Radionuclides
In the present study, the uncertainties of dose coefficients were calculated for ingestion of the cerium isotopes 141Ce [\(T_{1/2} =\) 32.5 days, \(\beta_{{{\text{av}}}}^{ - } =\) 129 keV (70%), \(\beta_{{{\text{av}}}}^{ - } =\) 180 keV (30%), \(\gamma =\) 145 keV (48%)], and 144Ce [\(T_{1/2} =\) 284.9 days, \(\beta_{{{\text{av}}}}^{ - } =\) 50 keV (19.2%), \(\beta_{{{\text{av}}}}^{ - } =\) 66 keV (3.9%), \(\beta_{{{\text{av}}}}^{ - } =\) 91 keV (76.9%), \(\gamma\) = 41 keV (0.32%), 80 keV (1.4%), 134 keV (10.83%)]. The percentages in parentheses show the number of electrons and photons emitted per 100 disintegrations.
Computation of organ and effective dose coefficients
Internal doses have been calculated following approach dosimetry published by the ICRP (2007, 2015).
$$ H\left( {r_{{\text{T}}} ,\tau } \right) = \mathop \sum \limits_{i} \mathop \sum \limits_{{r_{{\text{S}}} }} \tilde{A}\left( {r_{{\text{S}}} ,\tau } \right)S_{{\text{w}}} \left( {r_{{\text{T}}} \leftarrow r_{{\text{S}}} } \right)_{i} , $$
(1)
where \(\tilde{A}\left( {r_{{\text{S}}} ,\tau } \right)\) is the time-integrated activity (or total number of nuclear transformations) in a source organ or region \(r_{{\text{S}}}\) over the integration period \(\tau\), \(\tau\) is commonly taken to be 50 years, and \(S\left( {r_{{\text{T}}} \leftarrow r_{{\text{S}}} } \right)\) is the radionuclide-specific quantity representing the mean weighted equivalent dose in target tissue \(r_{{\text{T}}}\) due to nuclear transformations of radioisotope \(i\) in source region \(r_{{\text{S}}}\), the so-called S value.
Normalization to a unit administered activity \(A_{0}\) provides equivalent dose coefficients \(h\left( {r_{{\text{T}}} ,\tau } \right)\) in target tissue \(r_{{\text{T}}}\).
The effective dose coefficient \(e\left( \tau \right)\) for a reference person can be calculated, as defined by ICRP (2007, 2015), as a weighted sum of tissue-equivalent dose of the reference male and female according to the following formula:
$$ e\left( \tau \right) = \mathop \sum \limits_{T} w_{{\text{T}}} \left[ {\frac{{h\left( {r_{{\text{T}}} ,\tau } \right)^{{{\text{Male}}}} + h\left( {r_{{\text{T}}} ,\tau } \right)^{{{\text{Female}}}} }}{2}} \right], $$
(2)
where \(w_{{\text{T}}}\) is the tissue-weighting factor for the target tissue \(r_{{\text{T}}}\), and \(h\left( {r_{{\text{T}}} ,\tau } \right)^{{{\text{Male}}}}\) and \(h\left( {r_{{\text{T}}} ,\tau } \right)^{{{\text{Female}}}}\) are the equivalent dose coefficients for the male and female, respectively.
In the present study five voxel phantoms representing individuals, one male and four females, were previously constructed at Helmholtz Zentrum München, Germany (Petoussi-Henss et al. 2002; Becker et al. 2008; Zankl 2010), were considered (Fig. 1). Furthermore, the ICRP reference male and female phantoms were also considered. Table 1 shows the characteristics of the used phantoms. The aim of the present work was to estimate the variability of organ and effective dose for different phantoms. Since the effective dose is per definition estimated using both reference male and female phantoms representing the reference person (ICRP 2007), for the present study a “detriment-weighted dose coefficient” was calculated (Eq. 3):
$$ e_{{{\text{DW}}}} \left( \tau \right) = \mathop \sum \limits_{T} w_{{\text{T}}} h\left( {r_{{\text{T}}} ,\tau } \right)^{{{\text{Male}}/{\text{Female}}}} . $$
(3)
Table 1 Phantom characteristics Due to the sampling method used in the present study, the detriment-weighted dose coefficient was calculated here by using \(h\left( {r_{{\text{T}}} ,\tau } \right)^{{{\text{Male}}/{\text{Female}}}}\)—the equivalent dose coefficients for a randomized mixture for male and female.
