In Vivo Neutron Activation Analysis Research Articles

Sensitivity improvement of a deuterium-deuterium neutron generator based in vivo neutron activation analysis (IVNAA) system.

Our lab has been developing a deuterium-deuterium (DD) neutron generator-based neutron activation analysis (NAA) system to quantify metals and elements in the human body in vivo. The system has been used to quantify metals such as manganese, aluminum, sodium in bones of a living human. The technology provides a useful way to assess metal exposure and to estimate elemental deposition, storage and biokinetics. It has great potential to be applied in the occupational and environmental health fields to study the association of metal exposure and various health outcomes, as well as in the nutrition field to study the intake of essential elements and human health. However, the relatively low sensitivity of the system has greatly limited its applications. Neutron moderation plays an important role in designing an IVNAA facility, as it affects thermal neutron flux in irradiation cave and radiation exposure to the human subject. This study aims to develop a novel thermal neutron enhancement method to improve the sensitivity of the in vivo neutron activation analysis (IVNAA) system for elemental measurement but still maintain radiation dose. Utilizing a compact DD neutron source, we propose a new and practical moderator design that combines high density polyethylene with heavy water to enhance thermal neutrons by reducing thermal neutron absorption. All material dimensions are calculated by PHITS, a general-purpose Monte Carlo simulation program. The improvement of the new design predicted by the Monte Carlo simulation for the quantification of one of the elements, manganese was verified by experimental irradiation of manganese-doped bone equivalent phantoms. For the same radiation dose, a 67.9% thermal neutron flux enhancement is reached. With only 4.2% increase of radiation dose, the simulated thermal neutron flux and activation can be further increased by 84.2%. A 100% thermal neutron enhancement ratio is also achievable with a 20% dose increase. The experimental results clearly show higher manganese activation gamma ray counts for each specific phantom, with a significantly reduced minimum detection limit. Additionally, the photon dose was suppressed. The thermal neutron enhancement method can increase the number of useful neutrons significantly but maintain the radiation dose. This greatly decreased the detection limit of the system for elemental quantification at an acceptable dose, which will broadly expand the application of the technology in research and clinical use. The method can also be applied to other neutron medical applications, including neutron imaging and radiotherapy.

BONE ALUMINUM AS A BIOLOGICAL MONITORING OF OCCUPATIONAL EXPOSURE TO ALUMINUM

ABSTRACTThe current proposed biological monitoring of aluminum is based on the analysis of aluminum concentration in blood/serum or in urine, but both considered to be reflective of short-term exposure. Based on its toxic kinetics, aluminum has been demonstrated to be accumulated in the bone. The aim of this study is to find out whether by analyzing bone aluminum, we might have an overview of aluminum accumulation that might cause health problems in the future. This review was conducted through a method of search and selection of articles from Pubmed, Cochrane Library, and Google Scholar databases aimed to answer question rising from the problem statement of this study. The process of searching articles used the keywords “occupational aluminum” OR “bone aluminum” AND “biological monitoring” OR “biomonitoring”. The selection of articles was performed using the defined inclusion and exclusion criteria. Initially, 61 articles were obtained, but after the selection process and hand searching, four articles remained consisting of two case reports and two cross sectional studies. Based on the selected evidence-based resources, bone can be a promising potential biomarker of aluminum, especially for cumulative exposure assessment. The use of in vivo neutron activation analysis (IVNAA) or X-ray fluorescence (XRF) technology for the purpose of noninvasively quantifying aluminum concentration in the bone, is suitable enough to be performed in occupational settings. Keywords: Bone aluminum, occupational exposure, IVNAA, XRF, biomonitoring, biological monitoring

Characterization of bone aluminum, a potential biomarker of cumulative exposure, within an occupational population from Zunyi, China

