Skeletal Scintigraphy: The Use of Technetium 99M-Labeled Complexes in the Detection of Early Osseous Involvement by Metastatic Tumors

Skeletal scintigraphy using Technetium-99m (^99mTc) complexes was carried out in a series of 332 cancer patients. The results of scintigraphy were compared with the results of roentgenography and with the diagnostic usefulness of serum alkaline and acid phosphatase levels and the presence or absence of bone pain. In 25 percent of cases, lesions were first identified with scintigraphs. When metastastic lesions were present on both scintigraphs and roentgenograms, the number was greater on scintigraphs in 72 percent of cases. Six false negative studies were recorded (1 percent). Sixty percent of patients with early metastasis—that is, those with abnormal scintigraphs and negative roentgenograms—were asymptomatic. Serum alkaline and acid phosphatase levels were normal in 40 percent and 42 percent respectively of those with early skeletal involvement. Skeletal scintigraphy with ^99mTc complexes is superior to other commonly employed techniques used to assess bone metastasis.     

Whole Body Skeletal Scintiphotography in the Detection of Occult Metastatic Breast Carcinomas

Whole body skeletal scintiphotography was carried out in a series of 111 breast cancer patients. The results of scintiphotography were compared with the results of roentgenography and with the diagnostic usefulness of serum alkaline phosphatase levels and the presence or absence of bone pain. In 27 percent of cases, lesions were first identified with the scintiphotos. When lesions were present on both scintiphotos and roentgenograms, involvement generally appeared greater on the scintiphotos. Two false negative studies were recorded. Sixty-seven percent of patients with early metastasis—that is, those with positive scintiphotos and negative roentgenograms—were asymptomatic. Serum alkaline phosphatase levels were normal in 38 percent of those with early skeletal involvement. Skeletal scintiphotography is superior to other commonly employed techniques used to assess bone metastasis in breast carcinoma.     

Transfer of 85Sr and 134Cs from diet to reindeer foetuses and milk

Sr-85 and ¹³⁴Cs in aqueous solution of the chlorides were administered daily to four pregnant reindeer during the last part of gestation. Radionuclide concentrations were determined in calves sacrificed at birth, and secretion of the nuclides was measured in milk. Although the gastrointestinal absorption of ⁸⁵Sr was low, an apparently higher transfer of the absorbed fraction of ⁸⁵Sr than ¹³⁴Cs from the mother to the foetus led to similar accumulation of ⁸⁵Sr and ¹³⁴Cs in foetuses. At birth 1.4–1.6 and 1.5–2.5% of the total administered activities of ⁸⁵Sr and ¹³⁴Cs, respectively, were present in the calves‘ bodies. Transfer coefficients (F _m) for ⁸⁵Sr and ¹³⁴Cs from feed to milk were estimated at 0.0218±0.0026 and 0.185±0.025 day kg⁻¹, respectively, and the observed ratio (OR_milk-diet) for ⁸⁵Sr was 0.124±0.037. Transfer of radiostrontium to reindeer milk was in agreement with previously reported relationships between Ca intake and radiostrontium transfer in ruminants. These relationships suggest that the transfer of radiostrontium to foetuses and milk of free-ranging reindeer can be 3–4 times higher than observed in this experiment (due to lower Ca intake with natural forage), but the transfer to milk will not be as high as that of ionic ¹³⁴Cs. The concentrations of ⁸⁵Sr in milk suggested that the does mobilized skeletal stores of Ca and ⁸⁵Sr for milk production, although the diet appeared to satisfy the Ca requirements. In reindeer with radiostrontium intake during the whole year, radiostrontium concentrations in milk will therefore be higher than indicated by the F _m value observed in our study. No differences in half-times for ⁸⁵Sr and ¹³⁴Cs secretion in milk were detected. Both nuclides were secreted with short- and long-term half-times of 1–2 and 12–19 days, respectively. For ⁸⁵Sr, 80–90% of the activity was excreted with the short half-time, whereas the corresponding value for ¹³⁴Cs was 30–50%.     