Nevertheless, the tissue-weighting factors \(w_{{\text{T}}}\) for sex-specific organs were used.
Computation of S values
The S values \(S\left( {r_{{\text{T}}} \leftarrow r_{{\text{S}}} } \right)\), which express the dose to the target organ \(r_{{\text{T}}}\), per unit accumulated activity of a particular radionuclide in source organ \(r_{{\text{S}}}\), were calculated using an in house software package based on SAFs pre-calculated SAFs using various voxel phantoms. In contrast to other software packages that utilize a single adult male and a single adult female stylized phantom of reference size, the HMGU software employs the HMGU’s library of pre-calculated SAF values for photons and electrons, based on several anthropomorphic adult phantoms of reference and non-reference size (Virtual Human Database) as well as on the ICRP SAF values of Publication 133 (ICRP 2016). For any radionuclide, the software uses gamma-ray energies and detailed beta spectra as given in the electronic nuclear database accompanying ICRP Publication 107 (ICRP 2008).
The S value can be calculated according to the following formula:
$$ S_{{\text{w}}} \left( {r_{{\text{T}}} \leftarrow r_{{\text{S}}} } \right) = \mathop \sum \limits_{R} w_{R} \mathop \sum \limits_{i} E_{i} Y_{i} \frac{{\phi \left( {r_{{\text{T}}} \leftarrow r_{{\text{S}}} ,E_{i} } \right)}}{{M\left( {r_{{\text{T}}} } \right)}}, $$
(4)
where \(w_{{\text{R}}}\) is the radiation-weighting factor, \(E_{i}\) is the mean energy of radiation type \(i\), \(Y_{i}\) is the yield of radiation type \(i\) per nuclear transformation, \(\phi \left( {r_{{\text{T}}} \leftarrow r_{{\text{S}}} ,E_{i} } \right)\) is the so-called absorbed fraction (AF), the fraction of energy emitted in the source tissue \(r_{{\text{S}}}\) that is absorbed in the target tissue \(r_{{\text{T}}}\), and \(M\left( {r_{{\text{T}}} } \right)\) is the mass of the target tissue. Specific absorbed fraction \(\Phi \left( {r_{{\text{T}}} \leftarrow r_{{\text{S}}} ,E_{i} } \right)\) is defined as absorbed fraction per unit mass and is averaged over the entire volume of the target organ (acronym SAF).
Calculations of SAFs were performed using the Monte Carlo radiation transport code EGSnrc (Kawrakow et al. 2009), to follow photon or electron particle histories originating in a source tissue \(r_{{\text{S}}}\). The interaction processes of particles in the phantoms considered in the Monte Carlo simulation were photoelectric absorption, Compton scattering and pair production. For all phantoms, SAFs for photons were calculated. For electrons, SAFs obtained with Monte Carlo methods were considered for the following phantoms: ICRP reference male, ICRP reference female, Visible Human, and Katja.
Photon transport was terminated when the photon energy was below 2 keV. The secondary electrons generated by the interaction between the primary photons and target tissues were transported until their kinetic energy was below 20 keV.