ObjectivesAluminum (Al) is a neurotoxicant; however, efforts to understand Al toxicity are limited by the lack of a quantitative biomarker of cumulative exposure. Bone Al measurements may address this need. Here, we describe and compare non-invasive bone Al measurements with fingernail Al and Al cumulative exposure indices (CEIs). MethodsWe completed a cross-sectional study of 43 factory workers in Zunyi, China. Bone Al measurements were taken with a compact in-vivo neutron activation analysis system (IVNAA). Fingernail samples were analyzed using inductively coupled plasma mass spectrometry. CEIs, based on self-reported work history and prior literature, were calculated for the prior 5, 10, 15, 20 years and lifetime work history. Linear regressions adjusted for age and education compared fingernail Al and Al CEIs with bone Al. ResultsMedian (interquartile range (IQR)) Al measurements were: 15 μg/g dry bone (IQR = 28) for bone Al; 34.9 μg/g (43.3) for fingernail; and 24 (20) for lifetime CEI. In adjusted regression models, an increase in 15-year CEI was significantly associated with increased bone Al (β = 0.91, 95% confidence interval (CI): 0.16, 1.66). Associations of bone Al with 10- and 20-year CEI were approaching statistical significance (β = 0.98, 95% CI: -0.14, 2.1; β = 0.59, 95% CI: -0.01, 1.18, respectively). Other models were not statistically significant. ConclusionsBone Al was significantly associated with 15-year Al CEI, but not other Al CEIs or fingernail Al. Bone Al may be a useful measure of cumulative, rather than short-term, Al exposure. Additional refinement of this method is ongoing.

Determination of bone sodium (Na) and Na exchange in pig leg using in vivo neutron activation analysis (IVNAA)

Objective: The locations of sodium (Na) storage and its exchange mechanisms in the body are not well known. Understanding tissue Na storage and exchange is important for understanding the impact of Na intake, absorption, and retention on human health, especially on the risk of developing chronic diseases. The purpose of this study was to investigate the application of a deuterium–deuterium (DD) neutron generator-based IVNAA system in Na nutrition studies. Approach: The right legs of two live pigs, one on a low Na diet and one on a high Na diet, both for 14 d, were irradiated inside a customized irradiation cave for 10 min (45 mSv dose to the leg) and then measured with a 100% efficient high purity germanium detector (HPGe). The spectra were analyzed to obtain the net Na counts at different time points. Bone Na concentrations were calculated using the calibration created with Na bone phantoms. Main results: The results show that the difference in bone Na to calcium between the pigs on high versus low Na diets was 466 ± 137 ppm. The estimated bone Na to calcium concentrations were 1166 ± 80 and 1631 ± 111 ppm for low and high Na diet pigs, respectively. Analysis also shows rapid exchange of Na in the leg during the first 2 h measurements, while the exchange was minimal at the second and third 2 h measurements, taken 7 and 21 h post irradiation. The exchange decay time of Na in the leg was 51 min for the first measurement, and there was no significant change of Na activities between 2–21 h. Significance: With these results, we conclude there is a non or low exchangeable compartment (likely to be bone) for Na storage and that DD neutron generator-based IVNAA is a useful method for determining tissue Na distribution in nutrition studies.

The association of bone, fingernail and blood manganese with cognitive and olfactory function in Chinese workers

Occupational manganese (Mn) exposure has been associated with cognitive and olfactory dysfunction; however, few studies have incorporated cumulative biomarkers of Mn exposure such as bone Mn (BnMn). Our goal was to assess the cross-sectional association between BnMn, blood Mn (BMn), and fingernail Mn (FMn) with cognitive and olfactory function among Mn-exposed workers. A transportable in vivo neutron activation analysis (IVNAA) system was designed and utilized to assess BnMn among 60 Chinese workers. BMn and FMn were measured using inductively coupled plasma mass spectrometry. Cognitive and olfactory function was assessed using Animal and Fruit Naming tests, World Health Organization/University of California-Los Angeles Auditory Verbal Learning Test (AVLT) and the University of Pennsylvania Smell Identification Test (UPSIT). Additional data were obtained via questionnaire. Regression models adjusted for age, education, factory of employment, and smoking status (UPSIT only), were used to assess the relationship between Mn biomarkers and test scores. In adjusted models, increasing BnMn was significantly associated with decreased performance on average AVLT scores [β (95% confidence interval (CI)) = −0.65 (−1.21, −0.09)] and Animal Naming scores [β (95% CI) = −1.54 (−3.00, −0.07)]. Increasing FMn was significantly associated with reduced performance measured by the average AVLT [β (95% CI) = −0.35 (−0.70, −0.006)] and the difference in AVLT scores [β (95% CI) = −0.40 (−0.77, −0.03)]. BMn was not significantly associated with any test scores; no significant associations were observed with Fruit Naming or UPSIT tests. BnMn and FMn, but not BMn, are associated with cognitive function in Mn-exposed workers. None of the biomarkers were significantly associated with olfactory function.

