Biokinetics and radiation dosimetry of 14C-labelled triolein, urea, glycocholic acid and xylose in man. Studies related to nuclear medicine “breath tests” using accelerator mass spectrometry

University dissertation from Mikael Gunnarsson, Department of Radiation physics, Malmö university hospital, 205 02 Malmö

Abstract: 14C-labelled substances have been used in biomedical research and clinical medicine for over 50 years. Physicians and scientists however, often hesitate to use these substances in patients and volunteers because the radiation dosimetry is unclear. In this work detailed long-term biokinetic and dosimetric estimation have been carried out for four clinically used 14C-breath tests: 14C-triolein (examination of fat malabsorption), urea (detection of Helicobacter pylori infection in the stomach), glycocholic acid and xylose (examination of bacterial overgrowth in the small intestine) by using the highly sensitive accelerator mass-spectrometry (AMS) technique. The AMS technique has been used to measure low 14C concentrations in small samples of exhaled air, urine, faeces and tissue samples and has improved the base for the estimation of the absorbed dose to various organs and tissues and the effective dose to man. The high sensitivity of the AMS system has also made it possible to perform 14C breath tests on patient groups which were earlier subject for restriction (e.g. small children). In summary, our results show that for adult patients - and in the case of 14C-urea breath test also for children down to 3 years of age - the dose contributions are comparatively low, both described as organ doses and as effective doses. For adults, the latter is: 14C-glycocholic acid - 0.4 mSv/MBq, 14C-triolein - 0.3 mSv/MBq, 14C-xylose - 0.1 mSv/MBq and 14C-urea - 0.04 mSv/MBq. Thus, from a radiation protection point of view there is no reason for restrictions in using any of the 14C-labelled radiopharmaceutical included in this work in the activities normally used (0.07-0.2 MBq for a 70 kg patient).

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