation dose to patients from radiopharmaceuticals

123
Table C.106. Absorbed doses for I-iodide.

Absorbed dose per unit activity administered (mGy MBq1)

Organ Adult 15 years 10 years 5 years 1 year

Thyroid blocked, intravenous administration

Adrenals 8.8E03 1.1E02 1.7E02 2.7E02 4.9E02
Bone surfaces 9.2E03 1.1E02 1.8E02 2.7E02 5.3E02
Brain 4.1E03 5.2E03 8.4E03 1.4E02 2.5E02
Breast 3.6E03 4.5E03 7.1E03 1.2E02 2.2E02
Gallbladder wall 7.9E03 1.0E02 1.8E02 2.9E02 4.4E02
Gastrointestinal tract
Stomach wall 7.4E02 9.6E02 1.3E01 2.2E01 4.5E01
Small intestine wall 6.4E03 8.1E03 1.3E02 2.0E02 3.3E02
Colon wall 9.8E03 1.2E02 2.0E02 3.1E02 5.3E02
(Upper large intestine wall 9.5E03 1.2E02 2.0E02 3.1E02 5.4E02)
(Lower large intestine wall 1.0E02 1.3E02 2.1E02 3.1E02 5.2E02)
Heart wall 1.1E02 1.4E02 2.2E02 3.4E02 6.1E02
Kidneys 3.9E02 4.7E02 6.6E02 9.6E02 1.7E01
Liver 9.6E03 1.2E02 1.9E02 3.0E02 5.4E02
Lungs 9.0E03 1.2E02 1.8E02 2.9E02 5.5E02
Muscles 5.5E03 6.9E03 1.1E02 1.6E02 2.9E02
Oesophagus 5.2E03 6.6E03 1.0E02 1.7E02 3.2E02
Ovaries 8.1E03 1.0E02 1.6E02 2.4E02 3.9E02
Pancreas 1.3E02 1.6E02 2.4E02 3.5E02 6.0E02
Red marrow 5.5E03 6.8E03 1.0E02 1.6E02 2.8E02
Salivary glands 3.5E02 4.3E02 5.6E02 7.4E02 1.1E01
Skin 3.2E03 3.9E03 6.2E03 9.9E03 1.8E02
Spleen 1.2E02 1.5E02 2.3E02 3.5E02 6.1E02
Testes 5.5E03 7.3E03 1.2E02 1.9E02 3.1E02
Thymus 5.2E03 6.6E03 1.0E02 1.7E02 3.2E02
Thyroid 2.5E01 4.1E01 6.2E01 1.4E+00 2.5E+00
Urinary bladder wall 8.7E02 1.1E01 1.6E01 2.1E01 2.6E01
Uterus 1.2E02 1.5E02 2.5E02 3.5E02 5.1E02
Remaining organs 5.9E03 7.5E03 1.2E02 1.8E02 3.2E02

Effective dose (mSv MBq1) 3.2E02 4.5E02 6.6E02 1.2E01 2.2E01

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 ICRP Publication 128

Table C.106. (continued)

Absorbed dose per unit activity administered (mGy MBq1)

Organ Adult 15 years 10 years 5 years 1 year

Thyroid blocked, oral administration

Adrenals 9.6E03 1.2E02 1.9E02 2.8E02 5.2E02
Bone surfaces 9.1E03 1.1E02 1.8E02 2.7E02 5.3E02
Brain 3.8E03 4.8E03 7.8E03 1.3E02 2.3E02
Breast 3.6E03 4.6E03 7.3E03 1.2E02 2.3E02
Gallbladder wall 9.2E03 1.3E02 2.3E02 3.9E02 5.9E02
Gastrointestinal tract
Stomach wall 1.3E01 1.7E01 2.3E01 3.9E01 7.7E01
Small intestine wall 8.7E03 1.1E02 1.8E02 2.8E02 4.8E02
Colon wall 1.5E02 1.9E02 3.1E02 4.8E02 8.6E02
(Upper large intestine wall 1.5E02 1.9E02 3.2E02 5.1E02 9.0E02)
(Lower large intestine wall 1.4E02 1.8E02 2.9E02 4.4E02 8.0E02)
Heart wall 1.2E02 1.5E02 2.3E02 3.6E02 6.4E02
Kidneys 3.8E02 4.5E02 6.4E02 9.3E02 1.6E01
Liver 9.8E03 1.3E02 2.0E02 3.2E02 5.8E02
Lungs 9.0E03 1.2E02 1.8E02 2.9E02 5.5E02
Muscles 5.7E03 7.2E03 1.1E02 1.7E02 3.1E02
Oesophagus 5.0E03 6.4E03 1.0E02 1.6E02 3.1E02
Ovaries 8.5E03 1.1E02 1.7E02 2.6E02 4.3E02
Pancreas 1.9E02 2.3E02 3.6E02 5.0E02 8.4E02
Red marrow 5.6E03 6.9E03 1.1E02 1.6E02 2.8E02
Salivary glands 3.3E02 4.0E02 5.2E02 6.9E02 9.9E02
Skin 3.2E03 3.8E03 6.1E03 9.9E03 1.8E02
Spleen 1.6E02 1.8E02 2.8E02 4.1E02 7.1E02
Testes 5.0E03 6.6E03 1.1E02 1.7E02 2.9E02
Thymus 5.0E03 6.4E03 1.0E02 1.6E02 3.1E02
Thyroid 2.4E01 3.8E01 5.8E01 1.3E+00 2.4E+00
Urinary bladder wall 7.5E02 9.6E02 1.4E01 1.8E01 2.3E01
Uterus 1.2E02 1.4E02 2.4E02 3.4E02 5.1E02
Remaining organs 6.2E03 7.9E03 1.2E02 1.9E02 3.3E02

Effective dose (mSv MBq1) 3.7E02 5.2E02 7.7E02 1.4E01 2.6E01

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 Radiation dose to patients from radiopharmaceuticals

Table C.106. (continued)

Absorbed dose per unit activity administered (mGy MBq1)

Organ Adult 15 years 10 years 5 years 1 year

Thyroid, low uptake, intravenous administration

Adrenals 7.8E03 9.9E03 1.6E02 2.4E02 4.5E02
Bone surfaces 1.0E02 1.2E02 1.8E02 2.9E02 5.4E02
Brain 5.0E03 6.0E03 9.1E03 1.4E02 2.5E02
Breast 3.5E03 4.4E03 7.3E03 1.2E02 2.3E02
Gallbladder wall 7.0E03 9.2E03 1.6E02 2.6E02 4.0E02
Gastrointestinal tract
Stomach wall 6.4E02 8.4E02 1.2E01 1.9E01 3.9E01
Small intestine wall 5.6E03 7.2E03 1.1E02 1.7E02 2.9E02
Colon wall 8.6E03 1.1E02 1.8E02 2.7E02 4.7E02
(Upper large intestine wall 8.3E03 1.1E02 1.7E02 2.8E02 4.8E02)
(Lower large intestine wall 8.9E03 1.1E02 1.8E02 2.7E02 4.6E02)
Heart wall 1.0E02 1.3E02 2.1E02 3.2E02 5.9E02
Kidneys 3.4E02 4.1E02 5.8E02 8.5E02 1.5E01
Liver 8.6E03 1.1E02 1.8E02 2.7E02 5.1E02
Lungs 8.9E03 1.1E02 1.8E02 2.9E02 5.6E02
Muscles 6.4E03 8.1E03 1.3E02 2.0E02 3.6E02
Oesophagus 6.2E03 8.6E03 1.5E02 2.9E02 6.5E02
Ovaries 7.1E03 9.1E03 1.4E02 2.1E02 3.5E02
Pancreas 1.1E02 1.4E02 2.1E02 3.1E02 5.4E02
Red marrow 5.7E03 7.0E03 1.0E02 1.5E02 2.8E02
Salivary glands 3.1E02 3.8E02 4.9E02 6.4E02 9.2E02
Skin 3.3E03 4.0E03 6.3E03 9.9E03 1.9E02
Spleen 1.1E02 1.3E02 2.0E02 3.1E02 5.5E02
Testes 4.8E03 6.4E03 1.1E02 1.6E02 2.7E02
Thymus 6.2E03 8.6E03 1.5E02 2.9E02 6.5E02
Thyroid 2.7E+00 4.3E+00 6.4E+00 1.4E+01 2.6E+01
Urinary bladder wall 7.7E02 9.8E02 1.4E01 1.8E01 2.3E01
Uterus 1.1E02 1.3E02 2.2E02 3.1E02 4.5E02
Remaining organs 6.6E03 8.5E03 1.3E02 2.0E02 3.5E02

Effective dose (mSv MBq1) 1.5E01 2.3E01 3.5E01 7.5E01 1.4E+00

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 ICRP Publication 128

Table C.106. (continued)

Absorbed dose per unit activity administered (mGy MBq1)

Organ Adult 15 years 10 years 5 years 1 year

Thyroid, low uptake, oral administration

Adrenals 8.7E03 1.1E02 1.7E02 2.6E02 4.8E02
Bone surfaces 1.0E02 1.2E02 1.8E02 2.8E02 5.4E02
Brain 4.7E03 5.6E03 8.5E03 1.3E02 2.3E02
Breast 3.5E03 4.5E03 7.5E03 1.3E02 2.4E02
Gallbladder wall 8.4E03 1.1E02 2.1E02 3.6E02 5.5E02
Gastrointestinal tract
Stomach wall 1.2E01 1.6E01 2.2E01 3.6E01 7.1E01
Small intestine wall 8.0E03 1.0E02 1.6E02 2.5E02 4.4E02
Colon wall 1.4E02 1.7E02 2.8E02 4.5E02 8.0E02
(Upper large intestine wall 1.4E02 1.8E02 3.0E02 4.8E02 8.5E02)
(Lower large intestine wall 1.3E02 1.6E02 2.6E02 4.1E02 7.5E02)
Heart wall 1.1E02 1.4E02 2.2E02 3.4E02 6.3E02
Kidneys 3.3E02 4.0E02 5.6E02 8.2E02 1.4E01
Liver 8.8E03 1.2E02 1.9E02 2.9E02 5.5E02
Lungs 8.8E03 1.1E02 1.8E02 2.9E02 5.6E02
Muscles 6.5E03 8.3E03 1.3E02 2.0E02 3.7E02
Oesophagus 6.0E03 8.2E03 1.5E02 2.7E02 6.2E02
Ovaries 7.6E03 9.8E03 1.5E02 2.3E02 3.9E02
Pancreas 1.8E02 2.2E02 3.3E02 4.7E02 7.8E02
Red marrow 5.8E03 7.0E03 1.0E02 1.5E02 2.8E02
Salivary glands 2.9E02 3.5E02 4.5E02 6.0E02 8.6E02
Skin 3.3E03 4.0E03 6.2E03 9.9E03 1.9E02
Spleen 1.4E02 1.7E02 2.5E02 3.8E02 6.5E02
Testes 4.4E03 5.8E03 9.9E03 1.5E02 2.6E02
Thymus 6.0E03 8.2E03 1.5E02 2.7E02 6.2E02
Thyroid 2.5E+00 4.0E+00 6.0E+00 1.3E+01 2.4E+01
Urinary bladder wall 6.6E02 8.4E02 1.2E01 1.6E01 2.0E01
Uterus 1.0E02 1.3E02 2.1E02 3.0E02 4.6E02
Remaining organs 6.9E03 8.8E03 1.3E02 2.1E02 3.6E02

Effective dose (mSv MBq1) 1.5E01 2.3E01 3.4E01 7.2E01 1.3E+00

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 Radiation dose to patients from radiopharmaceuticals

Table C.106. (continued)

Absorbed dose per unit activity administered (mGy MBq1)

Organ Adult 15 years 10 years 5 years 1 year

Thyroid, medium uptake, intravenous administration

Adrenals 7.2E03 9.0E03 1.4E02 2.2E02 4.2E02
Bone surfaces 1.1E02 1.3E02 1.9E02 3.0E02 5.4E02
Brain 5.6E03 6.6E03 9.5E03 1.4E02 2.4E02
Breast 3.4E03 4.3E03 7.5E03 1.3E02 2.4E02
Gallbladder wall 6.3E03 8.4E03 1.5E02 2.4E02 3.8E02
Gastrointestinal tract
Stomach wall 5.8E02 7.6E02 1.1E01 1.8E01 3.5E01
Small intestine wall 5.1E03 6.5E03 1.0E02 1.6E02 2.7E02
Colon wall 7.8E03 9.9E03 1.6E02 2.5E02 4.4E02
(Upper large intestine wall 7.5E03 9.6E03 1.6E02 2.5E02 4.4E02)
(Lower large intestine wall 8.1E03 1.0E02 1.7E02 2.5E02 4.3E02)
Heart wall 9.6E03 1.2E02 2.0E02 3.1E02 5.8E02
Kidneys 3.1E02 3.7E02 5.3E02 7.8E02 1.4E01
Liver 7.9E03 1.0E02 1.6E02 2.6E02 4.9E02
Lungs 8.7E03 1.1E02 1.8E02 3.0E02 5.7E02
Muscles 7.0E03 9.0E03 1.4E02 2.3E02 4.1E02
Oesophagus 6.9E03 9.9E03 1.8E02 3.6E02 8.7E02
Ovaries 6.4E03 8.3E03 1.3E02 1.9E02 3.2E02
Pancreas 1.0E02 1.3E02 2.0E02 2.9E02 5.0E02
Red marrow 5.8E03 7.1E03 1.0E02 1.5E02 2.8E02
Salivary glands 2.8E02 3.4E02 4.4E02 5.8E02 8.3E02
Skin 3.4E03 4.1E03 6.4E03 9.9E03 1.9E02
Spleen 9.8E03 1.2E02 1.9E02 2.8E02 5.2E02
Testes 4.4E03 5.8E03 9.9E03 1.5E02 2.5E02
Thymus 6.9E03 9.9E03 1.8E02 3.6E02 8.7E02
Thyroid 4.3E+00 6.8E+00 1.0E+01 2.2E+01 4.1E+01
Urinary bladder wall 7.0E02 8.9E02 1.3E01 1.7E01 2.1E01
Uterus 9.8E03 1.2E02 2.0E02 2.8E02 4.1E02
Remaining organs 7.1E03 9.1E03 1.4E02 2.1E02 3.7E02

Effective dose (mSv MBq1) 2.3E01 3.6E01 5.5E01 1.2E+00 2.2E+00

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 ICRP Publication 128

Table C.106. (continued)

Absorbed dose per unit activity administered (mGy MBq1)

Organ Adult 15 years 10 years 5 years 1 year

Thyroid, medium uptake, oral administration

Adrenals 8.0E03 1.0E02 1.6E02 2.4E02 4.5E02
Bone surfaces 1.1E02 1.3E02 1.9E02 2.9E02 5.4E02
Brain 5.3E03 6.1E03 8.9E03 1.3E02 2.3E02
Breast 3.4E03 4.4E03 7.7E03 1.3E02 2.5E02
Gallbladder wall 7.8E03 1.1E02 2.0E02 3.4E02 5.3E02
Gastrointestinal tract
Stomach wall 1.1E01 1.5E01 2.1E01 3.5E01 6.8E01
Small intestine wall 7.5E03 9.5E03 1.5E02 2.4E02 4.2E02
Colon wall 1.3E02 1.6E02 2.7E02 4.3E02 7.7E02
(Upper large intestine wall 1.4E02 1.7E02 2.8E02 4.6E02 8.1E02)
(Lower large intestine wall 1.2E02 1.5E02 2.5E02 3.9E02 7.1E02)
Heart wall 1.0E02 1.3E02 2.1E02 3.3E02 6.1E02
Kidneys 3.0E02 3.6E02 5.1E02 7.5E02 1.3E01
Liver 8.2E03 1.1E02 1.8E02 2.8E02 5.3E02
Lungs 8.7E03 1.1E02 1.8E02 3.0E02 5.7E02
Muscles 7.1E03 9.1E03 1.4E02 2.3E02 4.1E02
Oesophagus 6.6E03 9.5E03 1.8E02 3.5E02 8.2E02
Ovaries 7.0E03 9.0E03 1.4E02 2.1E02 3.6E02
Pancreas 1.7E02 2.1E02 3.1E02 4.5E02 7.5E02
Red marrow 5.9E03 7.1E03 1.0E02 1.5E02 2.7E02
Salivary glands 2.6E02 3.2E02 4.1E02 5.4E02 7.8E02
Skin 3.4E03 4.1E03 6.3E03 9.9E03 1.9E02
Spleen 1.3E02 1.6E02 2.4E02 3.5E02 6.2E02
Testes 4.0E03 5.3E03 9.0E03 1.4E02 2.3E02
Thymus 6.6E03 9.5E03 1.8E02 3.5E02 8.2E02
Thyroid 4.0E+00 6.4E+00 9.6E+00 2.1E+01 3.8E+01
Urinary bladder wall 6.0E02 7.6E02 1.1E01 1.4E01 1.8E01
Uterus 9.3E03 1.2E02 1.9E02 2.8E02 4.2E02
Remaining organs 7.3E03 9.4E03 1.4E02 2.2E02 3.8E02

Effective dose (mSv MBq1) 2.2E01 3.5E01 5.2E01 1.1E+00 2.1E+00

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 Radiation dose to patients from radiopharmaceuticals

Table C.106. (continued)

Absorbed dose per unit activity administered (mGy MBq1)

Organ Adult 15 years 10 years 5 years 1 year

Thyroid, high uptake, intravenous administration

Adrenals 6.4E03 8.2E03 1.3E02 2.1E02 3.9E02
Bone surfaces 1.2E02 1.4E02 2.0E02 3.1E02 5.5E02
Brain 6.3E03 7.2E03 1.0E02 1.5E02 2.4E02
Breast 3.3E03 4.2E03 7.6E03 1.3E02 2.5E02
Gallbladder wall 5.7E03 7.5E03 1.3E02 2.2E02 3.5E02
Gastrointestinal tract
Stomach wall 5.1E02 6.7E02 9.4E02 1.6E01 3.1E01
Small intestine wall 4.5E03 5.8E03 9.3E03 1.4E02 2.5E02
Colon wall 6.9E03 8.8E03 1.4E02 2.2E02 3.9E02
(Upper large intestine wall 6.7E03 8.5E03 1.4E02 2.3E02 4.0E02)
(Lower large intestine wall 7.2E03 9.1E03 1.5E02 2.2E02 3.8E02)
Heart wall 8.9E03 1.1E02 1.8E02 3.0E02 5.7E02
Kidneys 2.8E02 3.3E02 4.7E02 7.0E02 1.2E01
Liver 7.2E03 9.4E03 1.5E02 2.4E02 4.7E02
Lungs 8.6E03 1.1E02 1.8E02 3.0E02 5.7E02
Muscles 7.6E03 9.9E03 1.6E02 2.5E02 4.6E02
Oesophagus 7.7E03 1.1E02 2.2E02 4.5E02 1.1E01
Ovaries 5.7E03 7.4E03 1.1E02 1.7E02 2.9E02
Pancreas 9.2E03 1.1E02 1.8E02 2.6E02 4.6E02
Red marrow 6.0E03 7.2E03 1.0E02 1.5E02 2.7E02
Salivary glands 2.4E02 3.0E02 3.9E02 5.1E02 7.4E02
Skin 3.5E03 4.2E03 6.4E03 9.9E03 1.9E02
Spleen 8.8E03 1.1E02 1.7E02 2.6E02 4.7E02
Testes 3.9E03 5.2E03 8.8E03 1.3E02 2.2E02
Thymus 7.7E03 1.1E02 2.2E02 4.5E02 1.1E01
Thyroid 6.0E+00 9.6E+00 1.4E+01 3.1E+01 5.8E+01
Urinary bladder wall 6.3E02 8.0E02 1.2E01 1.5E01 1.9E01
Uterus 8.8E03 1.1E02 1.8E02 2.5E02 3.7E02
Remaining organs 7.6E03 9.8E03 1.5E02 2.2E02 3.9E02

Effective dose (mSv MBq1) 3.1E01 5.0E01 7.5E01 1.6E+00 3.0E+00

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 ICRP Publication 128

Table C.106. (continued)

Absorbed dose per unit activity administered (mGy MBq1)

Organ Adult 15 years 10 years 5 years 1 year

Thyroid, high uptake, oral administration

Adrenals 7.4E03 9.2E03 1.5E02 2.3E02 4.2E02
Bone surfaces 1.1E02 1.3E02 1.9E02 3.0E02 5.5E02
Brain 5.9E03 6.7E03 9.4E03 1.4E02 2.3E02
Breast 3.3E03 4.3E03 7.8E03 1.4E02 2.5E02
Gallbladder wall 7.1E03 9.8E03 1.9E02 3.2E02 5.0E02
Gastrointestinal tract
Stomach wall 1.1E01 1.4E01 2.0E01 3.3E01 6.4E01
Small intestine wall 7.0E03 8.9E03 1.4E02 2.2E02 4.0E02
Colon wall 1.2E02 1.5E02 2.5E02 4.0E02 7.3E02
(Upper large intestine wall 1.3E02 1.6E02 2.7E02 4.3E02 7.8E02)
(Lower large intestine wall 1.1E02 1.4E02 2.3E02 3.6E02 6.7E02)
Heart wall 9.5E03 1.2E02 2.0E02 3.2E02 6.0E02
Kidneys 2.7E02 3.3E02 4.6E02 6.8E02 1.2E01
Liver 7.5E03 9.9E03 1.6E02 2.6E02 5.1E02
Lungs 8.6E03 1.1E02 1.8E02 3.0E02 5.7E02
Muscles 7.7E03 9.9E03 1.6E02 2.5E02 4.6E02
Oesophagus 7.3E03 1.1E02 2.1E02 4.2E02 1.0E01
Ovaries 6.3E03 8.2E03 1.3E02 1.9E02 3.3E02
Pancreas 1.6E02 1.9E02 3.0E02 4.2E02 7.1E02
Red marrow 6.0E03 7.2E03 1.0E02 1.5E02 2.7E02
Salivary glands 2.3E02 2.8E02 3.6E02 4.8E02 6.9E02
Skin 3.4E03 4.2E03 6.4E03 9.9E03 1.9E02
Spleen 1.2E02 1.5E02 2.2E02 3.3E02 5.8E02
Testes 3.5E03 4.7E03 8.0E03 1.2E02 2.1E02
Thymus 7.3E03 1.1E02 2.1E02 4.2E02 1.0E01
Thyroid 5.6E+00 8.9E+00 1.3E+01 2.9E+01 5.4E+01
Urinary bladder wall 5.3E02 6.7E02 9.9E02 1.3E01 1.6E01
Uterus 8.3E03 1.0E02 1.7E02 2.5E02 3.9E02
Remaining organs 7.8E03 1.0E02 1.5E02 2.3E02 3.9E02

Effective dose (mSv MBq1) 3.0E01 4.7E01 7.1E01 1.5E+00 2.8E+00

123
The physical half-life of I is 13.2 h.

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124
Table C.107. Absorbed doses for I-iodide.