The Operative Management of Crohn Disease

The natural history of Crohn disease^* is varied and unpredictable, and its cause is not known. No modality of treatment has definitely been shown to alter its course.Surgical treatment was carried out in a consistent fashion in 141 consecutive patients with Crohn disease. The indications for surgical operation were the complications of the disease only; these included fistula, abscess, obstruction and hemorrhage. Preoperative evaluation included upper gastrointestinal examination, barium enema, intravenous pyelogram, proctoscopy, and nutritional and volume support. In 76 of these patients previous operations had been carried out for Crohn disease.The surgical treatment was based upon the specific complication present, with adherence to the principle of resection of diseased tissue only. Ureterolysis also was necessary in 20 percent of these patients. The operative mortality was 1.4 percent, postoperative complications occurred in 54 patients and the surgical recurrence rate was 26 percent. A favorable result was accomplished in 85 percent of the patients.     

Influence of Nitrogen Supply on Uptake and Translocation of Strontium and Calcium in Wheat Seedlings

Supplying nitrate to N-depleted wheat seedlings (Triticum vulgare cv. Knox) stimulated the uptake and translocation of both ⁸³Sr and ⁴⁵Ca. Since the increase in ⁴⁵Ca accumulation was greater, the ⁸⁵Sr/⁴⁵Ca ratio in the plant tissue was decreased. Nitrate had relatively little influence on the amount of the divalent cations and ⁸⁵Sr/⁴⁵Ca ratio in the exchangeable fraction on the root surfaces, whereas it greatly increased the uptake into root tissue and translocation to shoots. The increase in percent transported to shoots occurred largely in the period of most rapid nitrate uptake. A split root study indicated that nitrate was ineffective when it was supplied to a different portion of the root system than that exposed to ⁸⁵Sr and ⁴⁵Ca. Nevertheless, ammonium and urea also increased the translocation of the two cations, indicating that the effects of nitrate could not entirely be ascribed to a direct effect of the nitrate anion.     

Evaluation of Chlorella as a Decorporation Agent to Enhance the Elimination of Radioactive Strontium from Body

Background

Release of radionuclides, such as ¹³⁷Cs and ⁹⁰Sr, into the atmosphere and the ocean presents an important problem because internal exposure to ¹³⁷Cs and ⁹⁰Sr could be very harmful to humans. Chlorella has been reported to be effective in enhancing the excretion of heavy metals; thus, we hypothesized that Chlorella could also enhance the elimination of ¹³⁷Cs or ⁹⁰Sr from the body. We evaluated the potential of Chlorella as a decorporation agent in vitro and in vivo, using ⁸⁵Sr instead of ⁹⁰Sr.

Methods

In vitro experiments of adsorption of ¹³⁷Cs and ⁸⁵Sr to Chlorella were performed under wide pH conditions. The maximum sorption capacity of Chlorella to strontium was estimated using the Langmuir model. A ⁸⁵Sr solution was orally administrated to mice pretreated with Chlorella. At 48 h after ⁸⁵Sr administration, the biodistribution of radioactivity was determined.

Results

In the in vitro experiments, although ⁸⁵Sr barely adsorbed to Chlorella at low pH, the ⁸⁵Sr adsorption ratio to Chlorella increased with increasing pH. The maximum sorption capacity of Chlorella to strontium was 9.06 mg / g. ¹³⁷Cs barely adsorbed to Chlorella under any pH conditions. In the biodistribution experiments, bone accumulation of radioactivity after ⁸⁵Sr administration was significantly decreased in the Chlorella pretreatment group compared with the non-treatment control group.

Conclusions

In conclusion, these results indicated that Chlorella could inhibit the absorption of ⁹⁰Sr into the blood and enhance the elimination of ⁹⁰Sr from the body through adsorption in intestine. Further studies are required to elucidate the mechanism and the components of Chlorella needed for adsorption to strontium and could promote the development of more effective decorporation agents.     

