Instructions PDF
Instructions PDF
Instructions PDF
Intakes of Radioisotopes
Prepared by
R. Anigstein, R. H. Olsher, and D. A. Loomis
S. Cohen & Associates
1608 Spring Hill Road
Vienna, Virginia 2218
Under
Prepared for
Under
Phillip Green
Project Officer
Contents
Page
Preface. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . v
1.1 Introduction.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
3.2 Modules. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
3.4.1 Adults.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
References. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . R-1
ii
Tables
Page
1. Primary Set of Energy Windows for Siemens e.cam Gamma Camera.. . . . . . . . . . . . . . . . . . . 2
A-2. Inhaled Activity of Type M 60Co vs. Count Rate (Bq/kcpm). . . . . . . . . . . . . . . . . . . . . . A-2
A-3. Inhaled Activity of Type S 60Co vs. Count Rate (Bq/kcpm).. . . . . . . . . . . . . . . . . . . . . . A-4
A-4. Inhaled Activity of Type F 90Sr vs. Count Rate (Bq/kcpm). . . . . . . . . . . . . . . . . . . . . . . A-6
A-5. Inhaled Activity of Type S 90Sr vs. Count Rate (Bq/kcpm). . . . . . . . . . . . . . . . . . . . . . . A-8
A-6. Inhaled Activity of Type F 131I vs. Count Rate (Bq/kcpm). . . . . . . . . . . . . . . . . . . . . . A-10
A-7. Inhaled Activity of Type F 137Cs vs. Count Rate (Bq/kcpm). . . . . . . . . . . . . . . . . . . . . A-12
A-8. Inhaled Activity of Type F 192Ir vs. Count Rate (Bq/kcpm).. . . . . . . . . . . . . . . . . . . . . A-14
A-9. Inhaled Activity of Type M 192Ir vs. Count Rate (Bq/kcpm). . . . . . . . . . . . . . . . . . . . . A-16
A-10. Inhaled Activity of Type S 192Ir vs. Count Rate (Bq/kcpm). . . . . . . . . . . . . . . . . . . . . A-18
A-11. Inhaled Activity of Type M 241Am vs. Count Rate (Bq/kcpm).. . . . . . . . . . . . . . . . . . A-20
iii
Figures
Page
1. Pediatric Patient with Philips SKYLight. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
2. Infant–Siemens e.cam. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
3. Infant–Philips SKYLight. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
4. 1-y-old–Siemens e.cam.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
5. 1-y-old–Philips SKYLight. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
6. 5-y-old–Siemens e.cam.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
7. 5-y-old–Philips SKYLight. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
8. 10-y-old–Siemens e.cam.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
9. 10-y-old–Philips SKYLight. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
iv
PREFACE
During the past three years, S. Cohen and Associates, sponsored by the Centers for Disease
Control and Prevention, prepared a series of reports which is being expanded, revised, and
reissued under the title “Use of Radiation Detection, Measuring, and Imaging Instruments to
Assess Internal Contamination from Intakes of Radionuclides.”
Part I of the series (Anigstein et al. 2007a) described a study to evaluate radiation detection and
imaging systems commonly found in hospitals to determine their suitability for rapidly scanning
individuals for internal contamination, and to develop recommendations regarding their potential
use. That report describes the measurement of count rates from single discrete radioactive
sources of 60Co, 137Cs, 192Ir, and 241Am, using a Philips AXIS gamma camera, an Atomlab thyroid
uptake system, and a Ludlum waste monitor.
Part II (Anigstein et al. 2007b) extended the earlier investigation by using realistic
anthropomorphic phantoms to study the responses of four instruments to five radionuclides
distributed in the lungs. The experimental measurements were performed on sources in the lung
region of a Rando Phantom—an anthropomorphic phantom that contains a human skeleton
embedded in a tissue-equivalent urethane rubber. Count rates from each of five
radionuclides—60Co, 90Sr, 137Cs, 192Ir, and 241Am—were measured on a Siemens e.cam gamma
camera, an Atomlab thyroid probe, a Ludlum survey meter, and a Ludlum waste monitor. In a
preliminary analysis, the Los Alamos MCNPX (Monte Carlo N Particle eXtended) computer
code was used to calculate calibration factors that relate count rates on these instruments to lung
burdens of each of the five nuclides. A mathematical model of each of the instruments was
constructed, using engineering drawings and other data obtained from the manufacturers. This
model was combined with an MCNP model of a Rando Phantom, constructed from CT scans of
this phantom (Wang et al. 2004). The combined model was used to simulate the response of
each instrument to sources in the phantom. The agreement between the calculated and measured
responses validated the MCNP models of the four instruments.
Part III (Anigstein et al. 2007c) extended the investigations to the Philips SKYLight camera.
The study was narrowed to three of the five radionuclides reported in part II: 60Co, 137Cs, and
241
Am. This study encompassed measurements and corresponding MCNP simulations of sources
of the three nuclides located in the lung region of a Rando Phantom. In addition, measurements
and simulations were carried out of the source capsules in air. The agreement between the
calculated and measured responses validated the MCNP model of this instrument.
Part IV (Anigstein et al. 2010) extended the earlier investigations to the response of the Philips
SKYLight camera to bremsstrahlung x rays following the â decay of 90Sr and its short-lived
daughter, 90Y. These studies utilized, as a primary standard, a calibrated source of 90Sr procured
from the National Institute of Standards and Technology. Measurements and Monte Carlo
simulations of this source, which was in the form of an aqueous solution sealed in a glass
ampoule, were supplemented by further studies on the encapsulated sources described in part II
of this series of reports. The agreement between the calculated and measured responses was
adequate to justify the use of the model for simulating the response of this camera to
distributions of 90Sr/90Y in the human body.
v
Part V (Anigstein and Olsher 2010) developed calibration factors to enable the use of gamma
cameras for assessing intakes of radionuclides and the resulting doses. The study utilized
biokinetic models to determine the retention of activity taken into the body and the distribution
of such activity among different regions of the body as a function of time following exposure.
Normalized count rates from activities of six radionuclides—60Co, 90Sr, 131I, 137Cs, 192Ir, and
241
Am—in various anatomical regions of children of five ages and adult men and women are
calculated by MCNPX. Adult men and women were represented by the NORMAN and NAOMI
voxel phantoms (Dimbylow 1998, 2005), while children were represented by the revised ORNL
phantom series described by Han et al. (2006). The Siemens e.cam and Philips SKYLight
gamma cameras were represented by models developed during the studies described in parts II
and III, respectively.
The present report distills the results of the previous studies into a form that is usable by hospital
personnel. Chapter 1 provides detailed directions to the nuclear medicine technologist on using
the camera equipment to determine the intakes of the six radionuclides for which calibration
factors were developed. Chapter 2 describes the use of the computer code package Assess
(Anigstein et al. 2009), which utilizes the calculations described in part V to enable the user to
compute the intake activity and resulting doses to an exposed individual. These calculations can
be performed by the technologist, a health physicist, or a physician. Chapter 3 presents a
technical description of the Assess program. Appendices A and B contain tables of calibration
factors and dose coefficients, respectively, that allow hospital personnel to calculate intakes and
doses if the Assess code is not available. These appendices replicate appendices D and E of
part V, with some revisions of the introductory text of each appendix.
The authors gratefully acknowledge the support and assistance of a number of individuals and
organizations, without whom this work would not have been possible. Keith Eckerman of the
Oak Ridge National Laboratory provided advice and information on the use of the DCAL
software system. Peter Dimbylow of the Radiation Protection Division of the Health Protection
Agency in the United Kingdom provided access to the NORMAN and NAOMI databases and
furnished additional data and information on the use of these models. Wesley Bolch, Professor
of Radiological and Biomedical Engineering at the University of Florida, provided the MCNP
models of the revised ORNL phantom series. Julie Timins, former Attending Radiologist, Christ
Hospital, Jersey City, NJ, reviewed an earlier version of these instructions and made thoughtful
comments and recommendations.
vi
Chapter 1
1.1 Introduction
The purpose of this set of instructions is to enable the nuclear medicine technologist to use a
gamma camera to assess the activity of a known radioisotope taken in by an exposed individual
at a known time after intake. These procedures apply under the following conditions:
Procedures have been developed for the assessment of six radioisotopes: 60Co, 90Sr, 131I, 137Cs,
192
Ir, and 241Am. Procedures have been developed for two gamma camera models: the Siemens
e.cam and the Philips SKYLight (cameras similar to the SKYLight were produced by ADAC
Laboratories, now a division of Philips, and are often referred to as ADAC cameras).
Section 1.5 explains how these procedures can be adapted to other makes and models of gamma
cameras. Because of differences in control consoles and software at individual installations,
even for the same model of gamma camera, these procedures are generic in nature. Each facility
may wish to develop more detailed instructions that are consistent with the configuration of its
gamma cameras and with its normal operating procedures.
Prior to receiving any exposed individuals, clear the nuclear medicine area of all radiation
sources so as to reduce the radiation background, which could interfere with the assessments.
All patients who have been administered radiopharmaceuticals and still retain any activity in the
body should be cleared from the nuclear medicine area. Remove any radioactive materials, such
as radiopharmaceuticals or calibration or flood sources.