Absorbed dose per unit activity administered (mGy MBq1)

Organ Adult 15 years 10 years 5 years 1 year

Thyroid blocked, intravenous administration

Adrenals 7.5E02 9.3E02 1.5E01 2.3E01 4.0E01
Bone surfaces 4.9E02 6.1E02 9.6E02 1.5E01 2.8E01
Brain 3.4E02 4.2E02 6.9E02 1.1E01 2.1E01
Breast 3.4E02 4.3E02 6.9E02 1.1E01 2.0E01
Gallbladder wall 6.7E02 7.9E02 1.4E01 2.2E01 3.5E01
Gastrointestinal tract
Stomach wall 6.9E01 9.1E01 1.3E+00 2.1E+00 4.4E+00
Small intestine wall 5.6E02 7.1E02 1.1E01 1.7E01 2.7E01
Colon wall 1.2E01 1.5E01 2.4E01 3.8E01 6.6E01
(Upper large intestine wall 1.1E01 1.3E01 2.2E01 3.4E01 5.9E01)
(Lower large intestine wall 1.4E01 1.7E01 2.8E01 4.4E01 7.7E01)
Heart wall 9.5E02 1.2E01 1.9E01 2.9E01 5.2E01
Kidneys 3.4E01 4.1E01 5.8E01 8.6E01 1.5E+00
Liver 8.1E02 1.0E01 1.6E01 2.5E01 4.5E01
Lungs 7.6E02 9.8E02 1.6E01 2.5E01 4.7E01
Muscles 4.7E02 5.9E02 9.1E02 1.4E01 2.5E01
Oesophagus 4.5E02 5.6E02 8.8E02 1.4E01 2.6E01
Ovaries 7.1E02 9.1E02 1.4E01 2.0E01 3.3E01
Pancreas 1.0E01 1.2E01 1.9E01 2.7E01 4.6E01
Red marrow 5.2E02 6.4E02 9.7E02 1.4E01 2.6E01
Salivary glands 2.6E01 3.2E01 4.1E01 5.3E01 7.4E01
Skin 3.1E02 3.8E02 6.0E02 9.6E02 1.8E01
Spleen 1.0E01 1.2E01 1.9E01 2.9E01 5.0E01
Testes 4.9E02 6.4E02 1.1E01 1.6E01 2.6E01
Thymus 4.5E02 5.6E02 8.8E02 1.4E01 2.6E01
Thyroid 2.5E+00 4.0E+00 6.1E+00 1.4E+01 2.6E+01
Urinary bladder wall 7.5E01 9.5E01 1.4E+00 1.9E+00 2.3E+00
Uterus 9.5E02 1.2E01 1.9E01 2.7E01 3.9E01
Remaining organs 5.0E02 6.4E02 9.9E02 1.6E01 2.7E01

Effective dose (mSv MBq1) 3.0E01 4.2E01 6.3E01 1.2E+00 2.2E+00

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 ICRP Publication 128

Table C.107. (continued)

Absorbed dose per unit activity administered (mGy MBq1)

Organ Adult 15 years 10 years 5 years 1 year

Thyroid blocked, oral administration

Adrenals 8.3E02 1.0E01 1.6E01 2.4E01 4.3E01
Bone surfaces 5.0E02 6.3E02 9.8E02 1.5E01 2.9E01
Brain 3.4E02 4.2E02 6.8E02 1.1E01 2.0E01
Breast 3.6E02 4.5E02 7.3E02 1.2E01 2.2E01
Gallbladder wall 7.7E02 9.3E02 1.7E01 2.8E01 4.3E01
Gastrointestinal tract
Stomach wall 1.1E+00 1.4E+00 1.9E+00 3.3E+00 6.6E+00
Small intestine wall 7.5E02 9.5E02 1.5E01 2.3E01 3.8E01
Colon wall 1.9E01 2.3E01 3.8E01 6.1E01 1.1E+00
(Upper large intestine wall 1.7E01 2.0E01 3.4E01 5.4E01 9.5E01)
(Lower large intestine wall 2.1E01 2.6E01 4.4E01 7.0E01 1.3E+00)
Heart wall 1.0E01 1.3E01 2.0E01 3.1E01 5.5E01
Kidneys 3.4E01 4.1E01 5.9E01 8.7E01 1.5E+00
Liver 8.5E02 1.1E01 1.7E01 2.7E01 4.9E01
Lungs 7.9E02 1.0E01 1.6E01 2.5E01 4.8E01
Muscles 5.0E02 6.2E02 9.6E02 1.5E01 2.6E01
Oesophagus 4.6E02 5.7E02 9.0E02 1.4E01 2.7E01
Ovaries 8.0E02 1.0E01 1.5E01 2.3E01 3.7E01
Pancreas 1.3E01 1.6E01 2.5E01 3.5E01 5.9E01
Red marrow 5.5E02 6.8E02 1.0E01 1.5E01 2.6E01
Salivary glands 2.6E01 3.1E01 4.0E01 5.2E01 7.3E01
Skin 3.2E02 4.0E02 6.2E02 9.9E02 1.9E01
Spleen 1.2E01 1.4E01 2.2E01 3.3E01 5.6E01
Testes 4.8E02 6.3E02 1.1E01 1.6E01 2.6E01
Thymus 4.6E02 5.7E02 9.0E02 1.4E01 2.7E01
Thyroid 2.4E+00 3.9E+00 6.0E+00 1.3E+01 2.5E+01
Urinary bladder wall 7.0E01 8.9E01 1.3E+00 1.7E+00 2.2E+00
Uterus 9.7E02 1.2E01 1.9E01 2.8E01 4.2E01
Remaining organs 5.4E02 6.8E02 1.1E01 1.7E01 2.9E01

Effective dose (mSv MBq1) 3.5E01 4.9E01 7.3E01 1.3E+00 2.5E+00

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 Radiation dose to patients from radiopharmaceuticals

Table C.107. (continued)

Absorbed dose per unit activity administered (mGy MBq1)

Organ Adult 15 years 10 years 5 years 1 year

Thyroid, low uptake, intravenous administration

Adrenals 7.8E02 1.0E01 1.7E01 2.8E01 5.5E01
Bone surfaces 1.2E01 1.4E01 1.9E01 2.9E01 5.1E01
Brain 1.4E01 1.5E01 1.9E01 2.5E01 4.0E01
Breast 6.1E02 7.9E02 1.5E01 2.4E01 4.5E01
Gallbladder wall 6.8E02 8.5E02 1.5E01 2.6E01 5.0E01
Gastrointestinal tract
Stomach wall 5.8E01 7.6E01 1.1E+00 1.8E+00 3.8E+00
Small intestine wall 5.0E02 6.5E02 1.1E01 1.6E01 3.1E01
Colon wall 1.1E01 1.4E01 2.3E01 4.0E01 8.0E01
(Upper large intestine wall 9.7E02 1.2E01 2.1E01 3.6E01 7.3E01)
(Lower large intestine wall 1.2E01 1.5E01 2.6E01 4.4E01 9.1E01)
Heart wall 1.2E01 1.6E01 2.7E01 4.5E01 9.0E01
Kidneys 3.1E01 3.8E01 5.5E01 8.8E01 1.7E+00
Liver 1.0E01 1.4E01 2.4E01 4.2E01 1.0E+00
Lungs 1.3E01 1.7E01 2.8E01 4.7E01 8.8E01
Muscles 1.3E01 1.6E01 2.6E01 4.1E01 7.1E01
Oesophagus 1.5E01 2.2E01 4.7E01 8.7E01 1.8E+00
Ovaries 6.3E02 8.2E02 1.3E01 2.0E01 3.7E01
Pancreas 9.6E02 1.2E01 1.9E01 3.0E01 5.7E01
Red marrow 1.0E01 1.2E01 1.7E01 2.5E01 4.4E01
Salivary glands 2.1E01 2.6E01 3.3E01 4.4E01 6.2E01
Skin 6.6E02 7.8E02 1.2E01 1.8E01 3.4E01
Spleen 9.7E02 1.2E01 2.0E01 3.2E01 6.3E01
Testes 4.2E02 5.7E02 9.7E02 1.5E01 2.8E01
Thymus 1.5E01 2.2E01 4.7E01 8.7E01 1.8E+00
Thyroid 1.7E+02 2.7E+02 4.1E+02 8.6E+02 1.5E+03
Urinary bladder wall 6.3E01 8.0E01 1.2E+00 1.6E+00 2.0E+00
Uterus 8.3E02 1.0E01 1.7E01 2.5E01 4.2E01
Remaining organs 1.3E01 1.6E01 2.5E01 3.5E01 6.1E01

Effective dose (mSv MBq1) 8.6E+00 1.4E+01 2.1E+01 4.4E+01 7.5E+01

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 ICRP Publication 128

Table C.107. (continued)

Absorbed dose per unit activity administered (mGy MBq1)

Organ Adult 15 years 10 years 5 years 1 year

Thyroid, low uptake, oral administration

Adrenals 8.6E02 1.1E01 1.8E01 2.9E01 5.8E01
Bone surfaces 1.2E01 1.4E01 1.9E01 2.9E01 5.1E01
Brain 1.3E01 1.5E01 1.9E01 2.5E01 3.9E01
Breast 6.2E02 8.1E02 1.5E01 2.5E01 4.6E01
Gallbladder wall 7.8E02 9.8E02 1.8E01 3.2E01 5.8E01
Gastrointestinal tract
Stomach wall 9.5E01 1.2E+00 1.7E+00 2.9E+00 6.0E+00
Small intestine wall 6.9E02 8.9E02 1.5E01 2.2E01 4.2E01
Colon wall 1.7E01 2.2E01 3.7E01 6.3E01 1.2E+00
(Upper large intestine wall 1.6E01 1.9E01 3.3E01 5.6E01 1.1E+00)
(Lower large intestine wall 1.9E01 2.5E01 4.2E01 7.1E01 1.4E+00)
Heart wall 1.3E01 1.6E01 2.8E01 4.7E01 9.2E01
Kidneys 3.1E01 3.8E01 5.6E01 8.8E01 1.7E+00
Liver 1.1E01 1.5E01 2.5E01 4.4E01 1.0E+00
Lungs 1.4E01 1.7E01 2.8E01 4.7E01 8.8E01
Muscles 1.3E01 1.6E01 2.6E01 4.1E01 7.2E01
Oesophagus 1.5E01 2.1E01 4.6E01 8.6E01 1.8E+00
Ovaries 7.2E02 9.3E02 1.5E01 2.3E01 4.2E01
Pancreas 1.3E01 1.6E01 2.5E01 3.8E01 7.0E01
Red marrow 1.1E01 1.3E01 1.7E01 2.5E01 4.5E01
Salivary glands 2.1E01 2.5E01 3.3E01 4.3E01 6.1E01
Skin 6.6E02 7.9E02 1.2E01 1.8E01 3.4E01
Spleen 1.2E01 1.4E01 2.3E01 3.6E01 6.9E01
Testes 4.2E02 5.6E02 9.5E02 1.5E01 2.8E01
Thymus 1.5E01 2.1E01 4.6E01 8.6E01 1.8E+00
Thyroid 1.7E+02 2.6E+02 4.0E+02 8.5E+02 1.4E+03
Urinary bladder wall 5.8E01 7.3E01 1.1E+00 1.5E+00 1.9E+00
Uterus 8.4E02 1.1E01 1.8E01 2.6E01 4.4E01
Remaining organs 1.3E01 1.6E01 2.5E01 3.6E01 6.1E01

Effective dose (mSv MBq1) 8.5E+00 1.4E+01 2.0E+01 4.3E+01 7.4E+01

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 Radiation dose to patients from radiopharmaceuticals

Table C.107. (continued)

Absorbed dose per unit activity administered (mGy MBq1)

Organ Adult 15 years 10 years 5 years 1 year

Thyroid, medium uptake, intravenous administration

Adrenals 8.0E02 1.1E01 1.8E01 3.1E01 6.4E01
Bone surfaces 1.6E01 1.8E01 2.5E01 3.7E01 6.4E01
Brain 1.9E01 2.1E01 2.6E01 3.3E01 5.0E01
Breast 7.6E02 1.0E01 1.9E01 3.2E01 5.9E01
Gallbladder wall 6.8E02 8.7E02 1.6E01 2.8E01 5.8E01
Gastrointestinal tract
Stomach wall 5.1E01 6.7E01 9.5E01 1.6E+00 3.4E+00
Small intestine wall 4.7E02 6.2E02 1.1E01 1.5E01 3.3E01
Colon wall 1.0E01 1.3E01 2.3E01 4.0E01 8.8E01
(Upper large intestine wall 9.1E02 1.2E01 2.1E01 3.7E01 8.0E01)
(Lower large intestine wall 1.1E01 1.4E01 2.5E01 4.5E01 9.9E01)
Heart wall 1.4E01 1.8E01 3.2E01 5.5E01 1.1E+00
Kidneys 2.9E01 3.6E01 5.4E01 8.8E01 1.8E+00
Liver 1.1E01 1.6E01 2.8E01 5.2E01 1.3E+00
Lungs 1.7E01 2.1E01 3.5E01 5.9E01 1.1E+00
Muscles 1.7E01 2.2E01 3.6E01 5.6E01 9.8E01
Oesophagus 2.2E01 3.1E01 6.8E01 1.3E+00 2.7E+00
Ovaries 5.8E02 7.7E02 1.2E01 2.0E01 4.0E01
Pancreas 9.4E02 1.2E01 2.0E01 3.2E01 6.4E01
Red marrow 1.3E01 1.6E01 2.1E01 3.0E01 5.5E01
Salivary glands 1.9E01 2.3E01 2.9E01 3.8E01 5.4E01
Skin 8.5E02 1.0E01 1.5E01 2.2E01 4.3E01
Spleen 9.5E02 1.2E01 2.0E01 3.4E01 7.1E01
Testes 3.9E02 5.3E02 9.1E02 1.5E01 2.9E01
Thymus 2.2E01 3.1E01 6.8E01 1.3E+00 2.7E+00
Thyroid 2.6E+02 4.2E+02 6.3E+02 1.3E+03 2.3E+03
Urinary bladder wall 5.5E01 7.1E01 1.1E+00 1.4E+00 1.8E+00
Uterus 7.6E02 9.6E02 1.6E01 2.5E01 4.4E01
Remaining organs 1.7E01 2.1E01 3.3E01 4.6E01 8.0E01

Effective dose (mSv MBq1) 1.3E+01 2.1E+01 3.2E+01 6.8E+01 1.2E+02

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 ICRP Publication 128

Table C.107. (continued)

Absorbed dose per unit activity administered (mGy MBq1)

Organ Adult 15 years 10 years 5 years 1 year

Thyroid, medium uptake, oral administration

Adrenals 8.7E02 1.1E01 1.9E01 3.2E01 6.6E01
Bone surfaces 1.6E01 1.8E01 2.5E01 3.7E01 6.4E01
Brain 1.9E01 2.1E01 2.5E01 3.3E01 5.0E01
Breast 7.7E02 1.0E01 1.9E01 3.2E01 5.9E01
Gallbladder wall 7.9E02 1.0E01 1.9E01 3.4E01 6.6E01
Gastrointestinal tract
Stomach wall 8.8E01 1.2E+00 1.6E+00 2.8E+00 5.7E+00
Small intestine wall 6.6E02 8.6E02 1.5E01 2.1E01 4.4E01
Colon wall 1.7E01 2.1E01 3.7E01 6.3E01 1.3E+00
(Upper large intestine wall 1.5E01 1.9E01 3.3E01 5.7E01 1.2E+00)
(Lower large intestine wall 1.9E01 2.4E01 4.1E01 7.1E01 1.5E+00)
Heart wall 1.4E01 1.8E01 3.3E01 5.6E01 1.1E+00
Kidneys 2.9E01 3.7E01 5.4E01 8.9E01 1.8E+00
Liver 1.2E01 1.7E01 2.9E01 5.4E01 1.3E+00
Lungs 1.7E01 2.1E01 3.5E01 5.9E01 1.1E+00
Muscles 1.7E01 2.2E01 3.6E01 5.6E01 9.8E01
Oesophagus 2.1E01 3.0E01 6.7E01 1.3E+00 2.7E+00
Ovaries 6.7E02 8.8E02 1.4E01 2.3E01 4.5E01
Pancreas 1.3E01 1.6E01 2.6E01 4.0E01 7.7E01
Red marrow 1.4E01 1.6E01 2.1E01 3.0E01 5.5E01
Salivary glands 1.8E01 2.2E01 2.9E01 3.7E01 5.3E01
Skin 8.6E02 1.0E01 1.5E01 2.2E01 4.3E01
Spleen 1.2E01 1.4E01 2.3E01 3.8E01 7.7E01
Testes 3.8E02 5.2E02 8.9E02 1.5E01 2.9E01
Thymus 2.1E01 3.0E01 6.7E01 1.3E+00 2.7E+00
Thyroid 2.6E+02 4.1E+02 6.2E+02 1.3E+03 2.3E+03
Urinary bladder wall 5.1E01 6.4E01 9.7E01 1.3E+00 1.7E+00
Uterus 7.7E02 9.9E02 1.6E01 2.6E01 4.6E01
Remaining organs 1.7E01 2.1E01 3.3E01 4.7E01 8.0E01

Effective dose (mSv MBq1) 1.3E+01 2.1E+01 3.1E+01 6.7E+01 1.1E+02

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 Radiation dose to patients from radiopharmaceuticals

Table C.107. (continued)

Absorbed dose per unit activity administered (mGy MBq1)