Relationship Between Total Body Protein and Cross‐Sectional Skeletal Muscle Area in Liver Cirrhosis Is Influenced by Overhydration

Sarcopenia as defined by reduced skeletal muscle area (SMA) on cross-sectional abdominal imaging has been proposed as an objective measure of malnutrition, and it is associated with both wait-list mortality and posttransplant complications in patients with cirrhosis. SMA, however, has never been validated against the gold standard measurement of total body protein (TBP) by in vivo neutron activation analysis (IVNAA). Furthermore, overhydration is common in cirrhosis, and its effect on muscle area measurement remains unknown. We aimed to examine the relationship between SMA and TBP in patients with cirrhosis and to assess the impact of overhydration on this relationship. Patients with cirrhosis who had undergone IVNAA and cross-sectional imaging within 30 days were retrospectively identified. Patients with significant clinical events between measurements were excluded. Psoas muscle area (PMA) and SMA at the level of the third lumbar vertebrae were determined. Total body water was estimated from a multicompartment model and expressed as a fraction of fat-free mass (FFM), as determined by dual-energy X-ray absorptiometry, to provide an index of hydration status. In total, 107 patients underwent 109 cross-sectional imaging studies (87 computed tomography; 22 magnetic resonance imaging) within 30 days of IVNAA. Median time between measurements was 1 day (IQR, -1 to 3 days). Between 43% and 69% of the cohort was identified as sarcopenic, depending on muscle area cutoff values used. TBP was strongly correlated with SMA (r=0.78; P<0.001) and weakly correlated with PMA (r=0.49; P<0.001). Multiple linear regression showed SMA was significantly and positively associated with FFM hydration (P<0.001) independently of TBP. In conclusion, SMA is more closely related to TBP than is PMA, and it should be preferred as a measure of sarcopenia. Overhydration significantly affects the measurement of cross-sectional muscle area.

Compact DD generator-based in vivo neutron activation analysis (IVNAA) system to determine sodium concentrations in human bone

Objective: This study presents the development of a noninvasive method for monitoring Na in human bone. Many diseases, such as hypertension and osteoporosis, are closely associated with sodium (Na) retention in the human body. Na retention is generally evaluated by calculating the difference between dietary intake and excretion. There is currently no method to directly quantify Na retained in the body. Bone is a storage for many elements, including Na, which renders bone Na an ideal biomarker to study Na metabolism and retention. Approach: A customized compact deuterium–deuterium (DD) neutron generator was used to produce neutrons for in vivo neutron activation analysis (IVNAA), with a moderator/reflector/shielding assembly optimized for human hand irradiation in order to maximize the thermal neutron flux inside the irradiation cave and to limit radiation exposure to the hand and the whole body. Main results: The experimental results show that the system is able to detect sodium levels in the bone as low as 16 µg Na g−1 dry bone with an effective dose to the body of about 27 µSv. The simulation results agree with the numbers estimated from the experiment. Significance: This is expected to be a feasible method for measuring the change of Na in bone. The low detection limit indicates this will be a useful system to study the association between Na retention and related diseases.