Hypermétabolismes médullaires en TEP au 18F-FDG chez les patients atteints de cancer : signification et comparaison à l’IRM médullaire

Diffuse bone marrow uptake of ¹⁸F-FDG-PET in cancer patients raises the problem of differential diagnosis between marrow involvement and stimulated marrow. In this study, we prospectively included, during a 1-year period, all cancer patients referred for initial staging showing an unexplained diffuse bone marrow uptake and explored consecutively by MRI. The abnormalities described on PET and the conclusion reached about disease status of bone marrow (“benign” or “malignant”) were compared with corresponding MRI results, as well as clinical and biological findings pertinent when bone marrow activity is studied, marrow status considered by referring clinicians, and follow-up data. During 1 year, 60 patients had diffuse bone marrow uptake on ¹⁸F-FDG-PET, 26 underwent MRI examination and were finally included in the study. Results of PET and MRI were concordant in 24 cases (six “malignant” and 18 “benign”) and two cases were discordant, judged “malignant” by MRI and “benign”by PET. The outcome after confrontation of MRI and PET, was “malignant”for one patient and “benign” for the other one. The final results, was “malignant” for seven patients and “benign” for 19 patients and this final diagnosis was retained by referring clinicians. Among the 19 patients with diffuse bone marrow uptake considered as benign, seven patients had a pejorative evolution and four of them developed osteomedullary metastases. In cancer patients, ¹⁸F-FDG-PET identify bone marrow diffuse uptake which seems to correspond well to abnormalities assessed on MRI studies. Notably, heterogenous 18F-FDG uptake and/or foci of increased uptake seems significative of marrow involvement. The limited population size and discordant published findings about bone marrow evaluation by ¹⁸F-FDG-PET compared with MRI can not permit to ensure that these imaging modalities or one of these are sufficient to assess bone marrow status without performing bone marrow biopsy. Some patients with unexplained diffuse bone marrow uptake develop disease progression, such observations could be interestingly assessed by further studies.     

Removal of radioactive strontium from the rat by feeding stable strontium

The effect of administering the stable isotope of strontium (as phos-phate) at different dietary levels to adult rats (fed on a cereal and pulse-based diet containing 0.4% Ca) on the retention of radiostrontium (⁸⁹Sr) and radiocalcium (⁴⁵Ca) in the femur and the whole skeleton was studied for a period up to 6 weeks after an intraperitoneal injection of the two radioisotopes. The ability of strontium to remove⁸⁹Sr under the above dietary conditions was examined. Feeding Sr at 0.5% or 1% levels for 6 weeks had no effect on the skeletal content of⁸⁹Sr or⁴⁵Ca while a dietary regimen of 2% Sr (2000 times the normal content), significantly lowered the⁸⁹Sr and⁴⁵Ca content by about 30% in the femur but not in the whole skeleton. At this Sr level, the urinary excretion of the isotopes increased with a concomitant decrease in their excretion in the faeces. This study underscores the limitations of dietary Sr to mobilise⁸⁹Sr from the bones after it is incorporated in the bone mineral.     

Bone scintigraphy leading to diagnosis of malignant osteopetrosis in a six-year-old boy

IntroductionOsteopetrosis is a rare disease but early detection is essential for future improvement of quality of life. Despite X-ray can be a diagnostic examination itself, bone scintigraphy can be helpful when the radiographic imaging is not typical.Case reportWe report a case of a 6-year-old boy with pain and limping of the left lower limb persisting 4 months after a left ankle sprain. He underwent a whole-body bone scintigraphy with HDP-99mTc and overlapping image focused on the hip, which showed abnormal increased diffuse uptake in proximal and distal epiphysis of femurs and tibias showing higher uptake in femurs. It also showed, involvement of proximal epiphysis of humerus. Kidneys were not visible, suggesting bone superscan. Differential diagnosis was recommended with osteopetrosis, osteomalacy.ConclusionBone scintigraphy can contribute for extensive skeletal evaluation and patients follow-up. Thus, bone scintigraphy may be useful in symptomatic and in asymptomatic patients with OP.     

Total Body Scanning with Strontium-85 in the Diagnosis of Metastatic Bone Disease

To demonstrate skeletal metastases before radiographic changes were apparent, Sr⁸⁵ scans were carried out on 46 patients who complained of sketetal pain but whose radiographs were negative. Positive scans were obtained in 34 patients, 20 of whom were subsequently shown to have metastases; three did not have skeletal metastases a year or more later; the outcome is unknown in 11 patients. Twelve patients had negative scans: three ultimately developed metastases, six did not, and three were inconclusive. Autoradiographs demonstrated Sr⁸⁵ concentrations in areas of reactive osteogenesis.Although not specific for skeletal metastases, Sr⁸⁵ scans are most helpful in substantiating this diagnosis when radiographic changes are absent.     