Organ Adult 15 years 10 years 5 years 1 year

Thyroid, high uptake, intravenous administration

Adrenals 8.2E02 1.1E01 1.9E01 3.4E01 7.3E01
Bone surfaces 2.0E01 2.2E01 3.0E01 4.5E01 7.7E01
Brain 2.5E01 2.7E01 3.2E01 4.2E01 6.1E01
Breast 9.1E02 1.2E01 2.3E01 3.9E01 7.3E01
Gallbladder wall 6.8E02 9.0E02 1.6E01 3.0E01 6.6E01
Gastrointestinal tract
Stomach wall 4.5E01 5.9E01 8.4E01 1.4E+00 3.1E+00
Small intestine wall 4.3E02 5.9E02 1.1E01 1.5E01 3.5E01
Colon wall 9.2E02 1.2E01 2.2E01 4.1E01 9.6E01
(Upper large intestine wall 8.5E02 1.1E01 2.0E01 3.8E01 8.8E01)
(Lower large intestine wall 1.0E01 1.3E01 2.4E01 4.5E01 1.1E+00)
Heart wall 1.5E01 2.0E01 3.7E01 6.4E01 1.3E+00
Kidneys 2.7E01 3.4E01 5.2E01 8.9E01 2.0E+00
Liver 1.3E01 1.8E01 3.2E01 6.2E01 1.6E+00
Lungs 2.0E01 2.5E01 4.2E01 7.1E01 1.3E+00
Muscles 2.1E01 2.8E01 4.5E01 7.1E01 1.2E+00
Oesophagus 2.8E01 4.0E01 8.9E01 1.7E+00 3.6E+00
Ovaries 5.3E02 7.2E02 1.2E01 2.0E01 4.3E01
Pancreas 9.3E02 1.2E01 2.0E01 3.4E01 7.1E01
Red marrow 1.6E01 1.9E01 2.5E01 3.6E01 6.6E01
Salivary glands 1.6E01 1.9E01 2.5E01 3.3E01 4.7E01
Skin 1.0E01 1.2E01 1.8E01 2.7E01 5.2E01
Spleen 9.3E02 1.2E01 2.1E01 3.6E01 7.8E01
Testes 3.5E02 4.9E02 8.5E02 1.4E01 3.0E01
Thymus 2.8E01 4.0E01 8.9E01 1.7E+00 3.6E+00
Thyroid 3.5E+02 5.7E+02 8.6E+02 1.8E+03 3.2E+03
Urinary bladder wall 4.8E01 6.2E01 9.3E01 1.2E+00 1.6E+00
Uterus 6.8E02 8.8E02 1.5E01 2.4E01 4.5E01
Remaining organs 2.1E01 2.6E01 4.1E01 5.8E01 9.9E01

Effective dose (mSv MBq1) 1.8E+01 2.9E+01 4.3E+01 9.2E+01 1.6E+02

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 ICRP Publication 128

Table C.107. (continued)

Absorbed dose per unit activity administered (mGy MBq1)

Organ Adult 15 years 10 years 5 years 1 year

Thyroid, high uptake, oral administration

Adrenals 8.9E02 1.2E01 2.0E01 3.5E01 7.5E01
Bone surfaces 1.9E01 2.2E01 3.0E01 4.5E01 7.7E01
Brain 2.5E01 2.7E01 3.2E01 4.1E01 6.0E01
Breast 9.2E02 1.2E01 2.4E01 4.0E01 7.3E01
Gallbladder wall 7.9E02 1.0E01 2.0E01 3.6E01 7.4E01
Gastrointestinal tract
Stomach wall 8.2E01 1.1E+00 1.5E+00 2.6E+00 5.3E+00
Small intestine wall 6.2E02 8.2E02 1.4E01 2.0E01 4.6E01
Colon wall 1.6E01 2.0E01 3.6E01 6.4E01 1.4E+00
(Upper large intestine wall 1.5E01 1.8E01 3.3E01 5.8E01 1.2E+00)
(Lower large intestine wall 1.8E01 2.3E01 4.0E01 7.1E01 1.6E+00)
Heart wall 1.6E01 2.0E01 3.8E01 6.5E01 1.3E+00
Kidneys 2.7E01 3.5E01 5.2E01 9.0E01 2.0E+00
Liver 1.3E01 1.9E01 3.3E01 6.3E01 1.7E+00
Lungs 2.0E01 2.5E01 4.2E01 7.1E01 1.3E+00
Muscles 2.1E01 2.8E01 4.5E01 7.1E01 1.2E+00
Oesophagus 2.7E01 3.9E01 8.8E01 1.7E+00 3.6E+00
Ovaries 6.2E02 8.3E02 1.4E01 2.3E01 4.8E01
Pancreas 1.3E01 1.6E01 2.6E01 4.2E01 8.3E01
Red marrow 1.6E01 1.9E01 2.5E01 3.6E01 6.6E01
Salivary glands 1.6E01 1.9E01 2.5E01 3.2E01 4.6E01
Skin 1.0E01 1.2E01 1.8E01 2.7E01 5.2E01
Spleen 1.1E01 1.4E01 2.4E01 4.0E01 8.4E01
Testes 3.5E02 4.8E02 8.3E02 1.4E01 3.0E01
Thymus 2.7E01 3.9E01 8.8E01 1.7E+00 3.6E+00
Thyroid 3.5E+02 5.6E+02 8.4E+02 1.8E+03 3.1E+03
Urinary bladder wall 4.4E01 5.6E01 8.5E01 1.1E+00 1.5E+00
Uterus 7.0E02 9.1E02 1.5E01 2.5E01 4.8E01
Remaining organs 2.1E01 2.7E01 4.1E01 5.8E01 9.9E01

Effective dose (mSv MBq1) 1.8E+01 2.8E+01 4.3E+01 9.1E+01 1.6E+02

124
The physical half-life of I is 4.18 days.

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125
Table C.108. Absorbed doses for I-iodide.

Absorbed dose per unit activity administered (mGy MBq1)

Organ Adult 15 years 10 years 5 years 1 year

Thyroid blocked, oral administration

Adrenals 5.4E03 7.2E03 1.3E02 2.1E02 4.3E02
Bone surfaces 8.3E03 1.0E02 1.8E02 3.0E02 6.7E02
Brain 3.4E03 4.4E03 7.4E03 1.2E02 2.4E02
Breast 2.5E03 3.2E03 4.9E03 8.5E03 1.7E02
Gallbladder wall 4.6E03 6.1E03 1.2E02 2.8E02 5.0E02
Gastrointestinal tract
Stomach wall 1.2E01 1.5E01 2.2E01 3.6E01 7.3E01
Small intestine wall 5.0E03 6.6E03 1.2E02 2.1E02 4.0E02
Colon wall 2.0E02 2.5E02 4.3E02 7.0E02 1.3E01
(Upper large intestine wall 1.7E02 2.0E02 3.6E02 5.9E02 1.1E01)
(Lower large intestine wall 2.4E02 3.0E02 5.1E02 8.4E02 1.6E01)
Heart wall 8.6E03 1.1E02 1.9E02 3.1E02 6.0E02
Kidneys 3.9E02 4.7E02 6.6E02 9.8E02 1.7E01
Liver 7.3E03 9.6E03 1.6E02 2.7E02 5.2E02
Lungs 7.9E03 1.0E02 1.7E02 2.8E02 5.6E02
Muscles 4.0E03 5.2E03 8.6E03 1.4E02 2.7E02
Oesophagus 3.3E03 4.2E03 7.3E03 1.3E02 2.8E02
Ovaries 5.9E03 7.9E03 1.4E02 2.3E02 4.3E02
Pancreas 1.1E02 1.4E02 2.3E02 3.7E02 7.0E02
Red marrow 3.0E03 3.9E03 6.6E03 1.1E02 2.2E02
Salivary glands 3.8E02 4.7E02 6.1E02 8.1E02 1.2E01
Skin 2.3E03 2.8E03 4.7E03 7.8E03 1.5E02
Spleen 9.4E03 1.2E02 2.0E02 3.3E02 6.3E02
Testes 3.1E03 4.3E03 8.1E03 1.4E02 2.6E02
Thymus 3.3E03 4.2E03 7.3E03 1.3E02 2.8E02
Thyroid 2.8E01 4.4E01 6.7E01 1.4E+00 2.7E+00
Urinary bladder wall 8.4E02 1.1E01 1.6E01 2.1E01 2.7E01
Uterus 7.2E03 9.4E03 1.8E02 2.9E02 4.8E02
Remaining organs 4.4E03 5.8E03 9.9E03 1.7E02 3.1E02

Effective dose (mSv MBq1) 3.8E02 5.3E02 8.0E02 1.5E01 2.7E01

Thyroid blocked, intravenous administration
Effective dose (mSv MBq1) 3.2E02 4.6E02 6.9E02 1.3E01 2.4E01
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 ICRP Publication 128

Table C.108. (continued)

Absorbed dose per unit activity administered (mGy MBq1)

Organ Adult 15 years 10 years 5 years 1 year

Thyroid, low uptake, oral administration

Adrenals 1.6E02 2.2E02 3.9E02 7.1E02 1.5E01
Bone surfaces 9.9E02 9.9E02 1.4E01 2.0E01 3.4E01
Brain 1.4E02 1.8E02 2.8E02 4.5E02 8.9E02
Breast 6.7E03 9.3E03 1.8E02 3.7E02 8.5E02
Gallbladder wall 1.7E02 2.5E02 4.1E02 7.7E02 1.9E01
Gastrointestinal tract
Stomach wall 1.1E01 1.4E01 2.1E01 3.6E01 7.5E01
Small intestine wall 8.1E03 1.1E02 2.1E02 4.1E02 8.7E02
Colon wall 3.3E02 4.5E02 8.3E02 1.5E01 3.2E01
(Upper large intestine wall 2.8E02 3.8E02 7.2E02 1.3E01 2.8E01)
(Lower large intestine wall 3.9E02 5.4E02 9.7E02 1.8E01 3.9E01)
Heart wall 2.5E02 3.4E02 6.3E02 1.2E01 2.5E01
Kidneys 8.8E02 1.1E01 1.7E01 2.7E01 5.2E01
Liver 6.8E02 9.4E02 1.6E01 2.6E01 5.4E01
Lungs 3.2E02 4.2E02 8.6E02 1.5E01 3.0E01
Muscles 8.1E02 1.0E01 1.6E01 2.2E01 3.0E01
Oesophagus 2.4E02 3.8E02 1.2E01 3.7E01 8.6E01
Ovaries 1.1E02 1.5E02 2.8E02 5.2E02 1.1E01
Pancreas 1.7E02 2.2E02 4.1E02 7.7E02 1.6E01
Red marrow 1.8E02 2.1E02 3.2E02 5.0E02 9.7E02
Salivary glands 3.3E02 4.0E02 5.3E02 7.2E02 1.1E01
Skin 1.7E02 1.8E02 2.6E02 3.7E02 7.3E02
Spleen 2.1E02 2.7E02 4.8E02 8.6E02 1.9E01
Testes 6.6E03 9.1E03 1.6E02 3.0E02 6.3E02
Thymus 2.4E02 3.8E02 1.2E01 3.7E01 8.6E01
Thyroid 1.8E+02 2.5E+02 3.3E+02 5.4E+02 6.2E+02
Urinary bladder wall 7.5E02 9.9E02 1.5E01 2.0E01 2.8E01
Uterus 1.1E02 1.4E02 2.8E02 4.9E02 9.7E02
Remaining organs 7.5E02 8.9E02 1.3E01 1.5E01 2.2E01

Effective dose (mSv MBq1) 8.9E+00 1.2E+01 1.7E+01 2.7E+01 3.1E+01

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 Radiation dose to patients from radiopharmaceuticals

Table C.108. (continued)

Absorbed dose per unit activity administered (mGy MBq1)

Organ Adult 15 years 10 years 5 years 1 year

Thyroid, medium uptake, oral administration

Adrenals 2.2E02 3.0E02 5.5E02 1.0E01 2.3E01
Bone surfaces 1.5E01 1.5E01 2.1E01 3.0E01 5.2E01
Brain 2.0E02 2.6E02 4.0E02 6.7E02 1.3E01
Breast 9.1E03 1.3E02 2.6E02 5.6E02 1.3E01
Gallbladder wall 2.5E02 3.6E02 5.9E02 1.1E01 2.9E01
Gastrointestinal tract
Stomach wall 1.0E01 1.4E01 2.0E01 3.6E01 7.6E01
Small intestine wall 9.9E03 1.4E02 2.7E02 5.3E02 1.2E01
Colon wall 4.0E02 5.7E02 1.1E01 2.1E01 4.5E01
(Upper large intestine wall 3.5E02 4.8E02 9.4E02 1.8E01 3.9E01)
(Lower large intestine wall 4.8E02 6.8E02 1.3E01 2.4E01 5.4E01)
Heart wall 3.5E02 4.8E02 9.0E02 1.8E01 3.8E01
Kidneys 1.2E01 1.5E01 2.3E01 3.8E01 7.6E01
Liver 1.0E01 1.5E01 2.4E01 4.1E01 8.7E01
Lungs 4.6E02 6.1E02 1.3E01 2.3E01 4.7E01
Muscles 1.3E01 1.6E01 2.5E01 3.6E01 4.8E01
Oesophagus 3.7E02 5.9E02 2.0E01 5.9E01 1.4E+00
Ovaries 1.4E02 2.0E02 3.6E02 7.0E02 1.5E01
Pancreas 2.0E02 2.8E02 5.3E02 1.0E01 2.2E01
Red marrow 2.7E02 3.2E02 4.7E02 7.4E02 1.5E01
Salivary glands 2.9E02 3.7E02 4.8E02 6.6E02 9.9E02
Skin 2.5E02 2.7E02 4.0E02 5.6E02 1.1E01
Spleen 2.7E02 3.6E02 6.5E02 1.2E01 2.7E01
Testes 8.7E03 1.2E02 2.1E02 4.0E02 8.8E02
Thymus 3.7E02 5.9E02 2.0E01 5.9E01 1.4E+00
Thyroid 2.8E+02 4.0E+02 5.4E+02 8.8E+02 1.0E+03
Urinary bladder wall 6.9E02 9.3E02 1.4E01 2.0E01 2.9E01
Uterus 1.3E02 1.8E02 3.4E02 6.1E02 1.3E01
Remaining organs 1.2E01 1.4E01 2.1E01 2.4E01 3.4E01

Effective dose (mSv MBq1) 1.4E+01 2.0E+01 2.7E+01 4.4E+01 5.2E+01

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 ICRP Publication 128

Table C.108. (continued)

Absorbed dose per unit activity administered (mGy MBq1)

Organ Adult 15 years 10 years 5 years 1 year

Thyroid, high uptake, oral administration

Adrenals 2.8E02 4.0E02 7.2E02 1.4E01 3.1E01
Bone surfaces 2.1E01 2.1E01 2.9E01 4.2E01 7.3E01
Brain 2.7E02 3.4E02 5.4E02 9.0E02 1.8E01
Breast 1.2E02 1.7E02 3.4E02 7.7E02 1.8E01
Gallbladder wall 3.3E02 4.8E02 7.9E02 1.4E01 3.9E01
Gastrointestinal tract
Stomach wall 9.9E02 1.3E01 2.0E01 3.6E01 7.7E01
Small intestine wall 1.2E02 1.7E02 3.3E02 6.8E02 1.5E01
Colon wall 4.9E02 7.0E02 1.3E01 2.7E01 6.0E01
(Upper large intestine wall 4.2E02 5.9E02 1.2E01 2.3E01 5.1E01)
(Lower large intestine wall 5.8E02 8.3E02 1.6E01 3.1E01 7.1E01)
Heart wall 4.5E02 6.3E02 1.2E01 2.4E01 5.3E01
Kidneys 1.5E01 1.9E01 2.9E01 5.0E01 1.0E+00
Liver 1.4E01 2.0E01 3.4E01 5.8E01 1.2E+00
Lungs 6.1E02 8.2E02 1.7E01 3.2E01 6.5E01
Muscles 1.8E01 2.2E01 3.6E01 5.1E01 6.9E01
Oesophagus 5.0E02 8.1E02 2.7E01 8.5E01 2.1E+00
Ovaries 1.7E02 2.5E02 4.6E02 9.0E02 2.0E01
Pancreas 2.4E02 3.4E02 6.5E02 1.3E01 2.9E01
Red marrow 3.7E02 4.3E02 6.4E02 1.0E01 2.0E01
Salivary glands 2.6E02 3.2E02 4.3E02 6.0E02 9.1E02
Skin 3.4E02 3.7E02 5.4E02 7.7E02 1.5E01
Spleen 3.4E02 4.6E02 8.3E02 1.6E01 3.6E01
Testes 1.1E02 1.5E02 2.6E02 5.2E02 1.2E01
Thymus 5.0E02 8.1E02 2.7E01 8.5E01 2.1E+00
Thyroid 3.9E+02 5.6E+02 7.6E+02 1.3E+03 1.5E+03
Urinary bladder wall 6.4E02 8.6E02 1.3E01 1.9E01 3.1E01
Uterus 1.5E02 2.1E02 4.0E02 7.5E02 1.7E01
Remaining organs 1.6E01 1.9E01 2.9E01 3.3E01 4.8E01

Effective dose (mSv MBq1) 2.0E+01 2.8E+01 3.8E+01 6.3E+01 7.5E+01

125
The physical half-life of I is 59.4 days.

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131
Table C.109. Absorbed doses for I-iodide.

Absorbed dose per unit activity administered (mGy MBq1)

Organ Adult 15 years 10 years 5 years 1 year

Thyroid blocked, oral administration

Adrenals 4.4E02 5.4E02 8.6E02 1.4E01 2.5E01
Bone surfaces 3.0E02 3.7E02 5.9E02 9.2E02 1.8E01
Brain 2.1E02 2.6E02 4.3E02 7.1E02 1.4E01
Breast 2.0E02 2.5E02 4.2E02 6.9E02 1.3E01
Gallbladder wall 3.7E02 4.8E02 8.5E02 1.3E01 2.1E01
Gastrointestinal tract
Stomach wall 8.7E01 1.1E+00 1.6E+00 2.8E+00 5.9E+00
Small intestine wall 3.5E02 4.4E02 7.0E02 1.1E01 1.9E01
Colon wall 1.4E01 1.8E01 3.0E01 5.0E01 9.2E01
(Upper large intestine wall 1.2E01 1.5E01 2.5E01 4.2E01 7.5E01)
(Lower large intestine wall 1.7E01 2.2E01 3.7E01 6.1E01 1.2E+00)
Heart wall 6.2E02 8.0E02 1.3E01 2.0E01 3.7E01
Kidneys 2.7E01 3.2E01 4.6E01 6.9E01 1.2E+00
Liver 5.0E02 6.5E02 1.0E01 1.6E01 3.0E01
Lungs 5.3E02 6.8E02 1.1E01 1.8E01 3.6E01
Muscles 2.6E02 3.2E02 5.1E02 8.0E02 1.5E01
Oesophagus 2.4E02 3.0E02 4.9E02 7.9E02 1.5E01
Ovaries 3.8E02 4.9E02 7.6E02 1.1E01 2.0E01
Pancreas 6.0E02 7.3E02 1.1E01 1.6E01 2.8E01
Red marrow 3.1E02 3.8E02 6.1E02 9.5E02 1.8E01
Salivary glands 2.7E01 3.3E01 4.4E01 5.9E01 8.6E01
Skin 1.9E02 2.3E02 3.8E02 6.2E02 1.2E01
Spleen 6.4E02 7.7E02 1.2E01 1.9E01 3.4E01
Testes 2.5E02 3.3E02 5.5E02 8.4E02 1.5E01
Thymus 2.4E02 3.0E02 4.9E02 7.9E02 1.5E01
Thyroid 2.2E+00 3.6E+00 5.6E+00 1.3E+01 2.5E+01
Urinary bladder wall 5.4E01 7.0E01 1.1E+00 1.4E+00 1.8E+00
Uterus 4.5E02 5.6E02 9.0E02 1.3E01 2.1E01
Remaining organs 2.9E02 3.7E02 6.0E02 1.0E01 1.8E01

Effective dose (mSv MBq1) 2.8E01 4.0E01 6.1E01 1.2E+00 2.3E+00

Thyroid blocked, intravenous administration
Effective dose (mSv MBq1) 2.4E01 3.6E01 5.4E01 1.1E+00 2.0E+00
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 ICRP Publication 128

Table C.109. (continued)

Absorbed dose per unit activity administered (mGy MBq1)