Since the tiny bone marrow cavities cannot be resolved by the voxel dimensions used in the voxel phantoms, an indirect method of bone dosimetry had to be applied. Bone voxels are assumed to consist of a mixture of red and yellow bone marrow and trabecular mineral bone. The amount of energy deposited in a bone voxel during a photon interaction event is then partitioned to the individual bone components according to their mass proportions and mass energy-absorption coefficients (for the photon energy before the interaction). For active (red) bone marrow and bone endosteum, additional correction factors are applied which account for the extra photo-electrons produced in the bone trabeculae that enter the marrow cavities. These correction factors differ between the various bone groups. Details of the method of bone marrow and endosteum dosimetry depended on the phantom. For the ICRP reference adult male and female phantom as well as for the Katja phantom, the relative red bone marrow content and marrow cellularity (i.e., the fraction of marrow that is still haematopoietically active) of different bone groups (ICRP 1995) were considered, and the dose enhancement factors from Johnson et al. (2011) were used. For the other phantoms (Donna, Helga, Irene and Visible Human), the marrow fraction of each bone voxel was estimated from the original CT number, an equal fraction of red and yellow marrow was assumed, and dose enhancement factors from King and Spiers (1985) were used.
For all other electron SAFs, the following approximations were used (ICRP 1979):
$$ \Phi \left( {r_{{\text{T}}} \leftarrow r_{{\text{S}}} } \right) = \left\{ {\begin{array}{*{20}l} {1/M_{{\text{T}}} \quad {\text{for}}\,r_{{\text{T}}} = r_{{\text{S}}} } \\ {0\quad {\text{for}}\,r_{{\text{T}}} \ne r_{{\text{S}}} } \\ {0.5/M_{{\text{c}}} \quad {\text{for}}\,r_{{\text{T}}} = {\text{wall}},\,r_{{\text{S}}} = {\text{content}}} \\ {1/M_{{{\text{TB}}}} \quad {\text{for}}\,r_{{\text{s}}} = {\text{Totalbody,}}} \\ \end{array} } \right. $$
(5)
where \(M_{{\text{c}}}\) is the mass of the contents of a walled organ, \({\text{TB}}\) is the total body, and \(M_{{\text{T}}}\) and \(M_{{{\text{TB}}}}\) are the masses of the target region and the total body, respectively.
As shown in the Fig. 1 and Table 1 the coverage of the phantoms was not the same. Also, some organs of Donna, Helga, Irene and visible human like breast, salivary glands, endosteum, heart wall, lymphatic nodes and oral mucosa have not been segmented and were therefore represented by ‘surrogate’ organs that have approximately the same anatomical position and size (Table 2).
As expected, the different organ topology, organ shape, and size in the anthropomorphic phantoms cause differences in the calculated SAF values. But also differences between the dosimetric methods—electron approximation, full or partial body coverage, surrogate regions, differences on skeletal dosimetry (Zankl et al. 2012; ICRP 2016)—can result in large deviations of SAF values for some source-target pairs. The comparison of the uncertainties of the biokinetic and dosimetric parameters could lead to the impression that the contribution of the SAFs to the uncertainty of the dose coefficients is much higher than that of the biokinetic parameters. To exclude the contribution to the uncertainties from the differences in the dosimetric methods mentioned above, calculations with three phantoms (ICRP reference male and female (ICRP 2009) and Katja (Becker et al. 2008)) were also performed. For these phantoms, the same dosimetric methods were used in determination of the SAF values.