In vivo neutron activation analysis of bone manganese in workers

Objective: Manganese (Mn) is a neurotoxin. However, the impact of elevated, chronic Mn exposure is not well understood, partially due to the lack of a cumulative exposure biomarker. To address this gap, our group developed a compact in vivo neutron activation analysis (IVNAA) system to quantify Mn concentration in bone (MnBn). Approach: In this study, we used this system and determined MnBn among male Chinese workers and compared results to their blood Mn (MnB), a measure of recent exposure, and the years of employment, a measure of cumulative exposure. A cross-sectional study was conducted with 30 ferroalloy smelters (exposed) and 30 general manufacturing workers (controls). MnBn was assessed using IVNAA, MnB was measured with inductively coupled plasma mass spectrometry, and occupational history and demographics were obtained via questionnaire. Mn-doped phantoms were used to generate a calibration curve; spectra from these phantoms were consistent with in vivo spectra. Main results: The median (interquartile range (IQR)) values for Mn biomarkers were 2.7 µg g−1 (7.2) for MnBn and 14.1 µg l−1 (4.0) for MnB. In regression models adjusted for age and education, the natural log transformed MnBn (ln(MnBn)) was significantly associated with the exposed/control status (β = 0.44, p = 0.047) and years of employment (β = 0.05, p = 0.002), but not with natural log transformed MnB (ln(MnB)) (β = 0.54, p = 0.188). Significance: Our results support the use of IVNAA to quantify MnBn and the use of MnBn as a biomarker of cumulative Mn exposure.

A Dosimetry Study of Deuterium-Deuterium Neutron Generator-based In Vivo Neutron Activation Analysis.

A neutron irradiation cavity for in vivo neutron activation analysis (IVNAA) to detect manganese, aluminum, and other potentially toxic elements in human hand bone has been designed and its dosimetric specifications measured. The neutron source is a customized deuterium-deuterium neutron generator that produces neutrons at 2.45 MeV by the fusion reaction 2H(d, n)3He at a calculated flux of 7 × 10(8) ± 30% s(-1). A moderator/reflector/shielding [5 cm high density polyethylene (HDPE), 5.3 cm graphite and 5.7 cm borated (HDPE)] assembly has been designed and built to maximize the thermal neutron flux inside the hand irradiation cavity and to reduce the extremity dose and effective dose to the human subject. Lead sheets are used to attenuate bremsstrahlung x rays and activation gammas. A Monte Carlo simulation (MCNP6) was used to model the system and calculate extremity dose. The extremity dose was measured with neutron and photon sensitive film badges and Fuji electronic pocket dosimeters (EPD). The neutron ambient dose outside the shielding was measured by Fuji NSN3, and the photon dose was measured by a Bicron MicroREM scintillator. Neutron extremity dose was calculated to be 32.3 mSv using MCNP6 simulations given a 10-min IVNAA measurement of manganese. Measurements by EPD and film badge indicate hand dose to be 31.7 ± 0.8 mSv for neutrons and 4.2 ± 0.2 mSv for photons for 10 min; whole body effective dose was calculated conservatively to be 0.052 mSv. Experimental values closely match values obtained from MCNP6 simulations. These are acceptable doses to apply the technology for a manganese toxicity study in a human population.

Identification of oxygen-19 during in vivo neutron activation analysis of water phantoms

Hand bone equivalent phantoms (250 ml) carrying selenium in various amounts were irradiated and counted for in vivo neutron activation analysis (IVNAA) by employing a 4π NaI(TI) based detection system. During the analysis of counting data, a feature at a higher energy than the gamma ray peak from 77mSe (0.162 MeV) was observed at 0.197 MeV. Further investigations were made by preparing water phantoms containing only de-ionized water in 250 ml and 1034 ml quantities. Neutrons were produced by the 7Li(p,n)7Be reaction using the high beam current Tandetron accelerator. Phantoms were irradiated at a fixed proton energy of 2.3 MeV and proton currents of 400 μA and 550 μA for 30 s and 22 s respectively. The counting data saved using the 4π NaI(TI) detection system for 10 s intervals in anticoincidence, coincidence and singles modes of detection were analyzed. Areas under gamma peaks at energies 0.197 MeV and 1.357 MeV were computed and half-lives from the number of counts for the two peaks were established. It was concluded that during neutron activation of water phantoms, oxygen-18 is activated, producing short-lived radioactive 19O having T1/2 = 26.9 s. Induced activity from 19O may contribute spectral interference in the gamma ray spectrum. This effect may need to be taken into account by researchers while carrying out IVNAA of biological subjects.