Organ Adult 15 years 10 years 5 years 1 year

Thyroid, low uptake, oral administration

Adrenals 5.1E02 6.7E02 1.2E01 2.0E01 4.4E01
Bone surfaces 8.9E02 1.0E01 1.4E01 2.2E01 4.0E01
Brain 9.3E02 1.0E01 1.3E01 1.8E01 3.0E01
Breast 3.8E02 5.0E02 1.0E01 1.7E01 3.2E01
Gallbladder wall 4.3E02 5.7E02 1.0E01 1.8E01 3.6E01
Gastrointestinal tract
Stomach wall 7.7E01 1.0E+00 1.5E+00 2.5E+00 5.3E+00
Small intestine wall 3.3E02 4.3E02 7.3E02 1.1E01 2.2E01
Colon wall 1.4E01 1.8E01 3.2E01 5.8E01 1.3E+00
(Upper large intestine wall 1.2E01 1.5E01 2.7E01 4.9E01 1.0E+00)
(Lower large intestine wall 1.7E01 2.2E01 3.9E01 7.1E01 1.6E+00)
Heart wall 8.9E02 1.2E01 2.1E01 3.6E01 7.7E01
Kidneys 2.7E01 3.4E01 5.0E01 8.4E01 1.8E+00
Liver 9.3E02 1.4E01 2.4E01 4.6E01 1.2E+00
Lungs 1.0E01 1.3E01 2.2E01 3.8E01 7.9E01
Muscles 8.4E02 1.1E01 1.7E01 2.7E01 4.8E01
Oesophagus 1.0E01 1.5E01 3.0E01 5.8E01 1.1E+00
Ovaries 3.7E02 4.9E02 8.0E02 1.3E01 2.8E01
Pancreas 6.4E02 8.0E02 1.3E01 2.1E01 4.1E01
Red marrow 7.2E02 8.6E02 1.2E01 1.9E01 3.7E01
Salivary glands 2.2E01 2.7E01 3.6E01 4.9E01 7.2E01
Skin 4.3E02 5.3E02 8.0E02 1.2E01 2.5E01
Spleen 6.9E02 8.9E02 1.5E01 2.6E01 5.5E01
Testes 2.4E02 3.2E02 5.6E02 9.5E02 2.0E01
Thymus 1.0E01 1.5E01 3.0E01 5.9E01 1.1E+00
Thyroid 2.8E+02 4.5E+02 6.7E+02 1.4E+03 2.3E+03
Urinary bladder wall 4.5E01 5.8E01 8.9E01 1.2E+00 1.6E+00
Uterus 4.2E02 5.4E02 9.0E02 1.5E01 2.8E01
Remaining organs 8.4E02 1.1E01 1.7E01 2.5E01 4.4E01

Effective dose (mSv MBq1) 1.4E+01 2.3E+01 3.4E+01 7.1E+01 1.1E+02

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Table C.109. (continued)

Absorbed dose per unit activity administered (mGy MBq1)

Organ Adult 15 years 10 years 5 years 1 year

Thyroid, medium uptake, oral administration

Adrenals 5.5E02 7.4E02 1.3E01 2.4E01 5.5E01
Bone surfaces 1.2E01 1.4E01 1.9E01 3.0E01 5.2E01
Brain 1.3E01 1.4E01 1.8E01 2.4E01 3.9E01
Breast 4.8E02 6.3E02 1.3E01 2.3E01 4.3E01
Gallbladder wall 4.6E02 6.3E02 1.2E01 2.1E01 4.5E01
Gastrointestinal tract
Stomach wall 7.1E01 9.5E01 1.4E+00 2.4E+00 5.0E+00
Small intestine wall 3.2E02 4.3E02 7.5E02 1.1E01 2.4E01
Colon wall 1.4E01 1.8E01 3.4E01 6.3E01 1.4E+00
(Upper large intestine wall 1.2E01 1.5E01 2.8E01 5.3E01 1.2E+00)
(Lower large intestine wall 1.7E01 2.2E01 4.0E01 7.6E01 1.8E+00)
Heart wall 1.0E01 1.4E01 2.5E01 4.5E01 1.0E+00
Kidneys 2.7E01 3.4E01 5.3E01 9.3E01 2.1E+00
Liver 1.2E01 1.8E01 3.1E01 6.2E01 1.7E+00
Lungs 1.3E01 1.6E01 2.8E01 5.0E01 1.0E+00
Muscles 1.2E01 1.5E01 2.4E01 3.8E01 6.6E01
Oesophagus 1.4E01 2.2E01 4.5E01 8.7E01 1.7E+00
Ovaries 3.6E02 4.9E02 8.2E02 1.5E01 3.3E01
Pancreas 6.6E02 8.4E02 1.4E01 2.4E01 4.9E01
Red marrow 9.5E02 1.1E01 1.5E01 2.4E01 4.8E01
Salivary glands 1.9E01 2.4E01 3.2E01 4.3E01 6.4E01
Skin 5.7E02 7.0E02 1.0E01 1.6E01 3.3E01
Spleen 7.2E02 9.6E02 1.6E01 2.9E01 6.8E01
Testes 2.3E02 3.2E02 5.6E02 1.0E01 2.3E01
Thymus 1.4E01 2.2E01 4.5E01 8.7E01 1.7E+00
Thyroid 4.3E+02 6.9E+02 1.0E+03 2.2E+03 3.6E+03
Urinary bladder wall 3.9E01 5.1E01 7.9E01 1.1E+00 1.5E+00
Uterus 4.0E02 5.3E02 8.9E02 1.5E01 3.2E01
Remaining organs 1.1E01 1.5E01 2.3E01 3.3E01 5.8E01

Effective dose (mSv MBq1) 2.2E+01 3.5E+01 5.3E+01 1.1E+02 1.8E+02

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Table C.109. (continued)

Absorbed dose per unit activity administered (mGy MBq1)

Organ Adult 15 years 10 years 5 years 1 year

Thyroid, high uptake, oral administration

Adrenals 5.9E02 8.2E02 1.5E01 2.8E01 6.6E01
Bone surfaces 1.6E01 1.8E01 2.4E01 3.7E01 6.5E01
Brain 1.7E01 1.8E01 2.3E01 3.0E01 4.9E01
Breast 5.8E02 7.7E02 1.7E01 2.8E01 5.4E01
Gallbladder wall 4.9E02 6.8E02 1.3E01 2.4E01 5.4E01
Gastrointestinal tract
Stomach wall 6.6E01 8.8E01 1.3E+00 2.2E+00 4.7E+00
Small intestine wall 3.2E02 4.3E02 7.7E02 1.2E01 2.6E01
Colon wall 1.4E01 1.9E01 3.5E01\ 6.8E01 1.6E+00
(Upper large intestine wall 1.2E01 1.6E01 3.0E01 5.8E01 1.4E+00)
(Lower large intestine wall 1.6E01 2.2E01 4.2E01 8.1E01 2.0E+00)
Heart wall 1.2E01 1.6E01 3.0E01 5.5E01 1.2E+00
Kidneys 2.7E01 3.5E01 5.5E01 1.0E+00 2.4E+00
Liver 1.4E01 2.2E01 3.9E01 7.9E01 2.2E+00
Lungs 1.5E01 2.0E01 3.5E01 6.1E01 1.3E+00
Muscles 1.5E01 1.9E01 3.1E01 4.9E01 8.6E01
Oesophagus 1.9E01 2.8E01 5.9E01 1.2E+00 2.3E+00
Ovaries 3.5E02 4.9E02 8.4E02 1.6E01 3.7E01
Pancreas 6.8E02 8.8E02 1.5E01 2.7E01 5.7E01
Red marrow 1.2E01 1.4E01 1.9E01 2.9E01 5.9E01
Salivary glands 1.6E01 2.0E01 2.7E01 3.7E01 5.5E01
Skin 7.1E02 8.7E02 1.3E01 1.9E01 4.1E01
Spleen 7.5E02 1.0E01 1.8E01 3.3E01 8.0E01
Testes 2.2E01 3.1E02 5.7E02 1.1E01 2.7E01
Thymus 1.9E01 2.8E01 5.9E01 1.2E+00 2.3E+00
Thyroid 5.8E+02 9.4E+02 1.4E+03 3.0E+03 4.9E+03
Urinary bladder wall 3.4E01 4.4E01 6.8E01 9.5E01 1.3E01
Uterus 3.8E02 5.1E02 8.9E02 1.6E01 3.6E01
Remaining organs 1.5E01 1.9E01 2.9E01 4.2E01 7.4E01

Effective dose (mSv MBq1) 2.9E+01 4.7E+01 7.1E+01 1.5E+02 2.5E+02

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The physical half-life of I is 8.04 days.

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 123
C.53. I-labelled fatty acids
C.53.1. Biokinetic model

(C159) Free fatty acids are major energy sources for the myocardium, and iodine-
labelled free fatty acids are used to study the energy metabolism of the heart. Long-
chain fatty acids are taken up rapidly by the heart and metabolised by b-oxidation
(Tamaki et al., 2000). The first iodine-labelled free fatty acids that were developed
had the disadvantage of excessive release of radioiodide. This was overcome by the
introduction of 123I-para-iodophenyl pentadecanoic acid (123I-IPPA), a terminally
phenylated straight-chain fatty acid, where the iodine was substituted in the phenyl
group (Machulla et al., 1980; Reske et al., 1982; Reske, 1985; Dudzcak et al., 1986).
(C160) The rapid clearance of 123I-IPPA from the myocardium is, however, a
problem when tomography (SPECT) is performed. This problem has been overcome
by the introduction of a methyl group on the 3-carbon of the fatty acid. 3-Methyl-
branched fatty acids are metabolised in the peroxisomes by initial a-oxidation fol-
lowed by peroxisomal b-oxidation, a process that is slower than mitochondrial
b-oxidation (Casteels et al., 2003). This principle was first used by Knapp et al.
(1986) by the introduction of b-methyl-p-(123I)-iodophenylpentadecanoic acid (123I-
BMIPP) [see references in Knapp and Kropp (1995)].
(C161) After intravenous injection, 123I-IPPA and 123I-BMIPP are cleared rapidly
from the blood (biological half-time 2.5–3.0 min) (Knapp et al., 1995) due to fast
uptake in various organs and tissues (Torizuka et al., 1991; Yoshizumi et al., 2000).
Whole-body pictures shortly after the injection (Torizuka et al., 1991; Sloof et al.,
1997; Caveliers et al., 1998; Yoshizumi et al., 2000) show a concentration of activity
in liver and heart, and uniform distribution in the rest of the body.
(C162) After uptake, only some 123I-IPPA and 123I-BMIPP will be metabolised
immediately to water-soluble low-molecular-weight products. 123I-IPPA is, to a large
extent, metabolised like long-chain fatty acids by rapid mitochondrial b-oxidation,
resulting in p-(123I)-iodobenzoic acid which is excreted in a conjugated form in the
urine. The metabolism of 123I-BMIPP is slower than that of 123I-IPPA due to the
methyl group on the b-carbon. The end product is p-(123I)-iodophenyl acetic acid,
which is also excreted as a conjugate in the urine. In either case, no release of free
iodine has been detected. The initially unmetabolised part of 123I-IPPA and
123
I-BMIPP will become incorporated into the fat stores in the body, which have
slow turnover thus causing considerably delayed metabolism.
(C163) Time–activity curves for the heart and liver indicate bi-exponential elim-
ination of 123I-BMIPP (Torizuka et al., 1991; De Geeter et al., 1998). Out of these
curves, initial uptake has been calculated to be 5.0–5.7% of the activity administered
(excluding blood activity) in the heart and 13–14% in the liver. For 123I-BMIPP, the
biological half-time of the fast phase is approximately 1 h, and that of the slow phase
is approximately 2 days. The fast phase corresponds to a fraction of 0.43 of uptake in
the heart. In the liver, the fast-eliminated fraction is 0.33–0.36. The final metabolite is
excreted via the kidneys and urinary bladder. After 16 h, 15% (Dudzcak et al., 1986)
has been excreted, and this increases to 22.6% after 24 h (Torizuka et al., 1991).

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There are no data for 123I-BMIPP covering longer time periods, but from studies on
labelled fatty acids (Gunnarsson et al., 2003), one must assume uptake into body fat
and, consequently, slow turnover of part of the administered activity.
(C164) The biokinetic model for 123I-BMIPP adopted here assumes initial uptake
of 6% of the administered activity in the heart and 14% in the liver. The rest is
assumed to be distributed uniformly in the remaining organs and tissues. From the
heart, 40% is excreted with a biological half-time of 1 h and 60% with a half-time of
48 h. For the liver, the fractions are 30% and 70%, respectively. Elimination from the
rest of the body is assumed to be bi-exponential, with a fast phase with a half-time of
48 h and a slow phase with a half-time exceeding 100 h (Gunnarsson et al., 2003).
(C165) The faster phase corresponds to the combined fast and slow phases of the
heart and liver, and represents the turnover of a more dynamic fat pool of the body.
The slow phase represents the turnover of the rest of the body fat. The size of the
latter long-lasting pool is taken to be 20% of the administered activity; a high value
according to data in the literature (Gunnarsson et al., 2003).
(C166) For 123I-IPPA, there are no data suitable for dose estimations. Initial
uptake in the heart, liver, and other organs and tissues is assumed to be the same
as for 123I-BMIPP. The first-phase elimination from heart and liver, however, should
be much faster as b-oxidation is not inhibited. The model assumes a half-time that is
five times lower (i.e. a biological half-time of 10 min for the initial fast phase). For the
slow phase of the heart and liver, and for elimination from the rest of the body, the
same figures are used as in the 123I-BMIPP model. Note that the models are intended
for 123I only.

123
C.53.2. References for I-labelled fatty acids
Casteels, M., Foulon, V., Mannaerts, G.P., van Veldhoven, P., 2003. Alpha-oxidation of
3-methyl-substituted fatty acids and its thiamine dependence. Eur. J. Biochem. 270,
1619–1627.
Caveliers, V., Franken, P.R., Florian, F.L., Lou, H., Knapp, F.F. Jr, 1998. Intra-individual
comparison of 3(R)-BMIPP and 3(S)-BMIPP isomers in humans. J. Nucl. Med. 39,
1672–1675.
De Geeter, F., Caveliers, V., Pansar, I., Bossuyt, A., Franken, P.R., 1998. Effect of oral
glucose loading on the biodistribution of BMIPP in normal volunteers. J. Nucl. Med.
39, 1850–1856.
Dudzcak, R., Schmoliner, R., Angelberger, P., Knapp, F.F., Goodman, M.M., 1986.
Structurally modified fatty acids: clinical potential as tracers of metabolism. Eur. J.
Nucl. Med. 12, S45–S48.
Gunnarsson, M., Stenström, K., Leide-Svegborn, S., et al., 2003. Biokinetics and radiation
dosimetry for patients undergoing a glycerol tri[1-14C]oleate fat malabsorption breath test.
Appl. Radiat. Isot. 58, 517–526.
Knapp, F.F. Jr, Ambrose, K.R., Goodman, M.M., 1986. New radioiodinated methyl-
branched fatty acids for cardiac studies. Eur. J. Nucl. Med. 12(Suppl.), S39–S44.
Knapp, F.F. Jr, Franken, P., Kropp, J., 1995. Cardiac SPECT with iodine-123-labeled fatty
acids: evaluation of myocardial viability with BMIPP. J. Nucl. Med. 36, 1022–1030.

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 Radiation dose to patients from radiopharmaceuticals

Knapp, F.F. Jr, Kropp, J., 1995. Iodine-123-labelled fatty acids for myocardial single-photon
emission tomography: current status and future perspectives. Eur. J. Nucl. Med. 22,
361–381.
Machulla, H.J., Marsmann, M., Dutschka, K., 1980. Biochemical concept and synthesis of a
radioiodinated phenyl fatty acid for in vivo metabolic studies of the myocardium. Eur. J.
Nucl. Med. 5, 171–173.
Reske, S.N., Biersack, H.J., Lackner, K., et al., 1982. Assessment of regional myocardial
uptake and metabolism of omega-(p-123I-phenyl) pentadecanoic acid with serial single-
photon emission tomography. Nuklearmedizin 21, 249–253.
Reske, S.N., 1985. 123I-phenylpentadecanoic acid as a tracer of cardiac free fatty acid meta-
bolism. Experimental and clinical results. Eur. Heart J. 6(Suppl. B), 39–47.
Sloof, G.W., Visser, F.C., van Lingen, A., et al., 1997. Evaluation of heart-to-organ ratios of
123
I-BMIPP and the dimethyl-substituted 123I-DMIPP fatty acid analogue in humans.
Nucl. Med. Commun. 18, 1065–1070.
Tamaki, N., Morita, K., Kuge, Y., Tsukamoto, E., 2000. The role of fatty acids in cardiac
imaging. J. Nucl. Med. 41, 1525–1534.
Torizuka, K., Yonekura, Y., Nishimura, T., et al., 1991. The phase 1 study of b-methyl-p-
(123I)-iodophenyl-pentadecanoic acid (123I-BMIPP). Kagu Igaku 28, 681–690.
Yoshizumi, T., Nozaki, S., Fukuchi, K., et al., 2000. Pharamacokinetics and metabolism of
123
I-BMIPP fatty acid analog in healthy and CD36-deficient subjects. J. Nucl. Med. 41,
1134–1138.

Table C.110. Biokinetic data for 123I-labelled fatty acids [beta-methyl-p-(123I)-iodophenylpen-

tadecanoic acid].

Organ (S) Fs T (h) a Ãs/A0 (h)

Heart wall 0.06 1.0 0.40 0.57

48 0.60
Liver 0.14 1.0 0.30 1.5
48 0.70
Other organs and tissues 0.80 48 0.75 13
15000 0.25
Urinary bladder contents 1.0
Adult, 15 years, 10 years 0.41
5 years 0.35
1 year 0.23
No free iodide is released.
123
This biokinetic model is intended for I alone.

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 ICRP Publication 128

Table C.111. Biokinetic data for 123I-labelled fatty acids (123I-para-iodophenyl pentadecanoic
acid).

Organ (S) Fs T (h) a Ãs/A0 (h)

Heart wall 0.06 0.17 0.40 0.54

48 0.60
Liver 0.14 0.17 0.30 1.5
48 0.70
Other organs and tissues 0.80 48 0.75 13
15,000 0.25
Urinary bladder contents 1.0
Adult, 15 years, 10 years 0.47
5 years 0.40
1 year 0.27
No free iodide is released.
123
This biokinetic model is intended for I alone.

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123
Table C.112. Absorbed doses for I-labelled fatty acids [beta-methyl-p-(123I)-iodophenyl-
pentadecanoic acid].

Absorbed dose per unit activity administered (mGy MBq1)

Organ Adult 15 years 10 years 5 years 1 year

Adrenals 1.5E02 1.9E02 2.9E02 4.4E02 7.9E02

Bone surfaces 2.0E02 2.4E02 3.8E02 5.9E02 1.1E01
Brain 9.6E03 1.2E02 2.0E02 3.3E02 5.9E02
Breast 8.9E03 1.1E02 1.7E02 2.7E02 5.3E02
Gallbladder wall 1.9E02 2.3E02 3.5E02 5.4E02 8.7E02
Gastrointestinal tract
Stomach wall 1.3E02 1.7E02 2.7E02 4.2E02 7.7E02
Small intestine wall 1.4E02 1.7E02 2.7E02 4.3E02 7.9E02
Colon wall 1.4E02 1.8E02 2.7E02 4.3E02 7.7E02
(Upper large intestine wall 1.4E02 1.8E02 2.7E02 4.5E02 7.8E02)
(Lower large intestine wall 1.4E02 1.7E02 2.7E02 4.1E02 7.6E02)
Heart wall 5.3E02 6.8E02 1.0E01 1.6E01 2.8E01
Kidneys 1.3E02 1.6E02 2.6E02 4.0E02 7.2E02
Liver 3.6E02 4.6E02 6.9E02 9.8E02 1.8E01
Lungs 1.3E02 1.7E02 2.6E02 4.0E02 7.4E02
Muscles 1.1E02 1.4E02 2.1E02 3.3E02 6.2E02
Oesophagus 1.3E02 1.6E02 2.4E02 3.8E02 6.9E02
Ovaries 1.4E02 1.8E02 2.7E02 4.3E02 8.0E02
Pancreas 1.6E02 2.0E02 3.1E02 4.9E02 8.7E02
Red marrow 1.1E02 1.3E02 2.0E02 3.0E02 5.5E02
Skin 7.5E03 9.0E03 1.4E02 2.3E02 4.4E02
Spleen 1.2E02 1.6E02 2.5E02 3.8E02 7.0E02
Testes 1.0E02 1.3E02 2.0E02 3.3E02 6.1E02
Thymus 1.3E02 1.6E02 2.4E02 3.8E02 6.9E02
Thyroid 1.1E02 1.4E02 2.3E02 3.7E02 6.9E02
Urinary bladder wall 3.9E02 5.1E02 7.3E02 1.1E01 2.0E01
Uterus 1.6E02 1.9E02 3.1E02 4.8E02 8.7E02
Remaining organs 1.1E02 1.4E02 2.1E02 3.4E02 6.2E02

Effective dose (mSv MBq1) 1.6E02 2.0E02 3.1E02 4.7E02 8.7E02

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The physical half-life of I is 13.2 h.