Biokinetic model
The transport of activity in the human body is described by a radionuclide-specific biokinetic model. The compartments of the model, which are the source organs for the activity, are linked to each other by biokinetic parameters. The time-integrated activity in each compartment is calculated by solving a system of ordinary linear differential equations with biokinetic parameters \(k\):
$$ \frac{{{\text{d}}q_{i} \left( t \right)}}{{{\text{d}}t}} = \dot{I}\left( t \right) - \mathop \sum \limits_{j = 0,j \ne i}^{n} k_{ji} q_{i} \left( t \right) - \lambda_{{\text{p}}} q_{i} \left( t \right) + \mathop \sum \limits_{j = 1,j \ne i}^{n} k_{ij} q_{j} \left( t \right), $$
(6)
where \(q_{i} \left( t \right)\left[ {Bq} \right]\) is the activity of the radioactive substance in compartment \(i\) at the time \(t\); \(\dot{I}\left( t \right)\left[ {Bq \cdot d^{ - 1} } \right]\) is the rate of input from outside of the system; \(k_{ji} \left[ {d^{ - 1} } \right]\) is the transfer coefficient from compartment \(i\) to \(j\); \(k_{ij} \left[ {d^{ - 1} } \right]\) is the transfer coefficient of substance transferred from \(j\) to \(i\); \(k_{0i}\) is the coefficient of loss rate to outside of the system; and \(\lambda_{{\text{p}}}\) is the radioactive decay constant (Berman 1976;1–14).
The solution of this system of differential equations provides the activity \(q_{i} \left( t \right)\) in each compartment, and the time-integrated activity in a source organ \(\tilde{A} = \int_{0}^{{T_{{\text{D}}} }} q \left( t \right){\text{d}}t\) can be calculated. The dose-integration period \(T_{{\text{D}}}\) is typically taken to be 50 years.
The compartment model that describes the behavior of lanthanides in the human body and its corresponding model parameters \(k\) have been reported by Taylor et al. (1998, 2003). Based on these publications the biokinetic model of 141Ce was created (Fig. 2). In the present study only ingestion of radionuclides was considered. For this reason, the model was extended to include the esophagus as a compartment. By solving the system of ordinary linear differential equations (Eq. 6) the time-integrated activity \(\tilde{A}\) in each compartment was calculated.
Because of many unstable daughter nuclides, the biokinetic model of 144Ce is more complicated than that of 141Ce. For the daughter nuclides 144mPr and 144Pr the biokinetic models have also to be defined and linked by the physical decay constant \(\lambda_{{\text{p}}}\). Because the biokinetic behavior of the light lanthanides Lanthanum, Cerium and Praseodymium is sufficiently similar (Taylor and Leggett 1998, 2003), they can be described by the same compartment model and parameter values. Because of the very long half-life of 144Nd (t1/2 = 2.29 × 1015 year) in the decay chain of 144Ce, the 144Nd was considered as stable.
Determination of uncertainty of biokinetic parameters
The determination of the uncertainties of the dose coefficients was carried out numerically. It was assumed that biokinetic and dosimetric parameters are statistical values with the normal or lognormal distribution. Solutions of models with parameters sampled from the according distributions have been inserted in Eq. 1.
For a sampling of the biokinetic parameters, the Latin hypercube sampling method (LHS) (Iman and Shortencarier 1984) was used. To generate the samples this technique requires minimum and maximum values and the type of distribution of the parameters. For \(n\) samples, LHS divides the range between the minimum and maximum values of each parameter into \(n\) intervals on the basis of equal probability. With respect to the probability density in the interval, one value from each interval will be selected randomly. The samples thus obtained for the first parameter were paired in a random manner with the samples of the second parameter, then with the third parameter and so forth until \(n\) \(m\)-tuples can be formed. This results in a \(n \times m\) matrix of input in which the \(i\)th row contains values of each of the \(m\) input variables to be used on the \(i\)th run (\(n\) runs) of the computer model.
The biokinetic parameters (i.e. transfer coefficients) \(k_{ij}\) (per day) can be related to the half-time \(T_{j}\) of removal from the compartment \(j\) according to the following formula:
$$ k_{ij} = \frac{\ln 2}{{T_{j} }}F_{ij} , $$
(7)
where \(F_{ij}\) is the deposition fraction of activity in compartment \(i\) transferred from compartment \(j\). The variables \(k_{ij}\), \(T_{j}\) and \(F_{ij}\) can be found in various publications (Taylor and Leggett 1998, 2003; ICRP 2006).