Radioisotopic Bone Scintigraphy with the Gamma Camera in the Investigation of Prostatic Cancer

Experience with x-rays, strontium-87m scintigraphy, and technetium-99m polyphosphate scintigraphy in the identification of bone metastases in 201 patients with prostatic cancer is reviewed. About 40% of the patients had demonstrable metastases in bone at the time of first presentation.Comparative studies of 247 x-ray and ^87mSr surveys indicated that x-rays failed to detect metastases in 10% of cases where they were identified by ^87mSr but that the isotopic survey similarly failed to detect radiologically evident deposits in 7% of cases.Similar studies comparing ^99mTc polyphosphate surveys with x-ray scans showed that x-rays missed isotopically detected metastases in 12% of cases, but in only one survey out of 67 did the isotope miss radiologically evident deposits. In a series of 32 patients investigated by both isotopic techniques ^99mTc polyphosphate did not fail to detect any metastases and identified deposits in one patient in whom they were missed by ^87mSr scintigraphy. About 15% of both x-ray and ^87mSr surveys gave equivocal results, but only 3% (2 out of 67) of ^99mTc polyphosphate surveys were equivocal.We concluded that ^99mTc polyphosphate bone scintigraphy with the gamma camera was the most reliable of the techniques used for the identification of bone metastases in patients with carcinoma of the prostate. The results of scintigraphy with ^87mSr suggested that serial surveys may provide early evidence of hormone resistance in prostatic cancer.     

Ecto-5′-nucleotidase (CD73) regulates bone formation and remodeling during intramembranous bone repair in aging mice

Ecto-5′-nucleotidase (CD73) generates adenosine, an osteoblast activator and key regulator of skeletal growth. It is unknown, however, if CD73 regulates osteogenic differentiation during fracture healing in adulthood, and in particular how CD73 activity regulates intramembranous bone repair in the elderly. Monocortical tibial defects were created in 46–52-week-old wild type (WT) and CD73 knock-out mice (CD73^?/?) mice. Injury repair was analyzed at post-operative days 5, 7, 14 and 21 by micro-computed tomography (micro-CT), histomorphometry, proliferating cell nuclear antigen (PCNA) immunostaining, alkaline phosphatase (ALP) and tartrate-resistant acid phosphatase (TRAP) histochemistry. Middle-aged CD73 knock-out mice exhibited delayed bone regeneration and significantly reduced bone matrix deposition detected by histomorphometry and micro-CT. Cell proliferation, ALP activity and osteoclast number were reduced in the CD73^?/? mice, suggesting a combined defect in bone formation and resorption due the absence of CD73 activity in this model of intramembranous bone repair. Results from this study demonstrate that osteoblast activation through CD73 activity is essential during bone repair in aging mice, and it may present a drugable target for future biomimetic therapeutic approaches that aim at enhancing bone formation in the elderly patients.     

Apport de la scintigraphie au 99mTc-dépréotide pour le diagnostic de lésions osseuses secondaires dans le cancer bronchopulmonaire non à petites cellules stade III–IV