Obtain a survey meter and survey the area for any stray sources of radiation. A GM (Geiger-
Müller) counter is usually more sensitive in locating stray sources. Next, use a survey meter
containing an ionization chamber to check the background. If one is not available, another type
of survey meter may be used. Record the background reading—you will need this information
later.
As the first step in setting up the camera, remove the collimators and cover the detectors to
protect them from contamination. You can use plastic sheeting, plastic bags, blue plastic chucks,
or any thin, lightweight materials. Next, set up energy windows specific to the camera and to the
radioisotope. Set the same energy windows on both detectors.
Energy Windows
Siemens e.cam
Use six energy windows with the Siemens camera for the most accurate results in counting 60Co,
90
Sr, 131I, 137Cs, or 192Ir. Group all six windows together in a single frame. Use two energy
windows for counting 241Am. These windows are listed in table 1.
Table 1. Primary Set of Energy Windows for Siemens e.cam Gamma Camera
Isotope: Co-60, Cs-137 Sr-90/Y-90, I-131, Ir-192 Am-241
W indow No. Peak (keV) Width (%) Peak (keV) W idth (%) Peak (keV) W idth (%)
1 41 50 35 50 35 50
2 69 50 59 50 59 50
3 116 50 99 50
4 194 50 166 50
5 324 50 277 50
6 541 50 462 50
If setting six windows is too cumbersome, or if the camera does not accept these windows, use
an alternate set of three windows for counting 60Co, 90Sr, 131I, 137Cs, or 192Ir. Group these
windows in a single frame. These alternate windows are listed in table 2.
Table 2. Alternate Set of Energy Windows for Siemens e.cam Gamma Camera
Isotope: Co-60 Sr-90/Y-90 I-131 Cs-137 Ir-192
Peak Width Peak W idth Peak W idth Peak W idth Peak W idth
W indow
(keV) (%) (keV) (%) (keV) (%) (keV) (%) (keV) (%)
1 101.3 50 46.3 50 109.9 50 97.3 50 96.0 50
2 168.9 50 77.2 50 183.3 50 162.3 50 160.1 50
3 281.6 50 128.7 50 305.6 50 270.6 50 266.9 50
Philips SKYLight
Use a set of two energy windows on the Philips camera to count 60Co, 90Sr, 131I, 137Cs, or 192Ir.
Set a single energy window to count 241Am. These windows are listed in table 3.
Counting Background
After setting the energy windows appropriate to the radioisotope that is the likely contaminant,
perform a static 2-minute acquisition and record the background count in each detector. Count
for 10 minutes if the likely contaminant is 90Sr or 241Am. You can enter “background” as the
patient name. If the background counts are unusually high, or if the background of one detector
is very different from the other, check for any stray sources of radiation in the area. Designate
the detector that will face the front of the patient as “anterior,” the other as “posterior.” Enter the
background counts and the energy window in the patient record.
Repeat the background counts after each patient if the patient count rate is more than twice the
previous background. Check for radiation sources, including exposed patients in the vicinity of
the camera room, if the background in either detector has increased significantly.
Prior to the patient being referred to the nuclear medicine department, he or she should undergo
a thorough external decontamination by the emergency responders, by the hospital’s health
physics personnel, or by nuclear medicine personnel. This may require a complete change of
clothing, showering or other forms of decontamination of the entire body, including the hair. Do
not allow any exposed individuals into the nuclear medicine area unless they are free of external
radioactive contamination.
Admit only one patient at a time to the area near the gamma camera. Have other patients wait
well away from the camera room.
Before using the gamma camera to measure internal radioactivity, check if the activity level of
the patient could be high enough to cause significant count rate losses in the camera.1 To do this,
hold a survey meter 1 meter away from the front of the patient at the waist level. Record the
exposure rate read from the meter and subtract the background that you previously recorded for
this instrument. Note this net exposure rate in the patient record.
If the exposure rate minus the background exceeds the value in table 4 for the given isotope, note
that fact in the patient record and inform the appropriate medical or health physics personnel that
the activity in the patient may be higher than the value calculated from the count rates on the
gamma camera. Proceed to count the patient using the gamma camera unless you are otherwise
instructed.
1
Some cameras will lose a significant fraction of the counts if the count rate, including background, is above 100
kcps.
Table 4
Exposure rate
Isotope
(ìR/h above bkg)
Co-60 35
Cs-137 12
Others 5
Note: These exposure rates correspond to count rates on gamma cameras of approximately 100 kcps under
some typical exposure conditions and geometries, which could result in significant count-rate losses.
The calibration factors for each isotope for the Siemens and Philips gamma cameras were
calculated from computer simulations in which lifelike representations of pediatric patients of
several ages and adults of both sexes were placed in positions similar to those used clinically for
lung or whole-body scans. It is therefore important to place the patient in the same position as
was used in the computer simulation; otherwise, the calibration factors will not produce a good
estimate of the activity taken in by the patient.
If a child is old enough to stand up and follow directions, have her stand between the two camera
heads, as shown in figure 1.2 Place younger children on the scanner bed and restrain them as
necessary. Unlike the acquisition of an image using collimators, when any movement of the
patient would result in a blurred image, slight
movements (of a fraction of an inch) will not
affect the accuracy of the counts.
2
All figures in this chapter are reproduced from Anigstein and Olsher 2010.
Figure 12. Adult Male–Siemens e.cam Figure 13. Adult Male–Philips SKYLight
Figure 14. Adult Female–Siemens e.cam Figure 15. Adult Female–Philips SKYLight
vertical position). For the Philips camera, set the two detectors at different heights for all but the
smallest pediatric patients to afford a better view of the internal organs.
The heights of the children represented by stylized diagrams shown in figures 2 to 11 are based
on average sizes of children of the indicated age, which are listed in table 5. The actual size will,
of course, vary from one child to another. Find the age of the reference individual in table 5 that
is nearest in height to the actual patient and use the diagram and the following description of the
position corresponding to that age to position the patient, rather than basing the position on the
actual age of the patient.
Position an infant so that the entire body is centered on the field of view (FOV) of each camera.
Position a one-year-old with the top of the head at the top of the FOV, which encompasses all
but the lower legs. (With the collimator removed, counts are registered from regions of the body
outside the normal field of view, but with reduced efficiencies.) Position a 5-year-old with the
lower pelvis at the bottom edge of the FOV. When counting a 10-year-old with a Siemens
camera, center the detectors on the region extending from the nose to the base of the trunk. (A
significant fraction of inhaled activity is contained in the anterior nasal cavity during the first day
following exposure.) Position the two heads of the Philips SKYLight such that the nasal cavity
of the 10-year-old is included in the FOV of the anterior detector, while all the major organs in
the trunk are within the FOV of the posterior detector. The positions of the 15-year-old and the
adults are typical of adults undergoing lung scans.
The nose of the adult male in figures 12 and 13 is touching the camera. This is due to the
rigidity of the figure in the computer model: the real patient would tilt his head back. In the
sagittal sections of the adult female shown in figures 14 and 15, the buttocks appear flattened
due to the supine position of the subject during the MRI scan. In addition, the breasts do not
appear in this medial view. The spacing of the camera heads shown in these figures maintains a
5-cm distance from the natural contours of the body of a patient standing erect. Because the
median plane lies between the lower legs of both individuals, only the upper portions of the legs
are shown in figures 12 to 15.
Since the collimators are removed, it may be necessary to set the collision override to enable you
to move the camera heads and use the camera system to perform acquisitions. In all cases, keep
a distance of 5 cm (about 2 inches) between the camera and the nearest portion of the body.
For longer acquisition times, or if the patient is not comfortable standing, a stool may be used by
adults or taller children, provided the position of the trunk is approximately the same as shown in
the appropriate diagram. Alternatively, the patient, especially a young child, can lie on the
imaging table. Since the calibration factors are based on a 5-cm space between the patient and
the aluminum window, it may be necessary to position the lower detector as close as possible to
the bottom of the table. Estimate and record the distance between the front of the aluminum
window and the lowermost part of the body.
All patients should face in the same direction, so that the “anterior” and “posterior” background
counts recorded previously always correspond to the anterior and posterior patient counts.
Enter the name of the patient to begin an acquisition. If the patient has not been assigned a
patient number, assign numbers sequentially to successive patients. Weigh or estimate the
weight of children who are less than 15 years old—this information is needed for calculating the
intake. You can record the weight in either pounds or kilograms.
Counts should be acquired for one minute. Count for 10 minutes if the likely isotope is 90Sr or
241
Am. Record the counts from each detector without subtracting the background. Specify the
detector facing the front of the patient as “anterior,” the one behind the patient as “posterior.”
The preferred units are cpm, kcpm, total counts, or total kcounts—use whichever is most
convenient. For total counts or total kcounts, you must also enter the counting time in minutes.
The procedures to be followed by the nuclear medicine technologist are illustrated by the
following example.
You are operating a Philips SKYLight gamma camera. You were alerted to expect patients that
have been exposed to airborne dust contaminated with 241Am. You send all ambulatory patients
who have been administered radioisotopes out of the nuclear medicine area and arrange for the
transportation of nonambulatory cases. You remove all radiopharmaceuticals, check sources,
flood sources, and other radioactive materials to a shielded area away from the gamma camera.