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Table C.113. Absorbed doses for 123I-labelled fatty acids (123I-para-iodophenyl pentadecanoic
acid).

Absorbed dose per unit activity administered (mGy MBq1)

Organ Adult 15 years 10 years 5 years 1 year

Adrenals 1.5E02 1.9E02 2.9E02 4.4E02 7.9E02

Bone surfaces 2.0E02 2.4E02 3.8E02 5.8E02 1.1E01
Brain 9.6E03 1.2E02 2.0E02 3.3E02 5.9E02
Breast 8.9E03 1.1E02 1.7E02 2.7E02 5.2E02
Gallbladder wall 1.8E02 2.3E02 3.5E02 5.3E02 8.5E02
Gastrointestinal tract
Stomach wall 1.3E02 1.7E02 2.7E02 4.2E02 7.6E02
Small intestine wall 1.4E02 1.7E02 2.7E02 4.3E02 7.8E02
Colon wall 1.4E02 1.8E02 2.7E02 4.3E02 7.6E02
(Upper large intestine wall 1.4E02 1.8E02 2.7E02 4.5E02 7.7E02)
(Lower large intestine wall 1.4E02 1.7E02 2.7E02 4.1E02 7.4E02)
Heart wall 5.1E02 6.5E02 9.9E02 1.5E01 2.7E01
Kidneys 1.3E02 1.6E02 2.6E02 4.0E02 7.2E02
Liver 3.5E02 4.5E02 6.7E02 9.6E02 1.7E01
Lungs 1.3E02 1.7E02 2.6E02 4.0E02 7.4E02
Muscles 1.1E02 1.4E02 2.1E02 3.3E02 6.1E02
Oesophagus 1.3E02 1.6E02 2.4E02 3.8E02 6.9E02
Ovaries 1.4E02 1.8E02 2.8E02 4.3E02 7.8E02
Pancreas 1.6E02 2.0E02 3.1E02 4.8E02 8.7E02
Red marrow 1.1E02 1.3E02 2.0E02 3.0E02 5.5E02
Skin 7.5E03 9.0E03 1.4E02 2.3E02 4.4E02
Spleen 1.2E02 1.6E02 2.5E02 3.8E02 7.0E02
Testes 1.0E02 1.3E02 2.0E02 3.2E02 5.9E02
Thymus 1.3E02 1.6E02 2.4E02 3.8E02 6.9E02
Thyroid 1.1E02 1.4E02 2.3E02 3.7E02 6.9E02
Urinary bladder wall 4.3E02 5.6E02 8.1E02 1.1E01 1.5E01
Uterus 1.6E02 2.0E02 3.2E02 4.8E02 8.2E02
Remaining organs 1.1E02 1.4E02 2.1E02 3.4E02 6.2E02

Effective dose (mSv MBq1) 1.6E02 2.0E02 3.1E02 4.7E02 8.3E02

123
The physical half-life of I is 13.2 h.

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 123
C.54. I-labelled brain receptor substances (generic model)
C.54.1. Biokinetic model

(C167) A large number of radiopharmaceuticals labelled with 18F and 123I have
been developed for PET and SPECT studies of different types of receptor in the
human brain. For many of these substances, the available biokinetic data are insuffi-
cient to construct realistic compound-specific biokinetic models for the calculation of
absorbed dose to persons undergoing an investigation. Therefore, a generic model
for radionuclide-labelled brain receptor substances that would predict the internal
radiation dose with sufficient accuracy for general radiation protection purposes has
been developed.
(C168) A generic model for 11C-labelled brain receptor substances has been pub-
lished (Nosslin et al., 2003). A review of the literature has identified biokinetic and
dosimetric data for five 18F-labelled and 15 123I-labelled compounds considered to be
potential substances for the clinical imaging of brain receptors (e.g. acetylcholines-
terase receptors, benzodiazepine receptors, dopamine receptors, dopamine transpor-
ters, and serotonin receptors). These data indicate that despite fairly large differences
in chemical structure, the patterns of uptake in the human brain, and other tissues
for which information are available, appear to be sufficiently similar to justify a
generic model for each radionuclide.
(C169) For some compounds, the published data on the dosimetry of 18F- and
123
I-labelled receptor radiopharmaceuticals were derived from PET and SPECT
studies in humans, and for other compounds, the biokinetic models were derived,
at least in part, from studies of biodistribution in experimental animals.
(C170) For the 123I model, it is assumed that fractions of 0.06 and 0.003 of the
administered activity are distributed instantaneously to brain and thyroid, respec-
tively. The activity is excreted from these tissues with a biological half-time of 100 h
(i.e. more than 99% of 123I will decay in situ). It is also assumed that 0.20 of the
administered activity is distributed instantaneously to the lungs and then excreted
with a biological half-time of 8 h. Fractions of 0.20 and 0.03 are assumed to be
deposited in the liver and the kidneys, and are excreted bi-exponentially with biolo-
gical half-times of 8 h (50%) and 100 h (50%), respectively. Thirty percent of the
activity uptake in liver is eliminated via the gallbladder, and the remainder of the
liver uptake is passed directly into the small intestine. It is assumed that 75% of the
administered 123I is excreted in the urine and 25% via the gastrointestinal tract.

123
C.54.2. References for I-labelled brain receptor substances (generic model)
Booij, J., Sokole, E.B., Stabin, M.G., Janssen, A.G.M., de Bruin, K., van Royen, E.A., 1998.
Human biodistribution and dosimetry of [123I]FP-CIT: a potent radioligand for imaging of
dopamine transporters. Eur. J. Nucl. Med. 25, 24–30.
Booij, J., Sokole, E.B., Stabin, M.G., Janssen, A.G.M., de Bruin, K., van Royen, E.A., 1998.
Human biodistribution and dosimetry of [123I]FP-CIT: a potent radioligand for imaging of
dopamine transporters: erratum. Eur. J. Nucl. Med. 25, 458.

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 ICRP Publication 128

Boundy, K.L., Barnden, L.R., Rowe, C.C., et al., 1995. Human dosimetry and biodistribution
of iodine-123-iododexetimide: a SPECT imaging agent for cholinergic muscarinic neuror-
eceptors. J. Nucl. Med. 36, 1332–1338.
Deterding, T.A., Votaw, J.R., Wang, C.K., et al., 2001. Biodistribution and radiation dosi-
metry of the dopamine transporter ligand [18F]FECNT. J. Nucl. Med. 42, 376–381.
Gründer, G., Siessmeier, T., Lange-Asschenfeldt, C., et al., 2001. [18F]Fluoroethylflumaazenil:
a novel tracer for PET imaging of human benzodiazepine receptors. Eur. J. Nucl. Med. 28,
1463–1470.
Gründer, G., Siessmeier, T., Piel, M., et al., 2003. Quantification of D2-like dopamine recep-
tors in the human brain with [18F]-desmethoxyfallypride. J. Nucl. Med. 44, 109–116.
Kauppinen, T.A., Bergström, K.A., Heikman, P., Hiltunen, J., Ahonen, A.K., 2003.
Biodistribution and radiation dosimetry of [123I]ADAM in healthy human subjects: pre-
liminary results. Eur. J. Nucl. Med. 30, 132–136.
Kuikka, J.T., Bergström, K.A., Ahonen, A., Länsimies, E., 1994. The dosimetry of iodine-123
labelled 2b-carbomethoxy-3b-(4-iodophenyl)tropane. Eur. J. Nucl. Med. 21, 53–56.
Mitterhauser, M., Wadsak, W., Wabnegger, L., et al., 2004. Biological evaluation of
20 -[18F]fluoroflumazenil ([18F]FFMZ) a potential GABA receptor ligand for PET. Nucl.
Med. Biol. 31, 291–295.
Mozley, P.D., Stubbs, J.T., Kim, H-J., et al., 1995. Dosimetry of a D2/D3 dopamine receptor
antagonist that can be used with PET or SPECT. J. Nucl. Med. 36, 1322–1331.
Mozley, P.D., Stubbs, J.T., Kim, H-J., et al., 1996. Dosimetry of an iodine-123-labeled tro-
pane to image dopamine transporters. J. Nucl. Med. 37, 151–159.
Nosslin, B., Johansson, L., Leide-Svegborn, S., Liniecki, J., Mattsson, S., Taylor, D.M., 2003.
A generic model for [11C]-labelled radiopharmaceuticals for imaging receptors in the
human brain. Rad. Prot. Dosim. 105, 587–591.
Taylor, D.M., 2000. Unpublished assessments.
van de Wiele, C., De Vos, F., De Sutter, J., et al., 1999. Biokinetics and dosimetry of (iodine-
123)-iodomethyl-N,N-dimethyltamoxifen, an (anti)oestrogen receptor radioligand. Eur. J.
Nucl. Med. 26, 1259–1264.
Verhoeff, N.P., Sokole, E.B., Stabin, M., et al., 1993. Dosimetry of iodine-123 iodobenzamide
in healthy volunteers. Eur. J. Nucl. Med. 20, 747–752.
Verhoeff, N.P., Busemann Sokole, E., Hengst, D., Stubbs, J.B., van Royen, E.A., 1993.
Dosimetry of iodine-123 iomazenil in humans. Eur. J. Nucl. Med. 20, 580–584.
Versijpt, J., Dumont, F., Thierens, H., et al., 2000. Biodistribution and dosimetry of [123I]iodo-
PK 11195: a potential agent for SPET imaging of the peripheral benzodiazepine receptor.
Eur. J. Nucl. Med. 27, 1326–1333.
Votaw, J.R., Ansari, M.S., Scott Mason, N., et al., 1995. Dosimetry of iodine-123-epidepride:
a dopamine D2 receptor ligand. J. Nucl. Med. 36, 1316–1321.
Volkow, N.D., Ding, Y-S., Fowler, J.S., et al., 1995. A new PET ligand for the dopamine
transporter: studies in human brain. J. Nucl. Med. 36, 2162–2168.
Waterhouse, R.N., Stabin, M.G., Page, J.G., 2003. Preclinical acute toxicity studies and
rodent-based dosimetry estimates of the novel sigma-1 receptor radiotracer [18F]FPS.
Nucl. Med. Biol. 30, 555–563.

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123
Table C.114. Biokinetic data for I-labelled brain receptor substances (generic model).

Organ (S) Fs T (h) a Ãs/A0 (h)

Brain 0.06 100 1.0 1.0

Thyroid 0.003 100 1.0 0.050
Lungs 0.20 8.0 1.0 1.4
Kidneys 0.03 8.0 0.50 0.36
100 0.50
Kidney excretion 0.75 0.020
Liver 0.20 8.0 0.50 2.4
100 0.50
Stomach wall 0.05 8.0 1.0 0.36
Other organs and tissues 0.457 8.0 0.50 5.5
100 0.50
Gallbladder contents 0.06 0.67
Gastrointestinal tract contents
Stomach 0.05 0.030
Small intestine 0.25 1.2
Upper large intestine 0.25 2.3
Lower large intestine 0.25 1.9
Urinary bladder contents 0.75
Adult, 15 years, 10 years 0.55
5 years 0.47
1 year 0.31

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123
Table C.115. Absorbed doses for I-labelled brain receptor substances (generic model).

Absorbed dose per unit activity administered (mGy MBq1)

Organ Adult 15 years 10 years 5 years 1 year

Adrenals 1.6E02 2.1E02 3.2E02 4.8E02 8.5E02

Bone surfaces 1.7E02 2.1E02 3.3E02 5.1E02 1.0E01
Brain 2.9E02 2.9E02 3.0E02 3.4E02 4.6E02
Breast 6.3E03 7.8E03 1.3E02 2.1E02 4.0E02
Gallbladder wall 1.8E01 2.1E01 2.7E01 4.7E01 1.5E+00
Gastrointestinal tract
Stomach wall 5.7E02 7.6E02 1.1E01 1.8E01 3.8E01
Small intestine wall 6.3E02 8.0E02 1.3E01 2.1E01 3.8E01
Colon wall 1.6E01 2.0E01 3.4E01 5.5E01 1.0E+00
(Upper large intestine wall 1.5E01 1.9E01 3.2E01 5.2E01 9.7E01)
(Lower large intestine wall 1.7E01 2.1E01 3.6E01 5.8E01 1.1E+00)
Heart wall 1.2E02 1.6E02 2.5E02 3.9E02 7.1E02
Kidneys 4.6E02 5.5E02 7.9E02 1.2E01 2.0E01
Liver 5.8E02 7.5E02 1.1E01 1.6E01 3.0E01
Lungs 4.1E02 5.9E02 8.3E02 1.3E01 2.4E01
Muscles 1.0E02 1.3E02 2.0E02 3.1E02 5.8E02
Oesophagus 7.6E03 9.8E03 1.5E02 2.4E02 4.4E02
Ovaries 3.7E02 4.9E02 7.6E02 1.1E01 2.0E01
Pancreas 1.9E02 2.5E02 4.3E02 6.9E02 1.2E01
Red marrow 1.2E02 1.4E02 2.1E02 2.9E02 4.7E02
Skin 5.2E03 6.3E03 1.0E02 1.7E02 3.2E02
Spleen 1.2E02 1.6E02 2.5E02 4.0E02 7.3E02
Testes 7.0E03 9.2E03 1.6E02 2.6E02 4.8E02
Thymus 7.6E03 9.8E03 1.5E02 2.4E02 4.4E02
Thyroid 5.5E02 8.7E02 1.3E01 2.9E01 5.4E01
Urinary bladder wall 5.2E02 6.6E02 9.9E02 1.3E01 1.9E01
Uterus 2.3E02 3.0E02 5.0E02 7.8E02 1.4E01
Remaining organs 1.3E02 1.8E02 2.9E02 4.8E02 7.7E02

Effective dose (mSv MBq1) 5.0E02 6.1E02 9.6E02 1.5E01 3.2E01

123
The physical half-life of I is 13.2 h.

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 C.55. 123I-labelled 2ß-carbomethoxy 3ß-(4-iodophenyl)-
N-(3-fluoropropyl) nortropane (FP-CIT, b-CIT-FP, ioflupane)
C.55.1. Biokinetic model

(C171) 123I-labelled 2ß-carbomethoxy 3ß-(4-iodophenyl)-N-(3-fluoropropyl) nor-

tropane (otherwise referred to as 123I-FP-CIT, 123I-ß-CIT-FP, or 123I-ioflupane) is a
radioiodinated cocaine analogue that binds with high affinity and selectivity to
dopamine transporters, which solely exists in the presynaptic terminals of dopami-
nergic neurons. By introducing an agent that binds to the dopamine transporters, a
quantitative measure and spatial distribution of the transporters can be obtained
(Booij et al., 1997; Colloby et al., 2004; Walker et al., 2004; Tolosa et al., 2007).
123
I-FP-CIT thus probes dopaminergic cell loss. It is used to detect and distinguish
states of degeneration of presynaptic dopaminergic neurons in the striatum (caudate
nucleus and putamen) from essential tremor in the diagnosis and staging of neuro-
degenerative disorders (e.g. Parkinson’s disease, Alzheimer’s disease, and dementia
with Lewy bodies). Thyroid blocking via oral administration of potassium iodide is
recommended to minimise unnecessary excessive uptake of radioiodine.
(C172) The kinetics of 123I-FP-CIT are relatively fast and allow adequate striatal
uptake for imaging 3 h post injection. Booij et al. (1998) studied uptake and retention
of 123I-FP-CIT in six male and six female healthy volunteers (mean age 40 years)
during a 48-h period using conjugate view scanning and analysis of blood and urine
samples. Sydoff et al. (2013) performed a similar study in 10 male patients (mean age
70 years) using planar and combined planar and SPECT/CT imaging over a 48-h
period, and blood and urine were also sampled. After uptake, the activity was mainly
concentrated in liver, lungs, and brain (Abi-Dargham, 1997; Booij et al., 1998;
Tavola et al., 2012; Sydoff et al., 2013). In the brain, the activity is concentrated
in the striatum, which could have 10–15 times higher concentrations than the average
for the whole brain. Activity is also seen in the spleen, gastrointestinal tract, and
urinary bladder. Sixty percent of the administered activity is assumed to be excreted
via urine and 14% through faeces (Boiij et al., 1998). The reader is referred to Booij
et al. (1997, 2007) and Lim et al. (2009) for further information.
(C173) The biokinetic model for 123I-FP-CIT adopted here assumes initial uptake
of 31% of the administered activity in the liver, 11% in the lungs, and 4% in the
brain. The rest is assumed to be distributed uniformly in the remaining organs and
tissues. For all organs and tissues, 80% is assumed to be excreted with a biological
half-time of 58 h, and 20% with a half-time of 1.6 h. It is further assumed that 60%
of the injected activity is excreted to the urine, and 40% is excreted to the gastro-
intestinal tract for all organs and tissues. Activity in the liver is excreted according to
the Publication 53 gallbladder model (ICRP, 1987), where 30% is eliminated via the
gallbladder and the remainder passes directly into the small intestine.
(C174) Absorbed dose calculations have been undertaken by Booij et al. (1998)
and Sydoff et al. (2013). Both papers show very similar organ doses for the organs
with highest uptake and for effective doses. These values do not differ significantly

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123
from the values presented here. Note that the models are intended for I-labelled
substance only.

123
C.55.2. References for I-labelled 2ß-carbomethoxy 3ß-(4-iodophenyl)-N-(3-fluoro-
propyl) nortropane
Abi-Dargham, A., Innis, R.B., Wisniewski, G., Baldwin, R.M., Neumeyer, J.L., Seibyl, J.P.,
1997. Human biodistribution and dosimetry of iodine-123-fluoroalkyl analogs of ß-CIT.
Eur. J. Nucl. Med. 24, 1422–1425.
Booij, J., Tissingh, G., Winogrodzka, A., et al., 1997. Practical beneEt of [123I]FP-CIT SPET
in the demonstration of the dopaminergic deEcit in Parkinson’s disease. Eur. J. Nucl. Med.
24, 68–71.
Booij, J., Busemann Sokole, E., Stabin, M.G., Janssen, A.G., de Bruin, K., van Royen, E.A.,
1998. Human biodistribution and dosimetry of [123I]FPCIT: a potent radioligand for ima-
ging of dopamine transporters. Eur. J. Nucl. Med. 25, 24–30.
Booij, J., de Jong, J., de Bruin, K., Knol, R., de Win, M.M., van Eck-Smit, B.L., 2007.
Quantification of striatal dopamine transporters with 123I-FP-CIT SPECT is influenced
by the selective serotonin reuptake inhibitor paroxetine: a double-blind, placebo-
controlled, crossover study in healthy control subjects. J. Nucl. Med. 48, 359–366.
Colloby, S.J., O’Brien, J.T., Fenwick, J.D., et al., 2004. The application of statistical para-
metric mapping to 123I-FP-CIT SPECT in dementia with Lewy bodies, Alzheimer’s disease
and Parkinson’s disease. Neuroimage 23, 956–966.
ICRP, 1987. Radiation dose to patients from radiopharmaceuticals. ICRP Publication 53.
Ann. ICRP 18(1–4).
Lim, S.M., KatsiEs, A., Villemagne, V.L., et al., 2009. The 18F-FDG PET cingulate island sign
and comparison to 123I-beta-CIT SPECT for diagnosis of dementia with Lewy bodies.
J. Nucl. Med. 50, 1638–1645.
Sydoff, M., Lizana, H., Mattsson, S., Stabin, M.G., Leide-Svegborn, S., 2013. Determination
of the biodistribution and dosimetry of 123I-FP-CIT in male patients with suspected
Parkinsonism or Lewy body dementia using planar and combined planar and SPECT/
CT imaging. Appl. Radiat. Isotopes 82, 300–307.
Tavola, F., Janzen, T., Giussani, A., et al., 2012. Non-linear compartmental model of 18F-
choline. Nucl. Med. Biol. 39, 261–268.
Tolosa, E., Borght, T.V., Moreno, E., 2007. Accuracy of DaTSCAN (123I-Ioflupane) SPECT
in diagnosis of patients with clinically uncertain parkinsonism: 2-year follow-up of an
open-label study. Mov. Disord. 22, 2346–2351.
Walker, Z., Costa, D.C., Walker, R.W., et al., 2004. Striatal dopamine transporter in demen-
tia with Lewy bodies and Parkinson disease: a comparison. Neurology 62, 1568–1572.