The distribution of the biokinetic parameters is unknown. The assumption that they are, as other physiological parameters, log-normally distributed, is not verifiable. Studies on the influence of the distributions of the biokinetic parameters on calculated radiation doses have shown that models whose parameters follow different distribution functions do not provide substantially different results (Klein 2011).
In the present study, it was assumed that these variables are normally distributed statistical values. For the biokinetic parameters for which there was insufficient information on how to base an estimate of the uncertainty, a coefficient of variation \(c_{{\text{v}}}\) of 20% was assumed. For a confidence interval of 95%, the coefficient of variance of 20% corresponds to a coverage probability of more than 99.2% (Sappakitkamjorn and Niwitpong 2013). The standard deviation \(\sigma\) was calculated for all statistical values according to Eq. 8:
$$ c_{{\text{v}}} = \frac{\sigma }{\mu }, $$
(8)
where \(\mu\) is the mean value.
By calculating \(\sigma\) values for the variables \(T_{i}\), \(F_{ij}\) and \({\text{DF}}_{ij}\) and with the propagation of uncertainty, the standard deviation for \(k\) was further estimated.
Based on a normal distribution and a confidence interval of 95%, the minimum and maximum values (97.5th and 2.5th percentiles of the normal distribution) of the model parameters \(k\) for the Latin hypercube sampling were estimated to be (Eqs. 9 and 10):
$$ {\text{Minimum}} = \mu - 1.96\sigma , $$
(9)
$$ {\text{Maximum}} = \mu + 1.96\sigma . $$
(10)
Determination of uncertainty of S values
As described above, tables of S values were created for 141Ce, 144Ce, 144mPr and 144Pr, and the seven voxel phantoms used in the present study. For each source-target pair of organs, up to seven S values were generated (a couple of organs were not available in all phantoms, therefore not for every organ pair S values could be evaluated).
First it was assumed that these S values are normally distributed. The corresponding mean value and standard deviation for this distribution were calculated. Based on the confidence interval of 95%, the minimum and maximum values were determined according to Eqs. 9 and 10.
For those organ pairs for which this method would introduce negative S values, a log-normal S value distribution was assumed. The geometric mean value \(\mu^{*}\) and the geometric standard deviation \(\sigma^{*}\) were determined and the minimum and maximum values (97.5th and 2.5th percentiles of the log-normal distribution) were recalculated according to Eqs. 11 and 12:
$$ {\text{Minimum}} = \mu^{*} \div \left( {\sigma^{*} } \right)^{1.96} , $$
(11)
$$ {\text{Maximum}} = \mu^{*} \times \left( {\sigma^{*} } \right)^{1.96} . $$
(12)
Determination of uncertainty of dose coefficients
Based on the Rosenbrock method (Rosenbrock 1963) for solving a system of stiff ordinary differential equations, a computer code called UnDose, written in C#, was developed for the present work, for calculating the uncertainty of the dose coefficients for 141Ce and 144Ce according to Eqs. 1 and 3.
Five hundred sample values of the biokinetic and dosimetric parameters generated with the LHS method were used as input for the software. As output, 500 samples of activity \(q_{i} \left( t \right)\) (Eq. 6) and time-integrated activities \(\tilde{A}\) (Eq. 1) in each compartment and 500 samples of distribution of equivalent (Eq. 1) and detriment weighted dose (Eq. 3) coefficients were calculated. These values reflect the uncertainty of the dose coefficients and can be used for calculating any statistical values—mean values, standard deviations, percentiles, etc.
To quantify the uncertainty of dose coefficients the uncertainty factor UF (Leggett 2001; Li et al. 2011, 2015; Puncher 2014) was used. The uncertainty-associated quantity can be expressed in terms of lower and upper bounds, A and B, respectively. The UF for a confidence interval of 95% is defined as the square root of the ratio between 97.5th (B) and 2.5th (A) percentiles.