You obtain a GM counter and observe the reading while you walk around the room—the reading
is steady, indicating that there are no stray sources left in the area. You obtain a survey meter
and read and record a background exposure rate of 5 ìR/h.
You remove both collimators from the camera and cover the detectors with plastic sheeting.
You then set an energy window with a peak of 51.3 keV and a width of 83%. You perform a
static acquisition for a preset time of 10 minutes. When the acquisition stops, you note that
10
98.9 kcounts were acquired in detector 1 and 72.2 kcounts in detector 2. You record this
information in an appropriate log book.
You now receive the patient: a 12-year-old male who is 160 cm (63 in) tall and weighs 50 kg
(110 lb). You enter this information in the patient record. You hold the survey meter at a
distance of 1 meter (~3 ft) away from the patient at waist level. The meter reads 5–6 ìR/h,
which is less than 1 ìR/h above background. You note this in the patient record. Since the
reading is less than 5 ìR/h above background, the threshold exposure rate from isotopes other
than 60Co and 137Cs listed in table 4, the count rate on the gamma camera will not be high enough
to result in significant count-rate losses.
You check table 5 and see that the patient’s height is closest to the height of the reference
15-year-old. You position him between the two heads of the camera, facing detector 1. You
position the camera heads as shown in figure 11, which illustrates the 15-year-old with the
Philips SKYLight. You perform a 10-minute static acquisition and note that 122 kcounts were
acquired in detector 1 and 80.3 kcounts in detector 2. You record these counts in the patient
record, together with the most recent background counts which were listed in the log book.
Chapter 2 describes the use of the Assess computer code (Anigstein et al. 2009) to compute the
intake activity and resulting doses to an exposed individual from the counts measured with the
gamma camera. Assess has the advantage of allowing the use of energy windows other than
those described in tables 1 to 3, as well as taking into account the weight as well as the age of
children under the age of 15. If the assessment will be performed with Assess, you can skip the
rest of section 1.4.
If the Assess code is not available, you can calculate intakes and doses using the tables in
appendices A and B, as described in the following sections.
Calculate the count rate in kcpm (thousands of counts per minute) separately for each detector by
dividing the total counts by the acquisition time in minutes. Some systems display the total as
kcounts. If the total is displayed as actual counts, divide by 1,000. Next, calculate the
background count rate for each detector, and subtract the background from the calculated count
rate for that detector. The two detectors will usually have different count rates.
Tables A-2 to A-17 list calibration factors for assessing activities inhaled or ingested by exposed
individuals at selected times after intake. These factors relate the count rate measured by a given
camera to the intake of a given radioisotope.
If the intake is by inhalation, you may need to know the lung absorption type of the isotope,
which depends on its chemical form. The lung absorption types of elements corresponding to
11
the isotopes for which calibration factors were calculated are listed in table 6. If the chemical
form is not known, use the lung absorption type corresponding to unspecified compounds.
I F All compounds
Cs F All compounds
F Unspecified compounds
Ir M Metallic iridium, halides, and nitrates
S Oxides and hydroxides
Am M All compounds
Source: ICRP 1994b, annexe F
When assessing a child, use the calibration factors for a reference individual nearest in weight to
that of the patient. The weights of reference individuals are listed in table 5. For an adult, use
the calibration factors appropriate to the sex of the patient. Next, find the time post intake
closest to the time elapsed between the peak exposure and the time the counts were taken. Then
find the calibration factor in the column corresponding to the gamma camera and the set of
energy windows used in measuring the count rate. Linear interpolation may be used to
determine a calibration factor for a time between two consecutive time steps, especially if there
is a large difference between the calibration factors for the two time steps.
Multiply the count rate in kcpm by the appropriate calibration factor to determine the inhaled
activity in becquerels (Bq). Divide by 37,000 to obtain a value in microcuries (ìCi). Perform
separate calculations for the count rates from the detectors in the anterior and posterior positions
and take the average of the two results. However, if the patient was counted on the imaging
table, and if the count rate from the posterior detector (the one beneath the table) yields a lower
intake than the one from the anterior detector, use the higher value of the estimated intake.
The calculation of the estimated intake, which should be performed by a health physicist, a
physician, a technologist, or another qualified health care professional, is illustrated by the
following example. The patient is the same one described in section 1.3.4.
Since both the background counts and the patient counts were acquired for 10 minutes, you
subtract the total background counts from the patient counts in each detector to get the net
counts. Since the anterior patient counts in this example are shown to the nearest kcounts, you
round off the background counts.
12
Since the counting time was 10 minutes, you divide each value by 10:
You enter this information in the patient record, along with the time and date of the acquisition.
In the present example, the exposure to radioactive dust occurred at 2 p.m., while the counts
were recorded at approximately 5 p.m., 3 hours later. The patient weighs 50 kg. According to
table 5, this is nearest to the weight of a 15-year-old. Therefore, you use the calibration factors
for a 15-year-old, even though the patient is 12 years old. Since the isotope is presumed to be
241
Am, you look in table A-11 under “15-y-old” and calculate calibration factors for 3 hours post
exposure by interpolating between the 2-h and 4-h factors for the Philips SKYLight, the camera
used to measure the count rates. You obtain the following values:
Anterior factor =
Posterior factor =
You calculate the intake separately for the anterior and posterior counts:
Taking the average of the two values, you report the estimated intake as 1,872 Bq (0.051 ìCi).
Note that this is the total inhaled activity, and includes a fraction that was promptly expelled.
The total inhaled activity is the relevant quantity for estimating doses to the patient.
Tables B-1 to B-6 list coefficients that you can use to calculate the cumulative effective dose,
which is the integrated effective dose from the time of intake until the time of the assessment, as
well as the lifetime effective dose commitment to the exposed individual, absent any medical
intervention. To calculate either dose, look up the appropriate dose coefficient and multiply it by
the inhaled or ingested activity calculated above.
The calculation of the estimated doses, which should be performed by a health physicist, a
physician, a technologist, or another qualified health care professional, is illustrated by the
following example. The patient is the same one described in section 1.3.4.
13
The dose assessment is performed soon after the patient was counted, so the time post intake is
still approximately 3 hours. Since the isotope is presumed to be 241Am, you look in table B-6
under inhalation in the column headed “15 y” and calculate the cumulative effective dose
coefficient at 3 hours post intake by interpolating between the 2-h and 4-h coefficients.
The cumulative effective dose to the present time is estimated by multiplying this coefficient by
the inhaled activity:
1,872 Bq × 3 × 10-8 Sv/Bq = 5.6 × 10-5 Sv (5.6 mrem)
To calculate the lifetime dose effective dose commitment without any medical intervention, find
the coefficient for the lifetime committed dose for inhalation for age 15 y in table B-6 and
multiply the inhaled activity by this coefficient:
These doses can be used in estimating the efficacy of possible medical intervention.
These instructions may be applicable to some other models of gamma cameras, provided they
meet the following criteria:
• The detectors are equipped with 3-inch (0.95 cm) NaI(Tl) crystals. This is the most
common thickness; however, some models have crystals up to 1-inch thick. The
calibration factors for thicker crystals would be significantly different from the ones
utilized in these assessments.
Set the energy windows according to the settings in tables 1 to 3, or other settings that result in
similar energy ranges. Avoid overlapping windows, which will not be accepted by some camera
models.
14
Chapter 2
The intakes and subsequent doses can be calculated by use of the Assess computer code. This
program uses the count rates measured on a gamma camera, along with information about the
camera, the patient, the time of exposure, and the radioactive material. The remainder of this
chapter contains instructions for using the program—a modified version of these instructions can
be accessed while executing the program. A technical overview of the program is presented in
chapter 3.
Assess includes three screens for user input and output. The first screen is displayed when the
program opens—you can return to it by pressing the Patient tab in the upper left-hand corner of
each screen. The other two screens are marked Camera and Energy Windows. The use of these
screens is discussed below. The fourth screen, marked Quick Reference, displays a modified
version of the quick-reference guide presented in this section.
On some computer display monitors, the first screen may overflow the size of the display. Scroll
bars are provided on the right and bottom sides of the screen to enable you to see the rest of the
screen. The screen prompts are underlined in the directions that follow. All entries are required
unless stated otherwise.
1. Patient: This screen is used to enter information about the patient and the incident leading to
his or her exposure. The results of the assessment are also displayed on this screen. The
screen consists of five panels. The panels are discussed in counterclockwise order, starting
with the upper left-hand corner.
a. First Panel (upper left-hand side of screen)
i. Last name
ii. First name (optional)
iii. Age of patient
(1) Actual age must be entered for all patients younger than 25
(2) For older patients, select “25 or older"
(3) For infants under 1 year, enter age in months
iv. Sex of patient (required for patients over 15 years old)
v. Weight of patient: Specify weight if patient is less than 15 years old. This entry is
optional; however, entering the weight enables a more accurate assessment since body
size affects the count rate from a given intake.
b. Second Panel (lower left-hand side of screen)
i. Date counts were measured and Time counts were measured: The correct date and time
are important, since the counts will change with time.