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 Radiation dose to patients from radiopharmaceuticals

Table C.116. Biokinetic data for 123I-labelled 2ß-carbomethoxy 3ß-(4-iodophenyl)-N-(3-fluor-

opropyl) nortropane.

Organ (S) Fs T (h) a Ãs/A0 (h)

Brain 0.04 1.6 0.2 0.53

58 0.8
Salivary glands 0.012 1.6 0.2 0.15
58 0.8
Heart wall 0.02 1.6 0.2 0.26
58 0.8
Lungs 0.11 1.6 0.2 1.4
58 0.8
Kidneys 0.00056 1.6 0.2 0.023
58 0.8
Kidney excretion 0.75 0.016
Liver 0.31 1.6 0.2 4.0
58 0.8
Spleen 0.01 1.6 0.2 0.13
58 0.8
Other organs and tissues 0.49 1.6 0.2 6.3
58 0.8
Gallbladder contents 0.037 0.072
Gastrointestinal tract contents
Small intestine 0.40 0.99
Upper large intestine 0.40 0.37
Lower large intestine 0.40 0.37
Urinary bladder contents 0.60
Adult, 15 years, 10 years 0.37
5 years 0.32
1 year 0.21
No free iodide is released.
123
This biokinetic model is intended for I-labelled substance only.

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123
Table C.117. Absorbed doses for I-labelled 2ß-carbomethoxy 3ß-(4-iodophenyl)-N-(3-
fluoropropyl) nortropane.

Absorbed dose per unit administrated activity (mGy MBq1)

Organ Adult 15 years 10 years 5 years 1 year

Adrenals 1.7E02 2.2E02 3.3E02 4.8E02 8.3E02

Bone surfaces 1.5E02 1.9E02 3.0E02 4.6E02 9.2E02
Brain 1.6E02 1.6E02 1.8E02 2.0E02 2.8E02
Breast 7.3E03 9.0E03 1.5E02 2.4E02 4.5E02
Gallbladder wall 4.4E02 5.2E02 7.2E02 1.2E01 2.9E01
Gastrointestinal tract
Stomach wall 1.2E02 1.6E02 2.7E02 4.4E02 8.2E02
Small intestine wall 2.6E02 3.3E02 5.4E02 8.7E02 1.6E01
Colon wall 5.9E02 7.6E02 1.3E01 2.1E01 3.9E01
(Upper large intestine wall 5.7E02 7.3E02 1.2E01 2.0E01 3.7E01)
(Lower large intestine wall 6.2E02 7.9E02 1.3E01 2.1E01 4.1E01)
Heart wall 3.2E02 4.1E02 6.2E02 9.5E02 1.7E01
Kidneys 1.3E02 1.6E02 2.5E02 3.7E02 6.1E02
Liver 8.5E02 1.1E01 1.6E01 2.3E01 4.2E01
Lungs 4.2E02 6.1E02 8.5E02 1.3E01 2.4E01
Muscles 8.9E03 1.1E02 1.7E02 2.7E02 5.2E02
Oesophagus 9.4E03 1.2E02 1.8E02 2.9E02 5.3E02
Ovaries 1.8E02 2.3E02 3.7E02 5.7E02 1.0E01
Pancreas 1.7E02 2.2E02 3.5E02 5.7E02 1.0E01
Red marrow 9.3E03 1.1E02 1.7E02 2.4E02 4.2E02
Salivary glands 4.1E02 5.0E02 6.5E02 8.6E02 1.2E01
Skin 5.2E03 6.3E03 1.0E02 1.6E02 3.2E02
Spleen 2.6E02 3.7E02 5.7E02 8.7E02 1.6E01
Testes 6.3E03 8.1E03 1.3E02 2.2E02 4.1E02
Thymus 9.4E03 1.2E02 1.8E02 2.9E02 5.3E02
Thyroid 6.7E03 8.6E03 1.4E02 2.4E02 4.5E02
Urinary bladder wall 3.5E02 4.4E02 6.6E02 8.9E02 1.2E01
Uterus 1.4E02 1.8E02 3.0E02 4.6E02 8.2E02
Remaining organs 1.0E02 1.3E02 2.0E02 3.1E02 5.1E02

Effective dose (mSv MBq1) 2.5E02 3.3E02 5.1E02 7.8E02 1.4E01

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The physical half-life of I is 13.2 h.

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 123
C.56. I-labelled monoclonal tumour-associated antibodies
C.56.1. Biokinetic model

(C175) The models for iodine-labelled antibodies and fragments are the same as
those used for the corresponding technetium-labelled substances (see Section C.41.1),
with the modification that released iodine is assumed to be handled by the body
according to the model proposed for iodine with blocking of uptake in the thyroid
(ICRP, 1987, p. 275). The reader is referred to Bischof Delaloye and Delaloye (1995),
Britton and Granowska (1987), and Fishman et al. (1989) for further information.
This biokinetic model is not intended to apply to therapeutic use of the substance.

123
C.56.2. References for I-labelled monoclonal tumour-associated antibodies
Bischof Delaloye, A., Delaloye, B., 1995. Radiolabelled monoclonal antibodies in tumour
imaging and therapy: out of fashion? Eur. J. Nucl. Med. 22, 571–580.
Britton, K.E., Granowska, M., 1987. Radioimmunoscintigraphy in tumour identification.
Cancer Surv. 6, 247–267.
Fishman, A.J., Khaw, B.A., Strauss, H.N., 1989. Quo vadis radioimmune imaging. J. Nucl.
Med. 20, 1911–1915.
ICRP, 1987. Radiation dose to patients from radiopharmaceuticals. ICRP Publication 53.
Ann. ICRP 18(1–4).

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Table C.118. Biokinetic data for I-labelled monoclonal tumour-associated antibodies.

Organ (S) Fs T (h) a Ãs/A0 (h)

Intact antibody
Kidneys 0.03 24 0.5 0.44
96 0.5
Liver 0.50 24 0.5 7.3
96 0.5
Spleen 0.09 24 0.5 1.3
96 0.5
Red marrow 0.20 24 0.5 2.9
96 0.5
Other organs and tissues 0.18 24 0.5 2.6
96 0.5
*
Released iodine 1.0 24 0.5
96 0.5
F(ab’)2 fragments
Kidneys 0.20 12 1.0 1.8
Liver 0.30 12 1.0 2.7
Spleen 0.06 12 1.0 0.54
Red marrow 0.10 12 1.0 0.91
Other organs and tissues 0.34 12 1.0 3.1
y
Released iodine 1.0 12 1.0
F(ab’) fragments
Kidneys 0.40 6.0 1.0 2.4
Liver 0.10 6.0 1.0 0.60
Spleen 0.02 6.0 1.0 0.12
Red marrow 0.03 6.0 1.0 0.18
Other organs and tissues 0.45 6.0 1.0 2.7
z
Released iodine 1.0 6.0 1.0
*To obtain the contribution from released 123I, the cumulated activity given in the model for iodide with
blocked thyroid should be multiplied by 0.24.
y
To obtain the contribution from released 123I, the cumulated activity given in the model for iodide with
blocked thyroid should be multiplied by 0.52.
z
To obtain the contribution from released 123I, the cumulated activity given in the model for iodide with
blocked thyroid should be multiplied by 0.69.

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123
Table C.119. Absorbed doses for I-labelled monoclonal tumour-associated antibodies.

Absorbed dose per unit activity administered (mGy MBq1)

Organ Adult 15 years 10 years 5 years 1 year

Intact antibody
Adrenals 2.7E02 3.4E02 5.0E02 6.9E02 1.1E01
Bone surfaces 3.2E02 3.7E02 6.0E02 1.0E01 1.8E01
Brain 4.5E03 5.8E03 9.0E03 1.5E02 2.8E02
Breast 6.0E03 7.4E03 1.2E02 1.9E02 3.7E02
Gallbladder wall 4.0E02 4.8E02 6.7E02 1.0E01 1.9E01
Gastrointestinal tract
Stomach wall 1.5E02 1.9E02 3.2E02 5.1E02 9.2E02
Small intestine wall 1.2E02 1.5E02 2.4E02 3.9E02 6.9E02
Colon wall 1.2E02 1.4E02 2.4E02 4.0E02 6.8E02
(Upper large intestine wall 1.4E02 1.7E02 3.0E02 5.0E02 8.6E02)
(Lower large intestine wall 8.6E03 1.1E02 1.7E02 2.6E02 4.4E02)
Heart wall 1.4E02 1.8E02 2.8E02 4.2E02 7.7E02
Kidneys 5.9E02 7.2E02 1.0E01 1.5E01 2.5E01
Liver 1.5E01 1.9E01 2.9E01 4.0E01 7.3E01
Lungs 1.4E02 1.8E02 2.7E02 4.0E02 7.2E02
Muscles 8.5E03 1.1E02 1.6E02 2.4E02 4.5E02
Oesophagus 6.9E03 8.6E03 1.3E02 2.0E02 3.5E02
Ovaries 9.4E03 1.2E02 1.9E02 2.9E02 5.0E02
Pancreas 3.0E02 3.7E02 5.8E02 8.9E02 1.5E01
Red marrow 3.7E02 4.2E02 6.7E02 1.3E01 3.0E01
Skin 4.7E03 5.7E03 9.1E03 1.5E02 2.8E02
Spleen 2.0E01 2.9E01 4.4E01 6.7E01 1.2E+00
Testes 4.3E03 5.6E03 9.0E03 1.4E02 2.6E02
Thymus 6.9E03 8.6E03 1.3E02 2.0E02 3.5E02
Thyroid 5.1E03 6.5E03 1.0E02 1.7E02 3.1E02
Urinary bladder wall 2.4E02 3.1E02 4.6E02 6.3E02 8.6E02
Uterus 9.3E03 1.2E02 1.9E02 2.9E02 5.0E02
Remaining organs 9.0E03 1.1E02 1.7E02 2.6E02 4.6E02

Effective dose (mSv MBq1) 2.6E02 3.3E02 5.1E02 8.0E02 1.5E01

(continued on next page)

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Table C.119. (continued)

Absorbed dose per unit activity administered (mGy MBq1)

Organ Adult 15 years 10 years 5 years 1 year

F(ab’)2 fragments
Adrenals 2.1E02 2.7E02 4.1E02 6.1E02 1.1E01
Bone surfaces 1.9E02 2.3E02 3.6E02 5.9E02 1.1E01
Brain 5.6E03 7.0E03 1.1E02 1.9E02 3.4E02
Breast 5.6E03 7.0E03 1.1E02 1.7E02 3.3E02
Gallbladder wall 2.3E02 2.8E02 4.0E02 6.0E02 1.0E01
Gastrointestinal tract
Stomach wall 1.2E02 1.6E02 2.5E02 3.8E02 6.7E02
Small intestine wall 1.1E02 1.4E02 2.3E02 3.7E02 6.5E02
Colon wall 1.1E02 1.4E02 2.2E02 3.5E02 6.2E02
(Upper large intestine wall 1.2E02 1.5E02 2.4E02 3.9E02 6.8E02)
(Lower large intestine wall 9.8E03 1.2E02 1.9E02 3.0E02 5.4E02)
Heart wall 1.1E02 1.3E02 2.1E02 3.1E02 5.7E02
Kidneys 1.7E01 2.0E01 2.8E01 4.1E01 7.1E01
Liver 6.0E02 7.7E02 1.2E01 1.6E01 2.9E01
Lungs 1.0E02 1.3E02 2.0E02 3.0E02 5.6E02
Muscles 8.3E03 1.0E02 1.6E02 2.4E02 4.6E02
Oesophagus 7.0E03 8.9E03 1.4E02 2.1E02 3.9E02
Ovaries 1.0E02 1.3E02 2.0E02 3.2E02 5.8E02
Pancreas 2.0E02 2.5E02 3.9E02 5.9E02 1.0E01
Red marrow 1.7E02 1.9E02 3.0E02 5.2E02 1.1E01
Skin 5.0E03 6.1E03 9.7E03 1.6E02 3.0E02
Spleen 9.3E02 1.3E01 2.0E01 3.0E01 5.3E01
Testes 6.4E03 8.3E03 1.3E02 2.1E02 4.1E02
Thymus 7.0E03 8.9E03 1.4E02 2.1E02 3.9E02
Thyroid 6.4E03 8.1E03 1.3E02 2.1E02 4.0E02
Urinary bladder wall 4.7E02 6.1E02 8.9E02 1.3E01 2.4E01
Uterus 1.2E02 1.5E02 2.4E02 3.8E02 6.8E02
Remaining organs 8.8E03 1.1E02 1.7E02 2.7E02 4.8E02

Effective dose (mSv MBq1) 1.9E02 2.3E02 3.5E02 5.4E02 9.9E02

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Table C.119. (continued)

Absorbed dose per unit activity administered (mGy MBq1)

Organ Adult 15 years 10 years 5 years 1 year

F(ab’) fragments
Adrenals 1.7E02 2.3E02 3.6E02 5.5E02 9.9E02
Bone surfaces 1.4E02 1.7E02 2.7E02 4.2E02 8.3E02
Brain 5.9E03 7.4E03 1.2E02 2.0E02 3.6E02
Breast 5.2E03 6.6E03 9.8E03 1.6E02 3.0E02
Gallbladder wall 1.4E02 1.7E02 2.6E02 4.0E02 6.1E02
Gastrointestinal tract
Stomach wall 1.0E02 1.3E02 2.1E02 3.1E02 5.3E02
Small intestine wall 1.1E02 1.4E02 2.2E02 3.4E02 6.0E02
Colon wall 1.1E02 1.4E02 2.1E02 3.2E02 5.4E02
(Upper large intestine wall 1.1E02 1.4E02 2.1E02 3.3E02 5.6E02)
(Lower large intestine wall 1.0E02 1.3E02 2.0E02 3.0E02 5.2E02)
Heart wall 8.5E03 1.1E02 1.7E02 2.5E02 4.6E02
Kidneys 2.2E01 2.6E01 3.6E01 5.1E01 8.9E01
Liver 1.8E02 2.3E02 3.5E02 5.0E02 8.8E02
Lungs 7.8E03 1.0E02 1.6E02 2.4E02 4.6E02
Muscles 8.0E03 9.9E03 1.5E02 2.3E02 4.3E02
Oesophagus 6.8E03 8.7E03 1.3E02 2.1E02 3.9E02
Ovaries 1.1E02 1.3E02 2.1E02 3.2E02 5.6E02
Pancreas 1.5E02 1.8E02 2.8E02 4.3E02 7.4E02
Red marrow 8.8E03 1.0E02 1.6E02 2.4E02 4.4E02
Skin 5.0E03 6.1E03 9.7E03 1.6E02 2.9E02
Spleen 3.0E02 4.1E02 6.3E02 9.6E02 1.7E01
Testes 7.2E03 9.3E03 1.5E02 2.3E02 4.1E02
Thymus 6.8E03 8.7E03 1.3E02 2.1E02 3.9E02
Thyroid 6.7E03 8.6E03 1.4E02 2.3E02 4.2E02
Urinary bladder wall 6.1E02 7.9E02 1.1E01 1.5E01 1.9E01
Uterus 1.3E02 1.7E02 2.7E02 3.9E02 6.3E02
Remaining organs 8.1E03 1.0E02 1.6E02 2.4E02 4.3E02

Effective dose (mSv MBq1) 1.7E02 2.1E02 3.1E02 4.6E02 7.8E02

123
The physical half-life of I is 13.2 h.

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 131
C.57. I-labelled monoclonal tumour-associated antibodies
C.57.1. Biokinetic model

(C176) The models for iodine-labelled antibodies and fragments are the same as
those used for the corresponding technetium-labelled substances (see Section C.41.1),
with the modification that released iodine is assumed to be handled by the body
according to the model proposed for iodine with blocking of uptake in the thyroid
(ICRP, 1987, p. 275). The reader is referred to Bischof Delaloye and Delaloye (1995),
Britton and Granowska (1987), and Fishman et al. (1989) for further information.
This biokinetic model is not intended to apply to therapeutic use of the substance.

131
C.57.2. References for I-labelled monoclonal tumour-associated antibodies
Bischof Delaloye, A., Delaloye, B., 1995. Radiolabelled monoclonal antibodies in tumour
imaging and therapy: out of fashion? Eur. J. Nucl. Med. 22, 571–580.
Britton, K.E., Granowska, M., 1987. Radioimmunoscintigraphy in tumour identification.
Cancer Surv. 6, 247–267.
Fishman, A.J., Khaw, B.A., Strauss, H.N., 1989. Quo vadis radioimmune imaging. J. Nucl.
Med. 20, 1911–1915.
ICRP, 1987. Radiation dose to patients from radiopharmaceuticals. ICRP Publication 53.
Ann. ICRP 18(1–4).

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131
Table C.120. Biokinetic data for I-labelled monoclonal tumour-associated antibodies.

Organ (S) Fs T (h) a Ãs/A0 (h)

Intact antibody
Kidneys 0.03 24 0.5 1.9
96 0.5
Liver 0.50 24 0.5 31
96 0.5
Spleen 0.09 24 0.5 5.5
96 0.5
Red marrow 0.20 24 0.5 12
96 0.5
Other organs and tissues 0.18 24 0.5 11
96 0.5
*
Released iodine 1.0 24 0.5
96 0.5
F(ab’)2 fragments
Kidneys 0.20 12 1.0 3.3
Liver 0.30 12 1.0 4.9
Spleen 0.06 12 1.0 0.98
Red marrow 0.10 12 1.0 1.6
Other organs and tissues 0.34 12 1.0 5.5
y
Released iodine 1.0 12 1.0
F(ab’) fragments
Kidneys 0.40 6.0 1.0 3.4
Liver 0.10 6.0 1.0 0.84
Spleen 0.02 6.0 1.0 0.17
Red marrow 0.03 6.0 1.0 0.25
Other organs and tissues 0.45 6.0 1.0 3.8
z
Released iodine 1.0 6.0 1.0
*To obtain the contribution from released 131I, the cumulated activity given in the model for iodide with
blocked thyroid should be multiplied by 0.78.
y
To obtain the contribution from released 131I, the cumulated activity given in the model for iodide with
blocked thyroid should be multiplied by 0.94.
z
To obtain the contribution from released 131I, the cumulated activity given in the model for iodide with
blocked thyroid should be multiplied by 0.97.

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131
Table C.121. Absorbed doses for I-labelled monoclonal antibodies.