ObjectiveIn non-small cell lung cancer (NSCLC), metastatic bone involvement is usually assessed using conventional ^99mTc-HMDP bone scintigraphy, which has a high sensitivity but a poor specificity. The purpose of this study was to assess the usefulness of the ^99mTc-D scintigraphy for the detection of malignant bone metastases in patients with NSCLC stage III or IV and to compare these results with ^99mTc-HMDP bone scan findings.MethodsNineteen patients (13 M and 6 F, mean age 59 years) with proven NSCLC, suspected to have stage III or IV were enrolled prospectively. All patients underwent whole body ^99mTc-HMDP and ^99mTc-D scintigraphy to detect bone metastases within a mean interval of 14 days. Each focal uptake of ^99mTc-D or ^99mTc-HMDP was considered benign or malignant, leading to positive or negative diagnosis for bone involvement. The final diagnosis of bone metastases was established by a lung specialist, on the basis of additional imaging modalities and of 12 months follow-up.ResultsTwelve bone lesions were identified by ^99mTc-D scintigraphy, 10 were classified as bone metastases and two were classified as inflammatory bone lesions. Four patients were metastatic. Fifty eight bone lesions were detected by ^99mTc-HMDP scintigraphy, 26 of whom were considered malignant, eight patients were thus considered metastatic. Thereby, the two nuclear medicine modalities were concordant for 13 patients, that is 68% of cases and were discordant for six patients, representing 32% of cases. Diagnostic sensitivity, specificity and accuracy of depreotide scintigraphy and ^99mTc-HMDP bone scintigraphy were 75% for both, 93.3 and 73.3%, and 89.5 and 73.3% respectively.ConclusionOur data suggest that depreotide scintigraphy with the same sensitivity, a better accuracy and specificity than those of ^99mTc-HMDP bone scan can detect metastatic bone lesions in patients with NSCLC suspected to have stage III or IV disease.     

Strontium metabolism in teeth and enamel dose assessment: analysis of the Techa river data

People living on the banks of the Techa river were exposed to ⁹⁰Sr in the early 1950s. Data obtained by radiochemical measurements of extracted permanent teeth, ⁹⁰Sr autopsy measurements in bone and tooth samples, in vivo measurements of surface beta activity of the anterior teeth and whole-body counter (WBC) measurements of ⁹⁰Sr in the skeleton have been analyzed. Surface beta activity measurements indicate a biological half-life of ⁹⁰Sr of about 35 years in enamel. The WBC measurements have been performed since 1974 and a model for the age-dependent strontium retention in human bone has been used to extrapolate to previous time periods when the other measurement results were obtained. For the first decade after the intake, the ratio of the ⁹⁰Sr concentrations in teeth and bones were found to decrease with age at the time of major intake, from about 10 for 1-year-old children to about 0.3 for adults. There was a considerable variability of individual data within each age group. For adults, the correlation between ⁹⁰Sr in skeleton and teeth was not high at 0.47 according to radiochemical data for posterior teeth (molars and premolars) and 0.43 according to measurements of surface beta activity for anterior teeth. For children and adolescents there was no correlation between individual measurements in the skeleton and teeth. The absorbed dose in enamel due to ⁹⁰Sr in dentine has been calculated by Monte Carlo simulations of the electron transport. The results are in agreement with EPR measurements of the absorbed dose in the enamel of persons exposed, mainly due to ⁹⁰Sr ingestion. Received: 19 July 1999 / Accepted: 5 May 2000     

Biokinetics of <Superscript>90</Superscript>Sr after chronic ingestion in a juvenile and adult mouse model

The aim of our study was to define the biokinetics of ⁹⁰Sr after chronic contamination by ingestion using a juvenile and adult murine model. Animals ingested ⁹⁰Sr by drinking water containing 20 kBq l⁻¹ of ⁹⁰Sr. For the juvenile model, parents received ⁹⁰Sr before mating and their offspring were killed between birth and 20 weeks of ingestion. For the adult model, ⁹⁰Sr ingestion started at 9 weeks of age and they were killed after different ingestion periods up to 20 weeks. The body weight, food and water consumption of the animals were monitored on a weekly basis. Before killing and sampling of organs, animals were put in metabolic cages. ⁹⁰Sr in organs and excreta was determined by liquid scintillation β counting. Highest ⁹⁰Sr contents were found in bones and were generally higher in females than in males, and ⁹⁰Sr retention varied according to the skeletal sites. An accumulation of ⁹⁰Sr in the bones was observed over time for both models, with a plateau level at adult age for the juvenile model. The highest rate of ⁹⁰Sr accumulation in bones was observed in early life of offspring, i.e. before the age of 6 weeks. With the exception of the digestive tract, ⁹⁰Sr was below the detection limit in all other organs sampled. Overall, our results confirm that ⁹⁰Sr mainly accumulates in bones. Furthermore, our results indicate that there are gender- and age-dependent differences in the distribution of ⁹⁰Sr after low-dose chronic ingestion in the mouse model. These results provide the basis for future studies on possible non-cancerous effects during chronic, long-term exposure to ⁹⁰Sr through ingestion in a mouse model, especially on the immune and hematopoietic systems.     