15
16
17
view that most closely resembles the actual position used for counting the patient. If
unsure, select diagram 1, which is usually appropriate for the selected camera.
3. Energy Windows: This screen is used to select the set of energy windows used in the
assessment and to enter new window parameters or to modify existing settings.
a. Energy window
i. Primary: You will see a set of primary energy windows that are recommended for
counting the specific isotope with the camera selected in the Camera screen. If the
camera is specified as Other, the heading will nevertheless read “Siemens e.cam gamma
camera” and the Siemens e.cam primary and alternate energy windows will appear but
will be dimmed. You can select either set by pressing the corresponding button—these
windows will then be used in the assessment.
ii. Alternate: For the Siemens e.cam and any isotope except 241Am, you will see an alternate
set of windows with fewer channels. The primary set produces the greatest sensitivity;
the alternate set involves fewer channels and may be quicker to set up, but makes the
camera somewhat less sensitive. There are no alternate sets of windows for the Philips
SKYLight.
iii. Custom: There are initially no values under Custom. You can create a custom set of
energy windows using the procedure described under Edit Windows, below.
b. Edit Windows: You can edit any set of windows by selecting that set and pressing Edit
Windows. The background in the boxes will change color and you will be able to enter or
edit the values. When adding new windows, you must first enter a nonzero value for the
width before entering the peak energy for each channel. To exit the Edit Windows
dialogue, press Save Changes or Restore Defaults.
There are several cautions that should be observed in interpreting the results calculated with this
program.
If the gross count rate (patient counts without background subtraction) exceeds 100 kcps
(6 million cpm), the camera may begin to lose counts. If the net exposure rate measured on a
survey meter at a distance of 1 m from the patient is more than 5 times the rate listed in table 4,
the gamma camera may become saturated, in which case the count rate will not provide a reliable
assessment of this patient. To determine if the system is saturated, count the patient in the
normal position, then move one of the detectors away from the patient in a stepwise manner and
observe the count rate in that detector. If the count rate increases as the detector is moved away,
the camera is saturated and cannot be used to assess that patient. The calibration factors used by
the program do not apply to patient positions other than those described in chapter 1.
18
The Assess code utilizes calibration factors that are based on computer simulations of the
response of gamma cameras to radioisotopes distributed in various regions of the human body.
These calculations are based on anatomical models of the human body and biokinetic models
that describe how radionuclides are distributed in the body at various times after intake
(Anigstein and Olsher 2010). These models were developed to determine radiation protection
standards for the general population; they do not necessarily reflect the anatomy or physiology of
any given individual.
19
Chapter 3
TECHNICAL DESCRIPTION OF ASSESS PROGRAM
This chapter presents a technical overview of the Assess program. It is not a complete
description of the code, nor is intended to be a programer’s guide.
Assess can be installed on a computer operating under Microsoft Windows by running the
program setup.exe, which is part of the package. Minimum system requirements are Windows
XP and approximately 30 MB of free disk space. Assess can be installed to the default folder,
\Program Files, or in another folder specified by the user. A folder named "Assess" will be
created in the specified location and all files will be installed in that folder or in subfolders
created during the installation. A button named "Disk Cost...", which appears during setup, can
be used to check available disk space on your computer. During the installation, Setup will ask
if the program should be available to anyone using this computer or just yourself. On computers
that are part of a network, the "Everyone" option can only be used by system administrators—all
other users should select "Just me," which is the default.
3.2 Modules
The Assess code comprises two modules. One is the driver program, compiled with Microsoft
Visual Basic 2005, that provides the user interface described in chapter 2. The other is the
analytical program, which is written in Fortran 90 and compiled with the Lahey Fortran 90
compiler.
The Assess folder (directory) structure, with a summary description of the files in each
subfolder, is listed below. The symbol \ precedes the main folder and each subfolder. The levels
of the subfolders are indicated by successive indentations. Names of individual files are listed in
italics.
\Assess: Executable images and lf90.eer—required for running programs compiled with
Lahey Fortran 90
\Activity: Activity distribution files accessed by analytical program
\Calib: Files of camera-specific calibration factors accessed by analytical program
\Dat: Other permanent data files and QuickReference.rtf, similar to section 2.1
\Dose: Dose coefficients accessed by analytical program
\Patient: Case files on each individual patient saved by driver program
3
Similar installation notes are found in a file named “Readme.txt” which is part of the Assess installation package.
20
3.4.1 Adults
The element-specific systemic biokinetic models incorporated in the DCAL System (ORNL
2006) define the onset of adulthood as age 20 for most elements, but age 25 for some bone-
seeking elements, including strontium and americium (Eckerman et al. 2006). Individuals of age
25 and older are therefore defined as adults for assessing intakes of 90Sr and 241Am, while
assessments of the other four nuclides in the present study define the age of adults as 20 or older.
If the counts from an adult were collected using one of the sets of energy windows listed in
tables 1 to 3, the assessment is relatively straightforward. The assessment uses calibration
factors for adult males and females that are contained in data files in the subfolder \Calib. These
factors correspond to those listed in appendix A; however, the factors in the data files are
tabulated for 50 time steps, spaced logarithmically over the interval 1 h–30 d, rather than the 12
steps in appendix A. Furthermore, they are the inverses of the factors in appendix A and are
tabulated in units of cps/Bq.
First, the calibration factors for the detectors with anterior and posterior views of the patient are
calculated by linear interpolation between the time steps that span the elapsed time between the
intake of the radioactive material and the counting of the patient with the gamma camera. The
net count rates (patient counts minus background) from these detectors, converted to cps, are
divided by the respective calibration factors. The estimated intake reported by the program is the
average of the intakes calculated from the count rates on the two detectors.
Next, the dose that has been already delivered to the patient from the time of intake until the time
the Assess program is executed is calculated by use of dose coefficients listed in data files in the
21
subfolder \Dose.4 These coefficients, a subset of which is listed in appendix B, are tabulated for
the same 50 time steps as the calibration factors discussed above. A coefficient corresponding to
the elapsed time is calculated by linear interpolation of the tabulated values and is multiplied by
the calculated intake to yield the cumulative effective dose. The committed effective dose
resulting from the intake is calculated by multiplying the intake by the coefficient for the lifetime
effective dose, which is also listed in appendix B. This is the dose that will be delivered during
50 years following intake, absent any medical intervention.
If a set of energy windows other than one of those listed in tables 1 to 3 is used, new calibration
factors are calculated that are specific to the individual case. The normalized count rate from
each anatomical region that is a source region in the biokinetic model of the given nuclide for the
pathway in question (inhalation or ingestion) is calculated by summing the normalized counts in
the spectra of count rates from that nuclide in each 1-keV energy bin that is within a given
window.5 The spectra from regions of adult females are tabulated in data files in the subfolder
\Spectra\Naomi, while those from males are in \Spectra\Norman. If one of the window limits
falls between the limits of a 1-keV bin (i.e., if the window limit, expressed in keV, is not an
integer), the counts in that bin are apportioned according to the fraction of the bin that lies inside
the window. Next, the normalized count rates from each region registered by the detectors with
anterior and posterior views of the patient are multiplied by the fractional activity in that region
at the time of the counting. These fractional activities, a subset of which is listed by Anigstein
and Olsher (2010, appendix A), are tabulated in data files in the \Activity subfolder, using the
same 50 time steps as the calibration factors discussed previously. Linear interpolation is used to
calculate the fractional activity at the precise time following intake. Finally, these products of
fractional activity and normalized count rate from each region are summed to produce calibration
factors for the anterior and posterior views. The remainder of the assessment is performed in the
same manner as described previously.
4
It is assumed that the computer has a clock and that the date and time are set correctly. Note that the time of the
execution of the program will, in general, occur later than the gamma camera counting.
5
The source regions comprise all anatomical regions which, in the aggregate, contain at least 99% of the activity of
the nuclide during the time span addressed in the present study. These regions, and the normalized count rates on
cameras using the sets of energy windows listed in tables 1 to 3 in the present report, are listed by Anigstein and Olsher
(2010, appendix C). Regions that do not contain significant fractions of the intake activity are omitted from the
compressed model constructed for the present studies. A detailed discussion of the biokinetic models as they are applied
in these assessments is presented by Anigstein and Olsher (2010, sections 2 and 3).
22
The committed effective dose to children (age 15 or younger) is defined as the dose delivered
from time of intake to age 70.
The spectra of count rates from anatomical regions of children 15 years old and younger were
calculated using anatomical models based on reference individuals whose heights and weights
are listed in table 5. However, the response of the gamma camera to activity in a given region is
more likely to correlate to the weight of the patient rather than to his or her age. Therefore,
unless the weight exactly corresponds to the weight of the reference individual of that age, as
interpolated from table 5, Assess calculates calibration factors specific to the weight and age of
the patient. This is done by first calculating the normalized count rates from regions of reference
individuals whose weights span the weight of the patient, using the tabulated spectra and the
energy windows used for counting the patient, as described in section 3.4.1, and interpolating
between them, based on the patient’s weight. The time-dependent fractional activity in each
region of reference individuals whose ages span the age of the patient is calculated as discussed
previously. An age-specific fractional activity is then calculated by interpolating between these
sets of fractional activities. (Age, rather than weight, is used for consistency with the age-
dependent biokinetic models.) The weight-adjusted count rates from each region are then
multiplied by the age-specific activity fractions to yield calibration factors for the individual
patient.