Absorbed dose per unit activity administered (mGy MBq1)

Organ Adult 15 years 10 years 5 years 1 year

Intact antibody
Adrenals 2.6E01 3.2E01 4.7E01 6.6E01 1.1E+00
Bone surfaces 4.5E01 4.7E01 8.1E01 1.4E+00 2.3E+00
Brain 6.2E02 7.9E02 1.3E01 2.1E01 4.1E01
Breast 8.2E02 1.0E01 1.7E01 2.7E01 5.2E01
Gallbladder wall 3.5E01 3.9E01 5.4E01 8.5E01 1.6E+00
Gastrointestinal tract
Stomach wall 1.6E01 2.0E01 3.1E01 5.0E01 9.3E01
Small intestine wall 1.3E01 1.7E01 2.7E01 4.3E01 7.5E01
Colon wall 1.3E01 1.6E01 2.6E01 4.1E01 7.3E01
(Upper large intestine wall 1.5E01 1.8E01 3.0E01 4.9E01 8.8E01)
(Lower large intestine wall 1.0E01 1.3E01 2.0E01 3.1E01 5.4E01)
Heart wall 1.5E01 1.9E01 3.0E01 4.4E01 7.9E01
Kidneys 1.0E+00 1.2E+00 1.7E+00 2.5E+00 4.4E+00
Liver 2.4E+00 3.2E+00 4.9E+00 7.3E+00 1.4E+01
Lungs 1.4E01 1.8E01 2.6E01 3.9E01 7.2E01
Muscles 9.8E02 1.2E01 1.9E01 3.0E01 5.6E01
Oesophagus 8.8E02 1.1E01 1.7E01 2.6E01 4.9E01
Ovaries 1.1E01 1.4E01 2.2E01 3.4E01 6.1E01
Pancreas 2.7E01 3.3E01 5.1E01 7.8E01 1.3E+00
Red marrow 7.4E01 8.2E01 1.4E+00 2.7E+00 6.6E+00
Skin 6.8E02 8.5E02 1.4E01 2.2E01 4.3E01
Spleen 4.0E+00 5.8E+00 9.0E+00 1.4E+01 2.6E+01
Testes 6.4E02 8.3E02 1.4E01 2.2E01 4.1E01
Thymus 8.8E02 1.1E01 1.7E01 2.6E01 4.9E01
Thyroid 7.0E02 8.9E02 1.4E01 2.3E01 4.5E01
Urinary bladder wall 5.0E01 6.4E01 9.8E01 1.3E+00 1.8E+00
Uterus 1.1E01 1.4E01 2.2E01 3.5E01 6.1E01
Remaining organs 1.1E01 1.4E01 2.2E01 3.5E01 6.2E01

Effective dose (mSv MBq1) 4.2E01 5.5E01 8.6E01 1.4E+00 2.7E+00

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Table C.121. (continued)

Absorbed dose per unit activity administered (mGy MBq1)

Organ Adult 15 years 10 years 5 years 1 year

F(ab’)2 fragments
Adrenals 9.9E02 1.2E01 1.9E01 2.9E01 5.2E01
Bone surfaces 9.9E02 1.1E01 1.8E01 3.1E01 5.4E01
Brain 4.2E02 5.3E02 8.9E02 1.5E01 2.8E01
Breast 4.4E02 5.6E02 9.1E02 1.5E01 2.9E01
Gallbladder wall 1.0E01 1.2E01 1.8E01 2.8E01 4.9E01
Gastrointestinal tract
Stomach wall 7.1E02 8.7E02 1.4E01 2.2E01 4.0E01
Small intestine wall 6.9E02 8.7E02 1.4E01 2.2E01 4.0E01
Colon wall 6.7E02 8.4E02 1.4E01 2.1E01 3.8E01
(Upper large intestine wall 7.0E02 8.7E02 1.4E01 2.2E01 4.0E01)
(Lower large intestine wall 6.4E02 7.9E02 1.3E01 2.0E01 3.5E01)
Heart wall 6.3E02 8.1E02 1.3E01 2.0E01 3.7E01
Kidneys 1.4E+00 1.7E+00 2.4E+00 3.6E+00 6.4E+00
Liver 4.0E01 5.3E01 8.2E01 1.2E+00 2.3E+00
Lungs 5.8E02 7.5E02 1.2E01 1.8E01 3.5E01
Muscles 5.4E02 6.8E02 1.1E01 1.7E01 3.3E01
Oesophagus 5.0E02 6.4E02 1.0E01 1.6E01 3.1E01
Ovaries 6.6E02 8.4E02 1.3E01 2.1E01 3.7E01
Pancreas 9.7E02 1.2E01 1.9E01 2.9E01 5.0E01
Red marrow 1.3E01 1.5E01 2.4E01 4.5E01 1.0E+00
Skin 4.2E02 5.2E02 8.6E02 1.4E01 2.7E01
Spleen 7.3E01 1.1E+00 1.6E+00 2.6E+00 4.8E+00
Testes 5.0E02 6.4E02 1.1E01 1.6E01 3.1E01
Thymus 5.0E02 6.4E02 1.0E01 1.6E01 3.1E01
Thyroid 4.7E02 6.0E02 9.7E02 1.6E01 3.1E01
Urinary bladder wall 5.6E01 7.3E01 1.1E+00 1.5E+00 1.9E+00
Uterus 7.6E02 9.5E02 1.5E01 2.3E01 4.0E01
Remaining organs 5.8E02 7.5E02 1.2E01 2.0E01 3.7E01

Effective dose (mSv MBq1) 1.4E01 1.8E01 2.8E01 4.2E01 7.6E01

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 ICRP Publication 128

Table C.121. (continued)

Absorbed dose per unit activity administered (mGy MBq1)

Organ Adult 15 years 10 years 5 years 1 year

F(ab’) fragments
Adrenals 7.1E02 9.1E02 1.4E01 2.3E01 4.1E01
Bone surfaces 5.1E02 6.2E02 9.7E02 1.5E01 3.0E01
Brain 3.7E02 4.7E02 7.9E02 1.3E01 2.5E01
Breast 3.6E02 4.6E02 7.4E02 1.2E01 2.4E01
Gallbladder wall 6.3E02 7.7E02 1.2E01 1.8E01 3.1E01
Gastrointestinal tract
Stomach wall 5.4E02 6.6E02 1.1E01 1.6E01 3.0E01
Small intestine wall 5.7E02 7.2E02 1.1E01 1.8E01 3.3E01
Colon wall 5.5E02 6.9E02 1.1E01 1.7E01 3.1E01
(Upper large intestine wall 5.5E02 6.9E02 1.1E01 1.7E01 3.1E01)
(Lower large intestine wall 5.6E02 6.9E02 1.1E01 1.7E01 3.0E01)
Heart wall 4.7E02 6.0E02 9.6E02 1.5E01 2.8E01
Kidneys 1.4E+00 1.7E+00 2.4E+00 3.6E+00 6.6E+00
Liver 8.7E02 1.1E01 1.7E01 2.6E01 4.7E01
Lungs 4.3E02 5.6E02 8.9E02 1.4E01 2.7E01
Muscles 4.5E02 5.7E02 9.1E02 1.4E01 2.8E01
Oesophagus 4.2E02 5.4E02 8.6E02 1.4E01 2.7E01
Ovaries 5.7E02 7.3E02 1.1E01 1.8E01 3.2E01
Pancreas 6.6E02 8.2E02 1.3E01 2.0E01 3.6E01
Red marrow 5.0E02 5.9E02 9.3E02 1.5E01 2.8E01
Skin 3.6E02 4.5E02 7.4E02 1.2E01 2.4E01
Spleen 1.6E01 2.2E01 3.4E01 5.3E01 9.6E01
Testes 4.5E02 5.9E02 9.6E02 1.5E01 2.8E01
Thymus 4.2E02 5.4E02 8.6E02 1.4E01 2.7E01
Thyroid 4.1E02 5.3E02 8.6E02 1.4E01 2.7E01
Urinary bladder wall 5.7E01 7.4E01 1.1E+00 1.5E+00 1.9E+00
Uterus 6.8E02 8.5E02 1.4E01 2.0E01 3.5E01
Remaining organs 4.6E02 5.8E02 9.3E02 1.5E01 2.8E01

Effective dose (mSv MBq1) 1.1E01 1.4E01 2.1E01 3.1E01 5.3E01

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The physical half-life of I is 8.04 days.

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 127
C.58. Xe gas
C.58.1. Biokinetic model

(C177) 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 that
can be regarded as combinations of the methods described.
(C178) The MIRD model (Atkins et al., 1980), which is partly based on Ackery
and Goddard (1975), Goddard and Ackery (1975), and Susskind et al. (1977), is
adopted here. The total body retention of xenon has been described as the 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 distributed
uniformly throughout the rest of the body. The rate of uptake in the rest of the body
during breath holding and rebreathing is assumed to be the same as the elimination
rate observed after discontinuing xenon administration.

127
C.58.2. References for Xe gas
Ackery, D.M., Goddard, B.A., 1975. Radiation doses from 133Xe and 127Xe used for lung
function investigations. In: Höfer, R. (Ed.), Radioaktive Isotope in Klinik und Forschung
11. Band. Urban und Schwarzenberg, Munich, pp. 31–43.
Atkins, H.L., Robertson, J.S., Croft, B.Y., et al., 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., Ackery, D.J., 1975. Xenon-133, 127Xe and 125Xe 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., Richards, P., 1977. Whole body retention
of radioxenon. J. Nucl. Med. 18, 462–471.

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127
Table C.122. Biokinetic data for Xe gas.

Organ (S) Fs T (h) a Ãs/A0 (h)

Single inhalation with 30-s breath hold or intravenous injection with 30-s breath hold
Lungs 0.98 0.0061 0.98 0.010
0.052 0.02
Remaining tissues 0.02 0.40 0.50 0.080
2.7 0.35
11 0.15
Rebreathing for 5 min
Lungs 0.86 0.0061 0.91 0.013
0.052 0.09
Remaining tissues 0.14 0.40 0.50 0.56
2.7 0.35
11 0.15
Rebreathing for 10 min
Lungs 0.77 0.0061 0.88 0.013
0.052 0.12
Remaining tissues 0.23 0.40 0.50 0.92
2.7 0.35
11 0.15

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127
Table C.123. Absorbed doses for Xe gas.

Absorbed dose per unit activity administered (mGy MBq1)

Organ Adult 15 years 10 years 5 years 1 year

Single inhalation or intravenous injection with 30-s breath hold

Adrenals 1.2E04 1.6E04 2.4E04 3.7E04 6.7E04
Bone surfaces 1.5E04 1.9E04 2.9E04 4.4E04 8.6E04
Brain 8.3E05 1.0E04 1.7E04 2.8E04 4.9E04
Breast 8.5E05 1.0E04 1.6E04 2.5E04 4.5E04
Gallbladder wall 1.2E04 1.5E04 2.4E04 3.5E04 5.1E04
Gastrointestinal tract
Stomach wall 1.1E04 1.4E04 2.2E04 3.3E04 5.7E04
Small intestine wall 1.2E04 1.4E04 2.2E04 3.4E04 6.2E04
Colon wall 1.1E04 1.4E04 2.1E04 3.3E04 5.8E04
(Upper large intestine wall 1.1E04 1.4E04 2.1E04 3.4E04 5.8E04)
(Lower large intestine wall 1.1E04 1.3E04 2.1E04 3.2E04 5.9E04)
Heart wall 1.3E04 1.7E04 2.6E04 3.9E04 6.8E04
Kidneys 1.1E04 1.3E04 2.0E04 3.1E04 5.8E04
Liver 1.2E04 1.5E04 2.3E04 3.4E04 6.1E04
Lungs 3.5E04 5.1E04 7.0E04 1.1E03 2.0E03
Muscles 9.4E05 1.2E04 1.8E04 2.7E04 5.2E04
Oesophagus 1.1E04 1.4E04 2.2E04 3.3E04 5.9E04
Ovaries 1.2E04 1.5E04 2.2E04 3.4E04 6.3E04
Pancreas 1.3E04 1.6E04 2.4E04 3.8E04 6.8E04
Red marrow 9.8E05 1.2E04 1.8E04 2.7E04 4.8E04
Skin 6.4E05 7.7E05 1.2E04 1.9E04 3.6E04
Spleen 1.1E04 1.4E04 2.2E04 3.4E04 6.2E04
Testes 8.6E05 1.1E04 1.6E04 2.5E04 4.6E04
Thymus 1.1E04 1.4E04 2.2E04 3.3E04 5.9E04
Thyroid 1.0E04 1.3E04 2.1E04 3.3E04 6.2E04
Urinary bladder wall 1.1E04 1.4E04 2.0E04 3.1E04 5.5E04
Uterus 1.2E04 1.5E04 2.3E04 3.5E04 6.2E04
Remaining organs 9.5E05 1.2E04 1.8E04 2.8E04 5.2E04

Effective dose (mSv MBq1) 1.3E04 1.8E04 2.6E04 4.0E04 7.2E04

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Table C.123. (continued)

Absorbed dose per unit activity administered (mGy MBq1)

Organ Adult 15 years 10 years 5 years 1 year

Rebreathing for 5 min

Adrenals 7.7E04 9.7E04 1.5E03 2.2E03 4.1E03
Bone surfaces 1.0E03 1.3E03 1.9E03 2.9E03 5.6E03
Brain 5.8E04 7.2E04 1.2E03 1.9E03 3.4E03
Breast 4.9E04 6.2E04 8.8E04 1.4E03 2.7E03
Gallbladder wall 8.1E04 1.0E03 1.6E03 2.4E03 3.4E03
Gastrointestinal tract
Stomach wall 7.4E04 9.3E04 1.4E03 2.2E03 3.7E03
Small intestine wall 8.1E04 1.0E03 1.5E03 2.4E03 4.3E03
Colon wall 7.8E04 9.6E04 1.5E03 2.3E03 4.0E03
(Upper large intestine wall 7.8E04 9.8E04 1.4E03 2.3E03 4.0E03)
(Lower large intestine wall 7.9E04 9.4E04 1.5E03 2.2E03 4.1E03)
Heart wall 7.5E04 9.5E04 1.5E03 2.1E03 3.9E03
Kidneys 7.1E04 8.8E04 1.3E03 2.1E03 3.8E03
Liver 7.2E04 9.1E04 1.4E03 2.1E03 3.9E03
Lungs 8.0E04 1.1E03 1.6E03 2.3E03 4.4E03
Muscles 6.2E04 7.6E04 1.2E03 1.8E03 3.4E03
Oesophagus 6.8E04 8.6E04 1.3E03 2.0E03 3.7E03
Ovaries 8.2E04 1.0E03 1.5E03 2.4E03 4.3E03
Pancreas 8.2E04 1.0E03 1.5E03 2.4E03 4.3E03
Red marrow 6.4E04 7.7E04 1.2E03 1.8E03 3.2E03
Skin 4.3E04 5.2E04 8.1E04 1.3E03 2.4E03
Spleen 7.2E04 9.1E04 1.4E03 2.1E03 3.9E03
Testes 6.0E04 7.4E04 1.1E03 1.8E03 3.2E03
Thymus 6.8E04 8.6E04 1.3E03 2.0E03 3.7E03
Thyroid 6.8E04 8.6E04 1.4E03 2.2E03 4.0E03
Urinary bladder wall 7.6E04 9.9E04 1.4E03 2.2E03 3.9E03
Uterus 8.3E04 1.0E03 1.6E03 2.4E03 4.3E03
Remaining organs 6.2E04 7.8E04 1.2E03 1.9E03 3.5E03

Effective dose (mSv MBq1) 7.1E04 9.0E04 1.3E03 2.1E03 3.7E03

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 Radiation dose to patients from radiopharmaceuticals

Table C.123. (continued)

Absorbed dose per unit activity administered (mGy MBq1)

Organ Adult 15 years 10 years 5 years 1 year

Rebreathing for 10 min

Adrenals 1.3E03 1.6E03 2.4E03 3.6E03 6.7E03
Bone surfaces 1.7E03 2.0E03 3.1E03 4.8E03 9.1E03
Brain 9.4E04 1.2E03 1.9E03 3.2E03 5.6E03
Breast 7.9E04 1.0E03 1.4E03 2.2E03 4.3E03
Gallbladder wall 1.3E03 1.7E03 2.6E03 3.9E03 5.6E03
Gastrointestinal tract
Stomach wall 1.2E03 1.5E03 2.3E03 3.6E03 6.1E03
Small intestine wall 1.3E03 1.6E03 2.5E03 3.9E03 7.0E03
Colon wall 1.3E03 1.6E03 2.4E03 3.8E03 6.6E03
(Upper large intestine wall 1.3E03 1.6E03 2.4E03 3.9E03 6.5E03)
(Lower large intestine wall 1.3E03 1.5E03 2.4E03 3.7E03 6.7E03)
Heart wall 1.2E03 1.5E03 2.3E03 3.5E03 6.3E03
Kidneys 1.2E03 1.4E03 2.2E03 3.4E03 6.3E03
Liver 1.2E03 1.5E03 2.3E03 3.4E03 6.3E03
Lungs 1.1E03 1.5E03 2.1E03 3.1E03 5.8E03
Muscles 1.0E03 1.2E03 1.9E03 2.9E03 5.6E03
Oesophagus 1.1E03 1.4E03 2.1E03 3.3E03 6.0E03
Ovaries 1.3E03 1.7E03 2.5E03 3.9E03 7.1E03
Pancreas 1.3E03 1.7E03 2.5E03 3.9E03 7.0E03
Red marrow 1.0E03 1.3E03 1.9E03 2.9E03 5.2E03
Skin 7.1E04 8.4E04 1.3E03 2.1E03 4.0E03
Spleen 1.2E03 1.5E03 2.3E03 3.4E03 6.3E03
Testes 9.9E04 1.2E03 1.8E03 2.9E03 5.3E03
Thymus 1.1E03 1.4E03 2.1E03 3.3E03 6.0E03
Thyroid 1.1E03 1.4E03 2.2E03 3.6E03 6.6E03
Urinary bladder wall 1.3E03 1.6E03 2.3E03 3.6E03 6.3E03
Uterus 1.4E03 1.7E03 2.6E03 4.0E03 7.1E03
Remaining organs 1.0E03 1.3E03 2.0E03 3.1E03 5.7E03

Effective dose (mSv MBq1) 1.1E03 1.4E03 2.1E03 3.3E03 6.0E03

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The physical half-life of Xe is 36.4 days.

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 133
C.59. Xe gas
C.59.1. Biokinetic model

(C179) 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 that
can be regarded as combinations of the methods described.
(C180) The MIRD model (Atkins et al., 1980), which is partly based on Ackery
and Goddard (1975), Goddard and Ackery (1975), and Susskind et al. (1977), is
adopted here. The total body retention of xenon has been described as the 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 distributed
uniformly throughout the rest of the body. The rate of uptake in the rest of the body
during breath holding and rebreathing is assumed to be the same as the elimination
rate observed after discontinuing xenon administration.

133
C.59.2. References for Xe gas
Ackery, D.M., Goddard, B.A., 1975. Radiation doses from 133Xe and 127Xe used for lung
function investigations. In: Höfer, R. (Ed.), Radioaktive Isotope in Klinik und Forschung
11. Band. Urban und Schwarzenberg, Munich, pp. 31–43.
Atkins, H.L., Robertson, J.S., Croft, B.Y., et al., 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., Ackery, D.J., 1975. Xenon-133, 127Xe and 125Xe 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., Richards, P., 1977. Whole body retention
of radioxenon. J. Nucl. Med. 18, 462–471.

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133
Table C.124. Biokinetic data for Xe gas.

Organ (S) Fs T (h) a Ãs/A0 (h)

Single inhalation with 30-s breath hold or intravenous injection with 30-s breath hold
Lungs 0.98 0.0061 0.98 0.010
0.052 0.02
Remaining tissues 0.02 0.40 0.50 0.076
2.7 0.35
11 0.15
Rebreathing for 5 min
Lungs 0.86 0.0061 0.91 0.013
0.052 0.09
Remaining tissues 0.14 0.40 0.50 0.53
2.7 0.35
11 0.15
Rebreathing for 10 min
Lungs 0.77 0.0061 0.88 0.013
0.052 0.12
Remaining tissues 0.23 0.40 0.50 0.88
2.7 0.35
11 0.15

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133
Table C.125. Absorbed doses for Xe gas.