Natural variation and differential diagnosis of skeletal changes in tuberculosis

Twenty-six documented cases (17 blacks, 9 whites) of skeletal tuberculosis from the Hamann-Todd Osteological Collection, Cleveland Museum of Natural History, were analyzed for lesion variability and patterns of multiple site involvement. In addition, several documented cases of pathologic conditions (osteomyelitis, vertebral fractures, and malignant bone tumors) that resemble skeletal tuberculosis were photographed and described for use in differential diagnosis. The range of variation of tuberculous lesions was found to be considerable. Thirty-eight percent (10/26) of the cases display skeletal lesions in two or more regions concomitantly. The average number of vertebrae affected, as well as the incidence of multiple bone involvement, were found to be higher in blacks. Certain combinations of skeletal lesions (e. g., spine-rib, spine-rib-sternum, and spine-hip) may be useful in the diagnosis of tuberculosis in dry bone material.     

Direct beta measurements to determine in vivo whole-body activities of 90Sr in residents of the Southern Urals: description of a new method

For 44 individuals living in areas of the Southern Urals with historical ⁹⁰Sr contamination, whole-body activities of this radionuclide were investigated using a new mobile detection system. β-particles from ⁹⁰Sr/⁹⁰Y decay were measured in vivo via two proportional counters mounted in front of the forehead and above the head, respectively. In order to correct for absorption by the skin, scalp thickness was measured using ultrasonic techniques. Corrections are given with respect to self-absorption by the bone matrix and absorption by hair. A procedure is described to extrapolate from measured ⁹⁰Sr activity of the skull bone to total ⁹⁰Sr skeleton burden. As a result, ⁹⁰Sr whole-body activities of up to 50 kBq were recorded in the selected cohort. For the same individuals, ⁹⁰Sr was measured via the detection of bremsstrahlung using an established whole-body counting device. The overall results of both systems agree within 15%, but differences exceeding a factor of 2 were observed in some cases.     

Childhood lead exposure in an enslaved African community in Barbados: Implications for birthplace and health status

Lead was ubiquitous on Caribbean sugar plantations, where it was used extensively in the production of sugar and rum. Previous studies suggest that skeletal lead contents can be used to identify African‐born individuals (as opposed to Creoles) among slave burials found in the New World. To test this hypothesis, we measured lead concentrations in enamel samples from 26 individuals from the Newton Plantation cemetery in Barbados, which was in use from around 1660 to 1820, and compared the results with enamel ⁸⁷Sr/⁸⁶Sr measurements that had been previously obtained for the same population. Results show a clear association between low (i.e., below 1 ppm) enamel lead concentrations and higher enamel ⁸⁷Sr/⁸⁶Sr ratios which have previously been interpreted as being indicative of African birth, suggesting that individuals with low enamel lead levels were indeed born in Africa as opposed to the New World. Based on these results, we propose that enamel lead measurements provide an effective and inexpensive way to determine African birth from skeletal remains. Furthermore, the lead measurements can provide useful insights into the health status and childhood environment of enslaved Africans during the colonial period. Am J Phys Anthropol, 2013. © 2012 Wiley Periodicals, Inc.     

Neurologic Complications of Paget Disease of Bone

ObjectiveTo review the epidemiology, evaluation, and management of the neurologic complications associated with Paget disease of bone (PDB).MethodsWe reviewed the English-language medical literature using MEDLINE data sources from 1950 to August 2008 and manually searched cross-references from original articles and reviews. Search terms included “Paget* disease of bone” and “neurologic* complications,” “cranial nerve,” “spinal cord,” or “peripheral nerve.”ResultsSeveral neurologic problems in the central and peripheral nervous systems may complicate PDB. Up to 76% of patients may have some form of neurologic involvement. Neurologic complications can occur in patients with a long history of PDB as well as in patients with previously unrecognized disease. The primary mechanisms of nerve damage in PDB involving the spine are ischemic myelitis and compression due to bone hypertrophy. Evaluation includes determining the serum alkaline phosphatase level and imaging by radiography, bone scintigraphy, computed tomographic scanning, and, for lesions of the central nervous system, magnetic resonance imaging. If a soft-tissue mass is found, biopsy should be considered to exclude the presence of sarcoma. Treatment strategies include calcium, vitamin D, bisphosphonates, and possibly surgical intervention for refractory cases.ConclusionNeurologic sequelae of PDB may be underappreciated. Despite the paucity of data guiding treatment, zoledronic acid is a reasonable first-line therapy. Lack of response to treatment or relapse should prompt diagnostic reevaluation with a heightened suspicion for tumor. (Endocr Pract. 2009;15:158-166)     