23
Appendix A
CALIBRATION FACTORS FOR CONVERTING COUNT RATES TO INTAKES6
Tables A-2 to A-17 list an alternate set of calibration factors that was calculated to provide a
simple method of estimating intakes without using the Assess computer code, as described in
section 1.4.2. Factors that relate the count rate measured by a gamma camera to the inhaled
activity of a given radionuclide with a given lung absorption type are listed in tables A-2 to
A-11. Corresponding factors for assessing ingested activities are listed in tables A-12 to A-17.
Calibration factors for assessing all nuclides except 241Am with the Siemens e.cam camera were
calculated for two sets of energy windows: one set consisted of six 50% windows, while the
second, narrower set consisted of three such windows. These windows are specified in tables 1
and 2. The calibration factors for these five nuclides using the first set of windows with the
Siemens camera are listed in tables A-2 to A-10 and A-12 to A-16 under the column heading
“6 Windows,” while those using the second set are under the heading “3 Windows.” Calibration
factors for assessing intakes of 241Am with the Siemens camera, listed in tables A-11 and A-17,
are based on a single set of two 50% windows. Calibration factors for the Philips SKYLight
camera are based on a single set of energy windows for each radionuclide, specified in table 3.
Separate calibration factors were calculated for the detectors in a two-headed camera system:
one with an anterior view of the phantom, the other with a posterior view. They are specific to
the default f1 values supplied with the DCAL System (ORNL 2006), which are listed in table A-1
and, for the inhalation pathway, to a particle size distribution with a 1 ìm AMAD.
6
This appendix is taken from Anigstein and Olsher 2010, appendix D, with some revisions of the introductory text.
A-1
Table A-2. Inhaled Activity of Type M 60Co vs. Count Rate (Bq/kcpm)
Camera
Time post intake Siemens e.cam
Philips SKYLight
6 Windows 3 Windows
d h Anterior Posterior Anterior Posterior Anterior Posterior
Infant
0.042 1 169 211 239 295 238 291
0.083 2 172 209 244 292 243 289
0.167 4 179 213 253 298 252 294
0.333 8 192 225 272 316 271 311
0.5 12 209 239 295 336 293 331
1 24 273 297 385 417 384 411
2 48 461 465 648 653 645 642
4 96 829 768 1,165 1,085 1,160 1,063
8 192 1,045 943 1,468 1,334 1,461 1,305
10 240 1,092 985 1,534 1,393 1,526 1,363
20 480 1,288 1,160 1,809 1,641 1,800 1,605
30 720 1,456 1,311 2,045 1,855 2,035 1,814
1-y-old
0.042 1 169 223 236 308 215 277
0.083 2 174 221 243 305 222 276
0.167 4 182 226 253 311 231 281
0.333 8 196 239 272 330 249 298
0.5 12 213 254 296 350 270 317
1 24 282 314 392 434 358 393
2 48 486 491 673 679 616 612
4 96 892 809 1,236 1,123 1,126 1,003
8 192 1,115 977 1,544 1,358 1,403 1,208
10 240 1,157 1,014 1,603 1,409 1,457 1,253
20 480 1,340 1,172 1,856 1,630 1,686 1,449
30 720 1,506 1,318 2,086 1,833 1,895 1,629
5-y-old
0.042 1 196 296 272 405 246 354
0.083 2 203 294 282 402 256 352
0.167 4 211 300 293 411 268 359
0.333 8 227 317 314 434 288 379
0.5 12 246 337 341 461 314 403
1 24 323 413 447 566 414 493
2 48 534 619 737 848 681 737
4 96 904 944 1,248 1,297 1,132 1,124
8 192 1,093 1,109 1,507 1,525 1,357 1,320
10 240 1,132 1,148 1,561 1,578 1,405 1,366
20 480 1,304 1,323 1,799 1,819 1,619 1,574
30 720 1,466 1,487 2,022 2,045 1,820 1,770
10-y-old
0.042 1 226 306 313 421 254 358
0.083 2 234 304 324 417 268 356
0.167 4 243 310 337 426 283 365
0.333 8 259 329 359 452 305 388
0.5 12 280 350 388 481 334 413
1 24 365 431 504 593 444 511
2 48 598 651 824 895 723 766
4 96 1,006 1,005 1,383 1,381 1,157 1,162
8 192 1,213 1,183 1,668 1,627 1,368 1,361
10 240 1,257 1,225 1,727 1,684 1,416 1,408
20 480 1,449 1,412 1,992 1,941 1,631 1,623
30 720 1,631 1,589 2,242 2,184 1,836 1,826
A-2
A-3
Table A-3. Inhaled Activity of Type S 60Co vs. Count Rate (Bq/kcpm)
Camera
Time post intake Siemens e.cam
Philips SKYLight
6 Windows 3 Windows
d h Anterior Posterior Anterior Posterior Anterior Posterior
Infant
0.042 1 168 210 238 294 237 291
0.083 2 171 207 242 290 241 287
0.167 4 176 210 249 294 248 290
0.333 8 187 220 265 308 263 304
0.5 12 202 232 284 325 283 320
1 24 263 287 370 401 368 395
2 48 465 470 653 660 649 648
4 96 939 865 1,318 1,222 1,308 1,193
8 192 1,186 1,058 1,665 1,497 1,651 1,459
10 240 1,215 1,083 1,706 1,533 1,692 1,494
20 480 1,334 1,188 1,872 1,682 1,858 1,640
30 720 1,443 1,286 2,026 1,820 2,010 1,774
1-y-old
0.042 1 168 222 235 306 214 276
0.083 2 173 220 242 303 221 274
0.167 4 180 223 251 308 229 278
0.333 8 192 235 268 324 244 293
0.5 12 208 248 289 342 264 310
1 24 275 306 381 422 349 382
2 48 482 487 667 673 611 607
4 96 928 836 1,285 1,161 1,168 1,034
8 192 1,141 992 1,580 1,380 1,432 1,223
10 240 1,166 1,013 1,615 1,409 1,464 1,249
20 480 1,271 1,104 1,761 1,536 1,595 1,361
30 720 1,368 1,189 1,896 1,653 1,718 1,466
5-y-old
0.042 1 195 294 271 403 245 352
0.083 2 201 291 280 399 255 348
0.167 4 209 296 290 405 265 354
0.333 8 222 311 308 426 283 371
0.5 12 240 328 332 450 307 392
1 24 313 400 432 548 401 477
2 48 523 606 721 830 667 720
4 96 909 946 1,254 1,300 1,134 1,124
8 192 1,077 1,088 1,485 1,496 1,331 1,292
10 240 1,100 1,111 1,517 1,527 1,360 1,319
20 480 1,198 1,210 1,652 1,664 1,481 1,437
30 720 1,290 1,303 1,779 1,792 1,594 1,548
10-y-old
0.042 1 224 304 310 417 252 355
0.083 2 232 300 321 412 266 352
0.167 4 239 305 331 419 280 359
0.333 8 253 321 349 441 300 378
0.5 12 271 340 375 467 326 401
1 24 351 415 484 571 430 492
2 48 582 634 802 872 706 745
4 96 1,007 1,002 1,384 1,377 1,146 1,154
8 192 1,191 1,156 1,636 1,588 1,324 1,323
10 240 1,216 1,180 1,671 1,621 1,352 1,350
20 480 1,326 1,286 1,822 1,767 1,473 1,471
30 720 1,428 1,385 1,963 1,903 1,586 1,584
A-4
A-5
Table A-4. Inhaled Activity of Type F 90Sr vs. Count Rate (Bq/kcpm)
Camera
Time post intake Siemens e.cam
Philips SKYLight
6 Windows 3 Windows
d h Anterior Posterior Anterior Posterior Anterior Posterior
Infant
0.042 1 3,607 6,841 4,804 8,737 4,660 8,712
0.083 2 3,704 6,956 4,935 8,909 4,799 8,882
0.167 4 3,868 7,200 5,153 9,262 5,021 9,229
0.333 8 4,186 7,531 5,564 9,716 5,429 9,657
0.5 12 4,518 7,786 5,988 10,049 5,846 9,962
1 24 5,525 8,529 7,262 11,016 7,100 10,854
2 48 7,287 9,833 9,469 12,720 9,280 12,452
4 96 9,031 11,161 11,635 14,459 11,427 14,102