Absorbed dose per unit activity administered (mGy MBq1)

Organ Adult 15 years 10 years 5 years 1 year

Single inhalation or intravenous injection with 30-s breath hold

Adrenals 1.0E04 1.3E04 2.2E04 3.7E04 7.4E04
Bone surfaces 1.3E04 1.7E04 2.8E04 4.6E04 9.2E04
Brain 9.6E05 1.2E04 2.1E04 3.5E04 7.0E04
Breast 9.5E05 1.2E04 2.0E04 3.4E04 6.8E04
Gallbladder wall 1.0E04 1.3E04 2.2E04 3.7E04 7.0E04
Gastrointestinal tract
Stomach wall 1.0E04 1.3E04 2.2E04 3.6E04 7.3E04
Small intestine wall 1.0E04 1.3E04 2.2E04 3.6E04 7.3E04
Colon wall 1.0E04 1.3E04 2.2E04 3.6E04 7.2E04
(Upper large intestine wall 1.0E04 1.3E04 2.2E04 3.6E04 7.2E04)
(Lower large intestine wall 1.0E04 1.3E04 2.2E04 3.6E04 7.2E04)
Heart wall 1.1E04 1.4E04 2.3E04 3.8E04 7.5E04
Kidneys 9.8E05 1.3E04 2.1E04 3.6E04 7.1E04
Liver 1.0E04 1.3E04 2.2E04 3.6E04 7.3E04
Lungs 8.2E04 1.3E03 1.8E03 2.8E03 5.6E03
Muscles 9.7E05 1.2E04 2.1E04 3.5E04 7.0E04
Oesophagus 1.0E04 1.3E04 2.2E04 3.6E04 7.2E04
Ovaries 1.0E04 1.3E04 2.2E04 3.6E04 7.3E04
Pancreas 1.0E04 1.3E04 2.2E04 3.7E04 7.4E04
Red marrow 9.4E05 1.2E04 2.1E04 3.4E04 6.9E04
Skin 9.0E05 1.2E04 2.0E04 3.3E04 6.6E04
Spleen 1.0E04 1.3E04 2.2E04 3.6E04 7.3E04
Testes 9.4E05 1.2E04 2.0E04 3.4E04 6.9E04
Thymus 1.0E04 1.3E04 2.2E04 3.6E04 7.2E04
Thyroid 9.9E05 1.3E04 2.2E04 3.6E04 7.2E04
Urinary bladder wall 9.9E05 1.3E04 2.2E04 3.6E04 7.3E04
Uterus 1.0E04 1.3E04 2.2E04 3.6E04 7.3E04
Remaining organs 9.7E05 1.2E04 2.1E04 3.5E04 7.0E04

Effective dose (mSv MBq1) 1.8E04 2.6E04 4.0E04 6.5E04 1.3E03

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 Radiation dose to patients from radiopharmaceuticals

Table C.125. (continued)

Absorbed dose per unit activity administered (mGy MBq1)

Organ Adult 15 years 10 years 5 years 1 year

Rebreathing for 5 min

Adrenals 7.0E04 9.0E04 1.5E03 2.5E03 5.1E03
Bone surfaces 8.8E04 1.1E03 1.9E03 3.1E03 6.3E03
Brain 6.7E04 8.7E04 1.5E03 2.5E03 4.9E03
Breast 6.4E04 8.3E04 1.4E03 2.3E03 4.7E03
Gallbladder wall 7.0E04 9.0E04 1.5E03 2.5E03 4.9E03
Gastrointestinal tract
Stomach wall 6.9E04 9.1E04 1.5E03 2.5E03 5.0E03
Small intestine wall 7.0E04 9.1E04 1.5E03 2.5E03 5.1E03
Colon wall 7.0E04 9.1E04 1.5E03 2.5E03 5.1E03
(Upper large intestine wall 7.0E04 9.1E04 1.5E03 2.5E03 5.0E03)
(Lower large intestine wall 7.0E04 9.0E04 1.5E03 2.5E03 5.1E03)
Heart wall 7.0E04 9.0E04 1.5E03 2.5E03 5.0E03
Kidneys 6.8E04 8.8E04 1.5E03 2.5E03 5.0E03
Liver 6.9E04 8.9E04 1.5E03 2.5E03 5.0E03
Lungs 1.1E03 1.7E03 2.4E03 3.8E03 7.6E03
Muscles 6.7E04 8.6E04 1.5E03 2.4E03 4.9E03
Oesophagus 6.8E04 8.8E04 1.5E03 2.5E03 4.9E03
Ovaries 7.1E04 9.1E04 1.5E03 2.5E03 5.1E03
Pancreas 7.1E04 9.1E04 1.5E03 2.5E03 5.1E03
Red marrow 6.5E04 8.4E04 1.4E03 2.4E03 4.8E03
Skin 6.3E04 8.1E04 1.4E03 2.3E03 4.6E03
Spleen 6.9E04 8.9E04 1.5E03 2.5E03 5.0E03
Testes 6.6E04 8.5E04 1.4E03 2.4E03 4.8E03
Thymus 6.8E04 8.8E04 1.5E03 2.5E03 4.9E03
Thyroid 6.9E04 8.8E04 1.5E03 2.5E03 5.0E03
Urinary bladder wall 6.9E04 9.2E04 1.5E03 2.5E03 5.1E03
Uterus 7.1E04 9.1E04 1.5E03 2.5E03 5.1E03
Remaining organs 6.7E04 8.6E04 1.5E03 2.4E03 4.9E03

Effective dose (mSv MBq1) 7.3E04 9.8E04 1.6E03 2.6E03 5.3E03

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 ICRP Publication 128

Table C.125. (continued)

Absorbed dose per unit activity administered (mGy MBq1)

Organ Adult 15 years 10 years 5 years 1 year

Rebreathing for 10 min

Adrenals 1.1E03 1.5E03 2.5E03 4.1E03 2.7E01
Bone surfaces 1.4E03 1.9E03 3.1E03 5.1E03 1.9E+00
Brain 1.1E03 1.4E03 2.4E03 4.0E03 1.0E01
Breast 1.1E03 1.4E03 2.3E03 3.8E03 1.3E01
Gallbladder wall 1.2E03 1.5E03 2.5E03 4.2E03 3.1E01
Gastrointestinal tract
Stomach wall 1.1E03 1.5E03 2.5E03 4.1E03 8.3E03
Small intestine wall 1.2E03 1.5E03 2.5E03 4.2E03 8.3E03
Colon wall 1.1E03 1.5E03 2.5E03 4.1E03 8.3E03
(Upper large intestine wall 1.1E03 1.5E03 2.5E03 4.2E03 8.3E03)
(Lower large intestine wall 1.2E03 1.5E03 2.5E03 4.1E03 8.3E03)
Heart wall 1.1E03 1.5E03 2.5E03 4.1E03 8.2E03
Kidneys 1.1E03 1.4E03 2.4E03 4.1E03 8.1E03
Liver 1.1E03 1.5E03 2.5E03 4.1E03 8.2E03
Lungs 1.2E03 1.8E03 2.6E03 4.0E03 8.0E03
Muscles 1.1E03 1.4E03 2.4E03 4.0E03 8.0E03
Oesophagus 1.1E03 1.4E03 2.4E03 4.0E03 8.1E03
Ovaries 1.2E03 1.5E03 2.5E03 4.2E03 8.4E03
Pancreas 1.2E03 1.5E03 2.5E03 4.2E03 8.3E03
Red marrow 1.1E03 1.4E03 2.3E03 3.9E03 7.8E03
Skin 1.0E03 1.3E03 2.3E03 3.8E03 7.6E03
Spleen 1.1E03 1.5E03 2.5E03 4.1E03 8.2E03
Testes 1.1E03 1.4E03 2.3E03 3.9E03 7.9E03
Thymus 1.1E03 1.4E03 2.4E03 4.0E03 8.1E03
Thyroid 1.1E03 1.4E03 2.5E03 4.1E03 8.2E03
Urinary bladder wall 1.1E03 1.5E03 2.5E03 4.1E03 2.2E01
Uterus 1.2E03 1.5E03 2.5E03 4.2E03 8.3E03
Remaining organs 1.1E03 1.4E03 2.4E03 4.0E03 8.0E03

Effective dose (mSv MBq1) 1.1E03 1.5E03 2.5E03 4.0E03 8.1E03

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The physical half-life of Xe is 5.25 days.

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 201
C.60. Tl ion
C.60.1. Biokinetic model

(C181) Intravenously injected ionic monovalent thallium leaves the blood rapidly
by uptake into the cells of all organs and tissues. The distribution is largely deter-
mined by the magnitude of the regional blood flow, 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 two- to three-fold during exercise,
with a corresponding reduction in other tissues.
(C182) The organ uptake data in the model are based on the reports by Samson
et al. (1978), Atkins et al. (1977), and Chen et al. (1983). Bartlett et al. (1984) showed
that 80% of thallium is excreted via the gastrointestinal tract and 20% by the renal
tract. The whole-body retention curve can be represented by a bi-exponential func-
tion, with half-times of 7 days for 63% of the injected activity and 28 days for 37% of
the injected activity (Chen et al., 1983). It is assumed here that all organs and tissues
have similar retention kinetics, with the exception of the heart which shows more
rapid initial clearance (Freeman et al., 1986).
(C183) The uptake of thallium ions in the testes has been studied extensively.
Direct organ measurements at autopsy in two cases (Samson et al., 1978) showed
0.11–0.12%, while Hosain and Hosain (1981) and Gupta et al. (1981) derived values
of 0.8–1.0% from gamma camera images of the testicular–scrotal region. More
recent studies, however, have indicated lower uptake (Rao et al., 1995; Nettleton
et al., 2004; Thomas et al., 2005). Thomas et al. (2005) measured testicular uptake in
28 individuals using a collimation method, so that the testes were shielded from body
background with lead during imaging. However, activity in the scrotum could still
influence the measurements. Based on data from Thomas et al. (2005) and
Krahwinkel et al. (1988), uptake in the testes of 0.3% has been adopted.

201
C.60.2. References for Tl ion
Atkins, H.L., Budinger, T.F., Lebowitz, E., et al., 1977. Thallium-201 for medical use. Part 3.
Human distribution and physical imaging properties. J. Nucl. Med. 18, 133–140.
Bartlett, R.D., Lathrop, K.A., Faulhaber, P.F., Harper, P.V., 1984. Transfer of thallous ion to
and from gastrointestinal sections. J. Nucl. Med. 25, 92.
Chen, C.T., Lathrop, K.A., Harper, P.V., et al., 1983. Quantitative measurement of long term
in vivo thallium distribution in the human. J. Nucl. Med. 24, 50.
Freeman, M.R., Kanwar, N., Armstrong, P.W., 1986. The variability of thallium half life at
rest as compared to exercise. J. Nucl. Med. 27, 997.
Gupta, S.M., Herrera, N., Spencer, R.P., et al., 1981. Testicular-scrotal content of 201Tl and
67
Ga after intravenous administration. Int. J. Nucl. Med. Biol. 8, 211–213.
Hosain, P., Hosain, F., 1981. Revision of gonadal radiation dose to man from thallium-201. In:
Proceedings of the Third International Radiopharmaceutical Dosimetry Symposium, Oak

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Ridge, TN, USA, October 7–10, 1980. (FDA 81-8166). U.S. Department of Health and
Human Services, Food and Drug Administration, Washington, DC, USA, pp. 333–345.
Krahwinkel, W., Herzog, H., Feinendegen, L.E., 1988. Pharmacokinetics of thallium-201 in
normal individuals after routine myocardial scintigraphy. J. Nucl. Med. 29, 1582–1586.
Nettleton, J.S., Lawson, R.S., Prescott, M.C., Morris, I.D., 2004. Uptake, localization, and
dosimetry of 111In and 201Tl in human testes. J. Nucl. Med. 45, 138–146.
Rao, D.V., Shepstone, B.J., Wilkins, H.B., Howell, R.W., 1995. Kinetics and dosimetry of
thallium-201 in human testes. J. Nucl. Med. 36, 607–609.
Samson, G., Wackers, F.J.Th., Becker, A.E., et al., 1978. Distribution of thallium-201 in man.
In: Oeff, K., Schmidt, H.A.E. (Eds.), Nuklearmedizin und biokybernetik. Vol. 1. Medico-
informationsdienste, Berlin, pp. 385–389.
Thomas, S.R., Stabin, M.G., Castronovo, F.P., 2005. Radiation-absorbed dose from 201Tl-
thallous chloride. J. Nucl. Med. 46, 502–508.

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201
Table C.126. Biokinetic data for Tl ion.

Organ (S) Fs T (h) a Ãs/A0 (h)

Bone 0.06 170 0.63 4.9

670 0.37
Thyroid 0.002 170 0.63 0.16
670 0.37
Heart wall 0.04 10 0.50 1.9
170 0.32
670 0.18
Lungs 0.04 170 0.63 3.3
670 0.37
Kidneys 0.06 170 0.63 4.9
670 0.37
Liver 0.09 170 0.63 7.3
670 0.37
Spleen 0.007 170 0.63 0.57
670 0.37
Red marrow 0.06 170 0.63 4.9
670 0.37
Stomach wall 0.006 170 0.63 0.49
670 0.37
Small intestine wall 0.03 170 0.63 2.4
670 0.37
Muscles 0.41 170 0.63 33
670 0.37
Ovaries 0.0003 170 0.63 0.024
670 0.37
Testes 0.003 170 0.63 0.24
670 0.37
Other organs and tissues 0.19 170 0.63 16
670 0.37
Gastrointestinal tract contents
Small intestine 0.80 0.77
Upper large intestine 0.80 2.2
Lower large intestine 0.80 3.3
Urinary bladder contents 0.20
Adult, 15 years, 10 years 0.087
5 years 0.074
1 year 0.050

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201
Table C.127. Absorbed doses for Tl ion.

Absorbed dose per unit activity administered (mGy MBq1)

Organ Adult 15 years 10 years 5 years 1 year

Adrenals 5.7E02 7.0E02 1.0E01 1.5E01 2.7E01

Bone surfaces 3.8E01 3.9E01 6.9E01 1.2E+00 1.9E+00
Brain 2.2E02 2.4E02 3.6E02 5.4E02 1.0E01
Breast 2.4E02 2.7E02 4.4E02 6.6E02 1.3E01
Gallbladder wall 6.5E02 8.1E02 1.3E01 1.9E01 3.1E01
Gastrointestinal tract
Stomach wall 1.1E01 1.5E01 2.2E01 3.5E01 7.3E01
Small intestine wall 1.4E01 1.8E01 3.1E01 5.0E01 9.4E01
Colon wall 2.5E01 3.2E01 5.5E01 9.2E01 1.8E+00
(Upper large intestine wall 1.8E01 2.3E01 3.9E01 6.4E01 1.2E+00)
(Lower large intestine wall 3.4E01 4.5E01 7.6E01 1.3E+00 2.5E+00)
Heart wall 1.9E01 2.4E01 3.8E01 6.0E01 1.1E+00
Kidneys 4.8E01 5.8E01 8.2E01 1.2E+00 2.2E+00
Liver 1.5E01 2.0E01 3.1E01 4.5E01 8.4E01
Lungs 1.1E01 1.6E01 2.3E01 3.6E01 6.9E01
Muscles 5.2E02 8.2E02 1.6E01 4.5E01 7.6E01
Oesophagus 3.6E02 4.2E02 6.0E02 9.0E02 1.6E01
Ovaries 1.2E01 1.2E01 2.9E01 4.9E01 1.1E+00
Pancreas 5.7E02 7.0E02 1.1E01 1.6E01 2.8E01
Red marrow 1.1E01 1.3E01 2.2E01 4.5E01 1.1E+00
Skin 2.1E02 2.4E02 3.8E02 5.8E02 1.1E01
Spleen 1.2E01 1.7E01 2.6E01 4.1E01 7.4E01
Testes 1.8E01 4.1E01 3.1E+00 3.6E+00 4.9E+00
Thymus 3.6E02 4.2E02 6.0E02 9.0E02 1.6E01
Thyroid 2.2E01 3.5E01 5.4E01 1.2E+00 2.3E+00
Urinary bladder wall 3.9E02 5.4E02 7.9E02 1.2E01 2.2E01
Uterus 5.0E02 6.2E02 9.9E02 1.5E01 2.7E01
Remaining organs 5.4E02 8.2E02 1.6E01 3.4E01 5.5E01

Effective dose (mSv MBq1) 1.4E01 2.0E01 5.6E01 7.9E01 1.3E+00

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The physical half-life of Tl is 3.05 days.

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 ANNEX D. RECOMMENDATIONS ON BREAST-FEEDING
INTERRUPTIONS
D.1. Introduction
(D1) As many radiopharmaceuticals are secreted in breast milk, it is safest to
assume that, unless there are data to the contrary, some radioactive compound
will be found in the breast milk when a radiopharmaceutical is administered to a
lactating female. Consideration should be given to postponing the procedure. If the
procedure is performed, the child should not be breast fed until the radiopharma-
ceutical is no longer secreted in an amount estimated to give an effective dose >1
mSv to the child. It is therefore recommended that the actions shown in Table D.1
should be taken for various radiopharmaceuticals (Ahlgren et al., 1985; Castronovo
et al., 2000; Evans et al., 1993; Johnston et al., 1996; McCauley and Mackie, 2002;
Mountford and Coakley, 1989; Rose et al., 1990; Rubow et al., 1994; Stabin and
Breitz, 2000; Tobin and Schneider, 1976).

D.2. References for Annex D

Ahlgren, L., Ivarsson, S., Johansson, L., Mattsson, S., Nosslin, B., 1985. Excretion of radio-
nuclides in human breast milk after the administration of radiopharmaceuticals. J. Nucl.
Med. 26, 1085–1090.
Castronovo, F.P. Jr, Stone, H., Ulanski, J., 2000. Radioactivity in breast milk following 111In-
octreotide. Nucl. Med. Commun. 21, 695–699.
Evans, J.L., Mountford, P.J., Herring, A.N., Richardson, M.A., 1993. Secretion of radioactiv-
ity in breast milk following administration of 99Tcm-MAG3. Nucl. Med. Commun. 14,
108–111.
Johnston, R.E., Mukherji, S.K., Perry, R.J., Stabin, M.G., 1996. Radiation dose from breast-
feeding following administration of thallium-201. J. Nucl. Med. 37, 2079–2082.
McCauley, E., Mackie, A., 2002. Breast milk activity during early lactation following maternal
99
Tcm macroaggregated albumin lung perfusion scan. Br. J. Radiol. 75, 464–466.
Mountford, P.J., Coakley, A.J., 1989. A review of the secretion of radioactivity in human
breast milk: data, quantitative analysis and recommendations. Nucl. Med. Commun. 10,
15–27.
Rose, M.R., Prescott, M.C., Herman, K.J., 1990. Excretion of iodine-123-hippuran, techne-
tium-99m-red blood cells, and technetium-99m-macroaggregated albumin into breast milk.
J. Nucl. Med. 31, 978–984.
Rubow, S., Klopper, J., Wasserman, H., Baard, B., van Niekerk, M., 1994. The excretion of
radiopharmaceuticals in human breast milk: additional data and dosimetry. Eur. J. Nucl.
Med. 21, 144–153.
Stabin, M.G., Breitz, H.B., 2000. Breast milk excretion of radiopharmaceuticals: mechanisms,
findings, and radiation dosimetry. J. Nucl. Med. 41, 863–873.
Tobin, R.E., Schneider, P.B., 1976. Uptake of 67Ga in the lactating breast and its persistence
in milk: case report. J. Nucl. Med. 17, 1055–1056.

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 ICRP Publication 128

Table D.1. Recommendations on breast-feeding interruptions after a nuclear medicine

investigation.

Radiopharmaceutical Interruption Radiopharmaceutical Interruption

14
C-labelled I-labelled
123
Triolein No I-beta-methyl-p- >3 weeksz,§
(123I)-iodophenylpen-
tadecanoic acid
123
Glycocholic acid No I-HSA (human >3 weeksz,§
serum albumin)
123
Urea No I-iodo hippurate 12 h
123
I-para-iodophenyl >3 weeksz,§
pentadecanoic acid
99m 123
Tc-labelled I-MIBG >3 weeksz,§
(metaiodo
benzylguanidine)
DISDA (diisopropyl No*,y 123
I-NaI >3 weeksz,§
iminodiacetic acid)
Dimercaptosuccinic acid (DMSA) No*,y 125
I-HSA (human >3 weeksz
serum albumin)
Diethylenetriaminepentaacetic No*,y 125
I-iodo hippurate 12 h
acid (DTPA)
Ethylenedicysteine diester (ECD) No*,y 131
I-iodo hippurate 12 h
Phosphonates (MDP) No*,y 131
I-MIBG >3 weeksz
(metaiodobenz
ylguanidine)
Gluconate No*,y 131
I-NaI >3 weeksz
Glucoheptonate No*,y Others
Hexamethylpropyleneamineoxine No*,y 11
C-labelled Noô
Sulphur colloids No*,y 13
N-labelled Noô
15
Macro-aggregated albumin 12 h O-labelled Noô
Mercaptoacetyl triglycine No*,y 18
F-fluoro-2-deoxy- No
D-glucose
2-methoxy-isobutyl-isonitrile No*,y 22
Na >3 weeksz
51
Microspheres (human albumin 12 h Cr-ethylenediami- No
microspheres, HAM) netetraacetic acid
67
Pertechnetate 12 h Ga-citrate >3 weeksz
PYP (pyrophosphate) No*,y 75
Se-labelled >3 weeksz
81m
Erythrocytes (in vivo) 12 h Kr gas No
Erythrocytes (in vitro) No*,y 111
In-octreotide No
Technegas No*,y 111
In-leukocyctes No
(continued on next page)

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 Radiation dose to patients from radiopharmaceuticals

Table D.1. (continued)

Radiopharmaceutical Interruption Radiopharmaceutical Interruption

*,y 133
Tetrofosmin No Xe No
201
Leukocytes 12 h Tl-chloride 48 h
MDP, methylene diphosphonate.
*Interruption not essential.
y
Interruption not essential for most of the 99mTc-labelled compounds, under the circumstance that no free
pertechnetate exists in the radiopharmaceutical. An interruption of 4 h during which one meal is discarded
can be advised to be on the safe side.
z
Interruption for 3 weeks (504 h) at least. However, difficult to maintain the milk supply ! cessation.
§
For all substances labelled with 123I (except iodo-hippurate), interruption for >3 weeks is recommended
due to the risk of contamination of other iodine isotopes.
ô
For 11C, 13N, and 15O-labelled substances, interruption not essential due to short physical half-life.

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