Feasibility of measuring selenium in humans using in vivo neutron activation analysis

Selenium (Se) is an element that, in trace quantities, plays an important role in the normal function of a number of biological processes in humans. Many studies have demonstrated that selenium deficiency in the body may contribute to an increased risk for certain neoplastic, cardiovascular, osseous, and nervous system diseases including retardation of bone formation. However, at higher concentrations Se is cytotoxic. For these reasons it is desirable to have a means of monitoring selenium concentration in humans.This paper presents the outcome of a feasibility study carried out for measuring selenium in humans using in vivo neutron activation analysis (IVNAA). In this technique a small dose of neutrons is delivered to the organ of interest, the neutrons are readily captured by the target nuclei, and the γ-rays given off are detected outside of the body. For the present study, human hand (bone) tissue equivalent phantoms were prepared with varying amounts of Se. These were irradiated by a low energy fast neutron beam produced by the 7Li(p,n)7Be reaction employing the high beam current Tandetron accelerator. The counting data saved using a 4π NaI(TI) detection system were analyzed. The selenium was detected via the neutron capture reaction, 76Se(n,γ)77mSe, whereas calcium was detected through the 48Ca(n,γ)49Ca reaction for the purpose of normalization of the Se signals to the calcium signals. From the calibration lines drawn between Se/Ca concentrations and Se/Ca counts ratio, the minimum detection limits (MDLs) were computed for two sets of phantoms irradiated under different irradiation parameters.In this study the optimized MDL value was determined to be 81 ng g−1 (Se/phantom mass) for an equivalent dose of 188 mSv to the phantom. This MDL was found at least 10 times lower than the reported data on Se concentration measured in bone tissues. It was concluded that the NAA technique would be a feasible means of performing in vivo measurements of selenium in humans. Currently the data on in vivo measurement of selenium in humans are limited; the results of the present study would greatly contribute to the present data.

Compact DD generator-based neutron activation analysis (NAA) system to determine fluorine in human bone in vivo: a feasibility study

The subject of whether fluorine (F) is detrimental to human health has been controversial for many years. Much of the discussion focuses on the known benefits and detriments to dental care and problems that F causes in bone structure at high doses. It is therefore advantageous to have the means to monitor F concentrations in the human body as a method to directly assess exposure. F accumulates in the skeleton making bone a useful biomarker to assess long term cumulative exposure to F. This study presents work in the development of a non-invasive method for the monitoring of F in human bone. The work was based on the technique of in vivo neutron activation analysis (IVNAA). A compact deuterium-deuterium (DD) generator was used to produce neutrons. A moderator/reflector/shielding assembly was designed and built for human hand irradiation. The gamma rays emitted through the 19F(n,γ)20F reaction were measured using a HPGe detector. This study was undertaken to (i) find the feasibility of using DD system to determine F in human bone, (ii) estimate the F minimum detection limit (MDL), and (iii) optimize the system using the Monte Carlo N-Particle eXtended (MCNPX) code in order to improve the MDL of the system. The F MDL was found to be 0.54 g experimentally with a neutron flux of 7 × 108 n s−1 and an optimized irradiation, decay, and measurement time scheme. The numbers of F counts from the experiment were found to be close to the (MCNPX) simulation results with the same irradiation and detection parameters. The equivalent dose to the irradiated hand and the effective dose to the whole body were found to be 0.9 mSv and 0.33 μSv, respectively. Based on these results, it is feasible to develop a compact DD generator based IVNAA system to measure bone F in a population with moderate to high F exposure.