8 192 10,011 12,257 12,877 15,887 12,653 15,489
10 240 10,297 12,657 13,245 16,408 13,016 16,000
20 480 11,249 14,113 14,467 18,300 14,219 17,861
30 720 11,787 14,990 15,156 19,440 14,897 18,984
1-y-old
0.042 1 4,231 9,160 5,509 11,415 5,060 10,679
0.083 2 4,462 9,228 5,813 11,518 5,355 10,779
0.167 4 4,806 9,476 6,263 11,858 5,781 11,088
0.333 8 5,362 9,878 6,974 12,383 6,455 11,569
0.5 12 5,925 10,235 7,685 12,836 7,131 11,988
1 24 7,788 11,401 10,014 14,307 9,356 13,348
2 48 11,902 13,836 15,095 17,393 14,237 16,178
4 96 17,906 17,194 22,415 21,659 21,309 20,081
8 192 22,847 20,957 28,513 26,418 27,167 24,475
10 240 24,445 22,375 30,501 28,204 29,076 26,134
20 480 30,175 27,531 37,606 34,664 35,947 32,160
30 720 33,885 30,877 42,190 38,840 40,409 36,070
5-y-old
0.042 1 5,685 14,347 7,400 17,745 6,580 16,128
0.083 2 6,077 14,752 7,930 18,256 7,072 16,612
0.167 4 6,667 15,482 8,714 19,181 7,778 17,478
0.333 8 7,604 16,427 9,928 20,366 8,879 18,564
0.5 12 8,508 17,118 11,079 21,221 9,947 19,331
1 24 11,476 19,166 14,813 23,750 13,459 21,599
2 48 18,333 23,406 23,318 29,022 21,554 26,348
4 96 29,157 29,483 36,537 36,607 34,285 33,191
8 192 38,594 36,637 48,206 45,517 45,351 41,286
10 240 41,755 39,349 52,162 48,884 49,037 44,376
20 480 53,982 49,319 67,467 61,222 63,160 55,858
30 720 62,664 55,996 78,333 69,461 73,100 63,620
10-y-old
0.042 1 8,258 17,068 10,608 20,892 7,887 18,751
0.083 2 9,039 17,624 11,644 21,582 8,663 19,467
0.167 4 10,103 18,628 13,048 22,838 9,699 20,690
0.333 8 11,551 19,819 14,906 24,324 11,175 22,077
0.5 12 12,837 20,579 16,517 25,263 12,563 22,923
1 24 16,856 22,671 21,491 27,850 17,056 25,204
2 48 25,408 26,779 31,911 32,948 26,996 29,671
4 96 36,929 31,982 45,738 39,412 40,952 35,347
8 192 45,571 37,419 56,273 46,134 50,916 41,335
10 240 48,441 39,417 59,811 48,598 54,031 43,533
20 480 59,322 46,290 73,201 57,046 65,479 51,026
30 720 66,380 50,313 81,858 61,980 72,702 55,378
A-6
A-7
Table A-5. Inhaled Activity of Type S 90Sr vs. Count Rate (Bq/kcpm)
Camera
Time post intake Siemens e.cam
Philips SKYLight
6 Windows 3 Windows
d h Anterior Posterior Anterior Posterior Anterior Posterior
Infant
0.042 1 3,590 6,895 4,758 8,701 4,611 8,688
0.083 2 3,733 6,779 4,939 8,536 4,799 8,501
0.167 4 3,903 6,874 5,152 8,650 5,013 8,592
0.333 8 4,223 7,186 5,554 9,051 5,403 8,956
0.5 12 4,627 7,516 6,065 9,473 5,899 9,345
1 24 6,297 8,985 8,199 11,338 7,970 11,120
2 48 11,656 13,831 15,036 17,491 14,624 17,076
4 96 24,467 23,085 31,178 29,292 30,393 28,536
8 192 31,101 27,187 39,455 34,536 38,500 33,634
10 240 31,806 27,763 40,347 35,269 39,369 34,348
20 480 34,592 30,214 43,886 38,389 42,813 37,388
30 720 37,120 32,461 47,100 41,249 45,940 40,174
1-y-old
0.042 1 4,055 9,194 5,251 11,368 4,794 10,537
0.083 2 4,264 8,992 5,516 11,100 5,050 10,292
0.167 4 4,496 9,097 5,809 11,221 5,324 10,384
0.333 8 4,906 9,523 6,326 11,750 5,799 10,851
0.5 12 5,417 9,969 6,969 12,308 6,400 11,367
1 24 7,499 11,828 9,586 14,635 8,856 13,526
2 48 13,944 17,420 17,655 21,659 16,377 19,889
4 96 28,351 26,669 35,463 33,394 32,743 30,206
8 192 35,378 30,479 44,072 38,247 40,565 34,424
10 240 36,138 31,078 45,017 39,001 41,430 35,099
20 480 39,199 33,685 48,834 42,280 44,937 38,045
30 720 42,008 36,086 52,338 45,300 48,158 40,760
5-y-old
0.042 1 5,221 13,291 6,740 16,232 6,015 14,735
0.083 2 5,510 13,084 7,114 15,974 6,385 14,431
0.167 4 5,824 13,312 7,506 16,246 6,770 14,617
0.333 8 6,362 14,012 8,163 17,092 7,407 15,324
0.5 12 7,027 14,694 8,981 17,922 8,197 16,036
1 24 9,651 17,220 12,231 21,017 11,314 18,739
2 48 17,091 23,839 21,394 29,178 19,981 25,923
4 96 30,936 33,067 38,172 40,641 35,497 36,008
8 192 36,891 36,729 45,331 45,194 42,013 40,013
10 240 37,642 37,428 46,251 46,057 42,862 40,774
20 480 40,802 40,561 50,139 49,919 46,459 44,183
30 720 43,722 43,462 53,733 53,496 49,785 47,341
10-y-old
0.042 1 7,137 15,541 9,065 18,833 6,932 16,696
0.083 2 7,577 15,204 9,610 18,405 7,497 16,358
0.167 4 7,986 15,447 10,108 18,679 8,031 16,643
0.333 8 8,624 16,310 10,878 19,710 8,813 17,602
0.5 12 9,450 17,147 11,889 20,725 9,785 18,528
1 24 12,773 20,165 15,966 24,420 13,578 21,789
2 48 21,889 27,935 27,099 33,983 23,478 29,931
4 96 37,544 38,631 45,976 47,255 39,113 40,798
8 192 43,975 42,832 53,691 52,474 45,230 45,057
10 240 44,851 43,635 54,759 53,461 46,116 45,898
20 480 48,615 47,243 59,363 57,896 49,972 49,698
30 720 52,096 50,580 63,622 61,999 53,540 53,214
A-8
A-9
Table A-6. Inhaled Activity of Type F 131I vs. Count Rate (Bq/kcpm)
Camera
Time post intake Siemens e.cam
Philips SKYLight
6 Windows 3 Windows
d h Anterior Posterior Anterior Posterior Anterior Posterior
Infant
0.042 1 139 201 164 236 167 236
0.083 2 149 212 175 248 179 248
0.167 4 170 242 200 283 205 284
0.333 8 216 313 255 366 262 369
0.5 12 267 390 316 456 324 460
1 24 434 602 512 703 526 712
2 48 748 863 881 1,009 901 1,020
4 96 1,222 1,193 1,438 1,395 1,460 1,404
8 192 2,137 2,017 2,515 2,360 2,548 2,374
10 240 2,779 2,621 3,270 3,067 3,313 3,085
20 480 10,312 9,726 12,136 11,380 12,294 11,445
30 720 38,114 35,949 44,857 42,059 45,441 42,303
1-y-old
0.042 1 147 235 175 280 160 250
0.083 2 157 245 187 293 171 262
0.167 4 179 279 213 333 195 297
0.333 8 226 357 270 426 248 381
0.5 12 279 440 333 524 305 469
1 24 451 656 538 782 492 699
2 48 785 903 938 1,075 854 958
4 96 1,283 1,203 1,535 1,433 1,387 1,274
8 192 2,148 1,935 2,572 2,305 2,320 2,050
10 240 2,729 2,457 3,267 2,927 2,948 2,603
20 480 9,064 8,161 10,853 9,722 9,791 8,646
30 720 30,117 27,119 36,063 32,305 32,535 28,728
5-y-old
0.042 1 183 339 221 415 195 350
0.083 2 194 351 235 430 207 364
0.167 4 217 392 262 479 232 408
0.333 8 274 499 331 608 292 521
0.5 12 342 617 413 751 363 648
1 24 570 930 688 1,128 599 988
2 48 992 1,263 1,203 1,529 1,039 1,345
4 96 1,567 1,633 1,909 1,979 1,644 1,735
8 192 2,486 2,499 3,033 3,028 2,613 2,652
10 240 3,080 3,095 3,756 3,749 3,238 3,283
20 480 9,063 9,109 11,055 11,037 9,532 9,663
30 720 26,758 26,895 32,641 32,587 28,144 28,530
10-y-old
0.042 1 239 382 293 478 216 383
0.083 2 256 400 314 500 232 403
0.167 4 290 456 355 569 262 460
0.333 8 373 600 456 748 329 608
0.5 12 473 769 578 956 406 781
1 24 802 1,258 979 1,555 651 1,281
2 48 1,331 1,779 1,632 2,191 1,076 1,813
4 96 1,937 2,266 2,390 2,790 1,618 2,307
8 192 2,881 3,283 3,560 4,042 2,435 3,341