Influence of human biokinetics of strontium on internal ingestion dose of <Superscript>90</Superscript>Sr and absorbed dose of <Superscript>89</Superscript>Sr to organs and metastases

The objective of the present work is to apply the plasma clearance parameters to strontium, previously determined in our laboratory, to improve the biokinetic and dosimetric models of strontium-90 (⁹⁰Sr) used in radiological protection; and also to apply this data for the estimation of the radiation doses from strontium-89 (⁸⁹Sr) after administration to patients for the treatment of the painful bone metastases. Plasma clearance and urinary excretion of stable strontium tracers of strontium-84 (⁸⁴Sr) and strontium-86 (⁸⁶Sr) were measured in GSF-National Research Center for Environment and Health (GSF) in 13 healthy German adult subjects after intravenous injection and oral administration. The biological half-life of strontium in plasma was evaluated from 49 plasma concentration data sets following intravenous injections. This value was used to determine the transfer rates from plasma to other organs and tissues. At the same time, the long-term retention of strontium in soft tissue and whole body was constrained to be consistent with measured values available. A physiological urinary path was integrated into the biokinetic model of strontium. Parameters were estimated using our own measured urinary excretion values. Retention and excretion of strontium were modeled using compartmental transfer rates published by the International Commission on Radiological Protection (ICRP), the SENES Oak Ridge Inc. (SENES), and the Urals Research Center for Radiation Medicine (TBM). The results were compared with values calculated by applying our GSF parameters (GSF). For the dose estimation of ⁸⁹Sr, a bone metastases model (GSF-M) was developed by adding a compartment, representing the metastases, into the strontium biokinetic model. The related parameters were evaluated based on measured data available in the literature. A set of biokinetic parameters was optimized to represent not only the early plasma kinetics of strontium but also the long-term retention measured in soft tissue and whole body. The ingestion dose coefficients of ⁹⁰Sr were computed and compared with different biokinetic model parameters. The ingestion dose coefficients were calculated as 2.8 × 10⁻⁸, 2.1 × 10⁻⁸, 2.5 × 10⁻⁸ and 3.8 × 10⁻⁸ Sv Bq⁻¹ for ICRP, SENES, TBM and GSF model parameters, respectively. Moreover, organ absorbed dose for the radiopharmaceutical of ⁸⁹Sr in bone metastases therapy was estimated based on the GSF and ICRP biokinetic model parameters. The effective doses were 3.3, 1.8 and 1.2 mSv MBq⁻¹ by GSF, GSF-M, and ICRP Publication 67 model parameters, respectively, compared to the value of 3.1 mSv MBq⁻¹ reported by ICRP Publication 80. The absorbed doses of red bone marrow and bone surface, 17 and 21 mGy MBq⁻¹ calculated by GSF parameters, and 7.1 and 8.8 mGy MBq⁻¹ by GSF-M parameters, are comparable to the clinical results of 3–19 mGy MBq⁻¹ for bone marrow and 16 mGy MBq⁻¹ for bone surface. Based on the GSF-M model, the absorbed dose of ⁸⁹Sr to metastases was estimated to be 434 mGy MBq⁻¹. The strontium clearance half-life of 0.25 h from the plasma obtained in the present study is obviously faster than the value of 1.1 h recommended by ICRP. There are no significant changes for ingestion dose coefficients of ⁹⁰Sr using different model parameters. A model including the metastases was particularly developed for dose estimation of ⁸⁹Sr treatment for the pain of bone metastases.