10 240 3,468 3,946 4,286 4,859 2,936 4,016
20 480 8,850 10,040 10,938 12,364 7,526 10,222
30 720 22,793 25,835 28,171 31,816 19,410 26,306
A-10
A-11
Table A-7. Inhaled Activity of Type F 137Cs vs. Count Rate (Bq/kcpm)
Camera
Time post intake Siemens e.cam
Philips SKYLight
6 Windows 3 Windows
d h Anterior Posterior Anterior Posterior Anterior Posterior
Infant
0.042 1 213 293 361 465 293 396
0.083 2 221 293 374 467 303 396
0.167 4 232 297 392 476 318 401
0.333 8 250 307 422 494 344 414
0.5 12 267 316 449 510 367 426
1 24 312 339 520 550 429 457
2 48 377 371 618 604 518 500
4 96 447 415 725 677 614 559
8 192 540 497 874 809 741 669
10 240 590 542 954 883 809 730
20 480 915 841 1,481 1,371 1,256 1,133
30 720 1,425 1,310 2,306 2,135 1,956 1,764
1-y-old
0.042 1 226 337 367 508 286 426
0.083 2 235 338 383 512 299 426
0.167 4 250 345 407 524 318 435
0.333 8 274 359 446 548 350 454
0.5 12 298 371 482 569 380 470
1 24 359 401 574 618 461 509
2 48 450 442 705 683 583 562
4 96 555 503 856 778 721 639
8 192 700 625 1,076 967 910 794
10 240 779 696 1,198 1,076 1,013 883
20 480 1,328 1,186 2,042 1,835 1,727 1,505
30 720 2,263 2,022 3,481 3,127 2,944 2,566
5-y-old
0.042 1 280 485 446 710 353 618
0.083 2 295 491 471 722 372 624
0.167 4 318 508 506 750 401 644
0.333 8 353 540 563 800 449 682
0.5 12 387 566 614 841 495 714
1 24 472 620 741 927 615 780
2 48 591 682 908 1,021 788 854
4 96 716 762 1,082 1,142 969 953
8 192 868 910 1,308 1,364 1,178 1,138
10 240 944 989 1,422 1,483 1,281 1,237
20 480 1,380 1,446 2,080 2,168 1,873 1,808
30 720 1,920 2,011 2,892 3,015 2,604 2,515
10-y-old
0.042 1 361 537 553 780 391 681
0.083 2 385 548 591 799 416 693
0.167 4 417 572 642 837 454 724
0.333 8 467 615 719 904 518 781
0.5 12 510 649 785 958 577 827
1 24 613 717 935 1,063 732 918
2 48 737 785 1,108 1,166 947 1,007
4 96 859 867 1,278 1,288 1,159 1,111
8 192 1,001 1,001 1,486 1,486 1,362 1,282
10 240 1,064 1,063 1,579 1,579 1,448 1,362
20 480 1,346 1,345 1,999 1,998 1,831 1,723
30 720 1,602 1,600 2,380 2,378 2,179 2,050
A-12
A-13
Table A-8. Inhaled Activity of Type F 192Ir vs. Count Rate (Bq/kcpm)
Camera
Time post intake Siemens e.cam
Philips SKYLight
6 Windows 3 Windows
d h Anterior Posterior Anterior Posterior Anterior Posterior
Infant
0.042 1 58 84 72 103 75 106
0.083 2 60 84 74 103 77 106
0.167 4 63 86 78 106 80 109
0.333 8 68 91 84 111 87 114
0.5 12 73 95 91 117 94 120
1 24 93 111 115 136 119 139
2 48 139 148 172 181 177 185
4 96 204 197 251 242 259 247
8 192 242 229 298 281 307 287
10 240 253 240 312 295 321 300
20 480 307 290 378 357 389 364
30 720 359 339 442 417 456 425
1-y-old
0.042 1 62 99 77 121 73 114
0.083 2 64 99 80 122 75 114
0.167 4 68 102 84 125 79 117
0.333 8 74 108 92 132 87 124
0.5 12 81 114 100 139 95 131
1 24 105 132 130 163 124 153
2 48 161 174 199 214 189 201
4 96 240 229 296 281 281 263
8 192 285 264 351 325 334 304
10 240 298 277 368 340 349 318
20 480 361 335 446 412 423 385
30 720 423 392 522 481 495 451
5-y-old
0.042 1 78 143 97 177 89 159
0.083 2 81 144 101 178 93 160
0.167 4 85 148 106 184 98 164
0.333 8 93 158 117 196 108 175
0.5 12 102 167 128 207 120 185
1 24 134 195 167 242 158 216
2 48 203 254 254 315 241 281
4 96 297 327 370 406 352 361
8 192 351 377 437 467 415 416
10 240 368 394 458 489 435 435
20 480 445 477 554 592 527 527
30 720 521 558 649 692 616 616
10-y-old
0.042 1 101 159 127 200 100 173
0.083 2 105 160 132 200 105 174
0.167 4 110 164 138 206 112 179
0.333 8 120 175 151 220 124 191
0.5 12 131 185 164 233 138 203
1 24 168 218 212 273 185 240
2 48 248 284 312 356 282 312
4 96 353 367 444 459 405 400
8 192 415 422 521 528 476 459
10 240 435 442 546 552 499 480
20 480 527 535 662 669 604 581
30 720 617 626 775 783 707 680
A-14
A-15
Table A-9. Inhaled Activity of Type M 192Ir vs. Count Rate (Bq/kcpm)
Camera
Time post intake Siemens e.cam
Philips SKYLight
6 Windows 3 Windows
d h Anterior Posterior Anterior Posterior Anterior Posterior
Infant
0.042 1 57 84 71 102 73 105
0.083 2 59 83 73 101 75 103
0.167 4 61 84 75 102 77 105
0.333 8 65 87 80 107 83 109
0.5 12 70 92 87 112 90 115
1 24 93 111 115 136 118 139
2 48 164 174 202 213 208 217
4 96 322 298 396 367 407 372
8 192 414 368 510 453 524 459
10 240 432 384 533 473 547 479
20 480 523 465 644 573 662 581
30 720 622 555 766 684 787 693
1-y-old
0.042 1 60 97 74 119 70 111
0.083 2 62 96 77 117 73 109
0.167 4 65 97 81 119 76 111
0.333 8 70 102 87 125 82 117
0.5 12 76 107 95 132 89 123
1 24 103 130 127 159 120 149
2 48 181 197 224 242 212 225
4 96 345 316 426 388 400 359
8 192 436 380 539 468 505 432
10 240 455 396 562 488 527 450
20 480 550 480 679 590 637 545
30 720 654 572 808 704 758 650
5-y-old
0.042 1 73 135 92 167 84 149
0.083 2 77 133 96 165 88 147
0.167 4 80 135 100 168 93 149
0.333 8 86 142 108 177 101 157
0.5 12 94 150 118 187 110 165
1 24 125 179 157 223 147 198
2 48 212 260 264 322 249 285
4 96 368 384 458 475 424 421
8 192 451 451 561 559 516 496
10 240 471 471 585 583 538 517
20 480 570 571 709 708 653 628
30 720 681 684 847 847 780 751
10-y-old
0.042 1 92 147 116 185 92 159
0.083 2 96 145 121 182 98 157
0.167 4 101 147 127 185 104 160
0.333 8 107 156 135 196 113 169
0.5 12 116 164 146 207 124 179
1 24 152 198 192 248 168 216
2 48 252 287 317 360 279 312
4 96 427 427 536 533 452 455
8 192 521 503 652 627 541 533
10 240 543 524 681 654 565 556
20 480 659 637 826 794 687 676
30 720 789 763 988 951 824 810
A-16
A-17
Table A-10. Inhaled Activity of Type S 192Ir vs. Count Rate (Bq/kcpm)
Camera
Time post intake Siemens e.cam
Philips SKYLight
6 Windows 3 Windows
d h Anterior Posterior Anterior Posterior Anterior Posterior
Infant
0.042 1 57 84 70 102 72 105
0.083 2 58 82 72 101 75 103
0.167 4 60 83 75 102 77 104
0.333 8 65 87 80 106 82 109
0.5 12 70 91 87 112 89 114
1 24 93 111 115 136 118 139
2 48 167 177 206 217 211 221
4 96 343 315 422 388 434 393
8 192 446 391 550 482 565 487
10 240 465 407 573 501 588 507
20 480 556 486 685 599 703 606
30 720 656 573 808 707 829 715
1-y-old
0.042 1 59 97 74 119 69 111
0.083 2 62 95 77 117 72 109
0.167 4 65 96 80 119 76 111
0.333 8 70 101 87 124 81 116
0.5 12 76 107 94 131 89 122
1 24 102 129 127 159 120 148
2 48 184 199 227 245 214 228
4 96 361 328 446 404 418 372
8 192 459 395 567 486 530 447
10 240 477 410 589 505 551 464
20 480 568 488 701 600 656 552
30 720 667 573 824 706 771 649
5-y-old
0.042 1 73 134 91 166 83 148
0.083 2 76 132 95 164 88 146
0.167 4 80 134 100 167 92 148
0.333 8 86 141 107 175 100 155
0.5 12 93 148 117 185 109 163
1 24 124 178 155 221 146 196
2 48 213 260 265 322 249 285
4 96 376 389 468 482 431 427
8 192 461 455 572 563 523 499
10 240 479 472 595 585 544 518
20 480 569 561 707 695 646 616
30 720 669 660 831 818 760 725
10-y-old
0.042 1 91 146 114 183 91 158
0.083 2 96 144 120 180 97 155
0.167 4 100 146 126 183 103 158
0.333 8 106 154 133 193 112 167
0.5 12 114 162 144 204 123 177
1 24 150 195 189 245 166 214
2 48 252 287 317 360 278 312
4 96 435 432 546 539 454 459
8 192 529 506 662 630 541 534
10 240 549 525 687 654 561 554
20 480 653 624 818 778 668 659
30 720 769 734 962 915 786 775
A-18
A-19
Table A-11. Inhaled Activity of Type M 241Am vs. Count Rate (Bq/kcpm)
Camera
Time post intake
Siemens e.cam Philips SKYLight
d h Anterior Posterior Anterior Posterior
Infant
0.042 1 310 597 355 675
0.083 2 323 586 370 661
0.167 4 337 592 386 666
0.333 8 362 614 414 691
0.5 12 393 638 449 717
1 24 524 749 597 841
2 48 926 1,116 1,052 1,251
4 96 1,767 1,773 2,006 1,988
8 192 2,145 2,050 2,434 2,299
10 240 2,182 2,090 2,476 2,344
20 480 2,320 2,258 2,635 2,534
30 720 2,438 2,407 2,770 2,704
1-y-old
0.042 1 351 846 375 887
0.083 2 372 829 397 870
0.167 4 393 838 420 880
0.333 8 427 872 457 917
0.5 12 470 906 503 954
1 24 645 1,049 690 1,105
2 48 1,161 1,473 1,241 1,548
4 96 2,201 2,120 2,337 2,215
8 192 2,666 2,379 2,824 2,482
10 240 2,718 2,424 2,880 2,529
20 480 2,929 2,621 3,108 2,738
30 720 3,118 2,801 3,313 2,928
5-y-old
0.042 1 467 1,302 485 1,319
0.083 2 497 1,281 519 1,295
0.167 4 527 1,300 553 1,313
0.333 8 574 1,359 605 1,373
0.5 12 632 1,412 669 1,427
1 24 863 1,609 919 1,627
2 48 1,492 2,119 1,587 2,147
4 96 2,572 2,787 2,693 2,827
8 192 3,012 3,060 3,134 3,106
10 240 3,070 3,121 3,195 3,168
20 480 3,316 3,398 3,454 3,452
30 720 3,537 3,654 3,687 3,714
10-y-old
0.042 1 685 1,593 578 1,576
0.083 2 739 1,563 631 1,552
0.167 4 782 1,587 679 1,580
0.333 8 838 1,666 747 1,665
0.5 12 913 1,735 829 1,741
1 24 1,216 1,980 1,148 1,995
2 48 2,008 2,589 1,945 2,589
4 96 3,241 3,362 3,109 3,312
8 192 3,729 3,681 3,554 3,612
10 240 3,803 3,754 3,626 3,685
20 480 4,128 4,093 3,942 4,021
30 720 4,426 4,409 4,234 4,335
A-20
A-21
A-22
A-23
A-24
A-25
A-26
A-27
A-28
A-29
A-30
A-31
A-32
A-33
Appendix B
CUMULATIVE EFFECTIVE DOSE AT SELECTED TIMES AFTER INTAKE7
As was discussed in section 1.4.4, two sets of dose coefficients are listed to help in assessing the
biological effects of internal exposure. The first are coefficients for the cumulative effective
dose, which is the integrated dose from the time of acute intake until the time of the assessment.
The second set represents the lifetime effective dose commitment to the exposed individual,
absent any medical intervention. The lifetime dose commitment to a child is defined as the
integrated dose until age 70. The committed dose to an adult is the dose integrated over a period
of 50 years following intake.
The coefficients in tables B-1 to B-6 are tabulated at 12 time steps, a subset of the 50 time steps
used by the Assess computer code. They are specific to the f1 values listed in table A-1 and, for
the inhalation pathway, to a particle size distribution with a 1 ìm AMAD. These coefficients
can be used to determine doses resulting from intakes that are calculated using the calibration
factors in appendix A, an alternative to using Assess. Such dose calculations can be useful in
assessing the efficacy of any potential intervention.
7
This appendix is taken from Anigstein and Olsher 2010, appendix D, with some revisions of the introductory text.
B-1
Table B-1. Cumulative Effective Dose Following Intake of 60Co (Sv/Bq)
Time post intake Age
d h 3 mo 1y 5y 10 y 15 y 20 y
Inhalation: Type M
0.042 1 9.97e-11 6.88e-11 3.62e-11 2.54e-11 1.93e-11 1.54e-11
0.083 2 1.91e-10 1.34e-10 7.07e-11 4.97e-11 3.70e-11 2.96e-11
0.167 4 3.60e-10 2.60e-10 1.37e-10 9.67e-11 7.03e-11 5.66e-11
0.333 8 7.00e-10 5.17e-10 2.71e-10 1.91e-10 1.34e-10 1.09e-10
0.5 12 1.05e-09 7.83e-10 4.08e-10 2.85e-10 1.98e-10 1.61e-10
1 24 2.01e-09 1.53e-09 7.88e-10 5.50e-10 3.76e-10 3.05e-10
2 48 3.41e-09 2.61e-09 1.36e-09 9.47e-10 6.59e-10 5.32e-10
4 96 4.95e-09 3.79e-09 2.04e-09 1.43e-09 1.05e-09 8.43e-10
8 192 6.90e-09 5.27e-09 2.96e-09 2.10e-09 1.65e-09 1.32e-09
10 240 7.75e-09 5.92e-09 3.37e-09 2.40e-09 1.92e-09 1.53e-09
20 480 1.14e-08 8.74e-09 5.14e-09 3.68e-09 3.08e-09 2.45e-09
30 720 1.42e-08 1.10e-08 6.55e-09 4.68e-09 3.98e-09 3.17e-09
Lifetime committed dose 4.16e-08 3.39e-08 2.13e-08 1.46e-08 1.21e-08 1.02e-08
Inhalation: Type S
0.042 1 1.04e-10 7.18e-11 3.79e-11 2.67e-11 2.04e-11 1.62e-11
0.083 2 2.01e-10 1.41e-10 7.45e-11 5.25e-11 3.94e-11 3.15e-11
0.167 4 3.84e-10 2.74e-10 1.46e-10 1.03e-10 7.52e-11 6.05e-11
0.333 8 7.63e-10 5.53e-10 2.90e-10 2.04e-10 1.45e-10 1.17e-10
0.5 12 1.16e-09 8.44e-10 4.40e-10 3.08e-10 2.14e-10 1.74e-10
1 24 2.29e-09 1.67e-09 8.60e-10 6.00e-10 4.11e-10 3.33e-10
2 48 3.93e-09 2.87e-09 1.49e-09 1.04e-09 7.25e-10 5.84e-10
4 96 5.64e-09 4.16e-09 2.23e-09 1.57e-09 1.16e-09 9.25e-10
8 192 7.69e-09 5.76e-09 3.24e-09 2.30e-09 1.82e-09 1.45e-09
10 240 8.60e-09 6.48e-09 3.69e-09 2.63e-09 2.13e-09 1.69e-09
20 480 1.26e-08 9.66e-09 5.72e-09 4.10e-09 3.47e-09 2.75e-09
30 720 1.59e-08 1.23e-08 7.40e-09 5.31e-09 4.57e-09 3.62e-09
Lifetime committed dose 9.15e-08 8.57e-08 5.88e-08 4.03e-08 3.42e-08 3.07e-08
Ingestion
0.042 1 2.79e-10 1.80e-10 1.01e-10 6.56e-11 4.65e-11 3.74e-11
0.083 2 4.65e-10 3.16e-10 1.79e-10 1.17e-10 8.11e-11 6.60e-11
0.167 4 7.69e-10 5.76e-10 3.28e-10 2.17e-10 1.46e-10 1.22e-10
0.333 8 1.33e-09 1.12e-09 6.37e-10 4.24e-10 2.79e-10 2.44e-10
0.5 12 1.88e-09 1.69e-09 9.56e-10 6.36e-10 4.16e-10 3.73e-10
1 24 3.36e-09 3.22e-09 1.82e-09 1.21e-09 7.87e-10 7.31e-10
2 48 5.35e-09 5.21e-09 2.95e-09 1.95e-09 1.27e-09 1.19e-09
4 96 7.08e-09 6.61e-09 3.74e-09 2.47e-09 1.61e-09 1.48e-09
8 192 8.47e-09 7.24e-09 4.11e-09 2.71e-09 1.77e-09 1.56e-09
10 240 8.99e-09 7.43e-09 4.22e-09 2.78e-09 1.82e-09 1.58e-09
20 480 1.10e-08 8.15e-09 4.64e-09 3.05e-09 2.00e-09 1.63e-09
30 720 1.24e-08 8.70e-09 4.96e-09 3.26e-09 2.15e-09 1.67e-09
Lifetime committed dose 5.42e-08 2.68e-08 1.69e-08 1.12e-08 7.94e-09 3.42e-09
B-2
B-3
B-4
B-5
B-6
B-7
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