Studying the effect of the lung size variation on dosimetry and systematic parameters of FUM-IVNAA facility

The aim of this paper was quantifying the uncertainties of dosimetry parameters and systematic factors of an in vivo neutron activation analysis (IVNAA) facility for neutron-irradiated individuals with different lung sizes. A series of statistical phantoms with adjustable lungs were modeled in IVNAA facility using Monte Carlo MCNP code. Obtained results showed that the fluctuation of the organ-absorbed dose and effective dose due to the lung size variation is negligible (less than 3 %). Also, changing the lung size will not significantly affect the systematic parameters of the facility.

In-Vivo Neutron Activation Analysis for Aluminium in Bone: System Upgrade and Improve Data Analysis

An existing NaI(Tl) multidetector array at McMaster University used for in vivo measurement of aluminum by means of neutron activation has been recently upgraded with an in-house built pulse processing system. The new system is capable of collecting spectra in coincidence and anticoincidence modes which allows for better discrimination between the 1.78 MeV28Al peak and the interfering38Cl peak. The system is interfaced with Matlab and controlled using a custom graphical user interface, which provides periodic spectral data storage during the acquisition. This feature makes it possible to validate the acquired data and the spectral fitting routines through half-life analysis of the radionuclides. A new set of calibration phantoms spanning a narrower range of aluminum concentrations than employed in the previous study, has also been developed. The combined effect of the new improvements resulted in the minimum detectable level of aluminum in aqueous solutions containing Na, Cl, and Ca in physiological levels, equal to approximately 3 µgAl/gCa.

Facility optimization to improve activation rate distributions during IVNAA.

Currently, determination of body composition is the most useful method for distinguishing between certain diseases. The prompt-gamma in vivo neutron activation analysis (IVNAA) facility for non-destructive elemental analysis of the human body is the gold standard method for this type of analysis. In order to obtain accurate measurements using the IVNAA system, the activation probability in the body must be uniform. This can be difficult to achieve, as body shape and body composition affect the rate of activation. The aim of this study was to determine the optimum pre-moderator, in terms of material for attaining uniform activation probability with a CV value of about 10% and changing the collimator role to increase activation rate within the body. Such uniformity was obtained with a high thickness of paraffin pre-moderator, however, because of increasing secondary photon flux received by the detectors it was not an appropriate choice. Our final calculations indicated that using two paraffin slabs with a thickness of 3 cm as a pre-moderator, in the presence of 2 cm Bi on the collimator, achieves a satisfactory distribution of activation rate in the body.

The feasibility of in vivo quantification of bone-fluorine in humans by delayed neutron activation analysis: a pilot study

Fluorine (F) plays an important role in dental health and bone formation. Many studies have shown that excess fluoride (F−) can result in dental or skeletal fluorosis, while other studies have indicated that a proper dosage of fluoride may have a protective effect on bone fracture incidence. Fluorine is stored almost completely in the skeleton making bone an ideal site for measurement to assess long-term exposure. This paper outlines a feasibility study of a technique to measure bone-fluorine non-invasively in the human hand using in vivo neutron activation analysis (IVNAA) via the 19F(n,γ)20F reaction. Irradiations were performed using the Tandetron accelerator at McMaster University. Eight NaI(Tl) detectors arranged in a 4π geometry were employed for delayed counting of the emitted 1.63 MeV gamma ray. The short 11 s half-life of 20F presents a difficult and unique practical challenge in terms of patient irradiation and subsequent detection. We have employed two simultaneous timing methods to determine the fluorine sensitivity by eliminating the interference of the 1.64 MeV gamma ray from the 37Cl(n,γ)38Cl reaction. The timing method consisted of three counting periods: an initial 30 s (sum of three 10 s periods) count period for F, followed by a 120 s decay period, and a subsequent 300 s count period to obtain information pertaining to Ca and Cl. The phantom minimum detectable limit (MDL) determined by this method was 0.96 mg F/g Ca. The MDL was improved by dividing the initial timing period into three equal segments (10 s each) and combining the results using inverse variance weighting. This resulted in a phantom MDL of 0.66 mg F/g Ca. These detection limits are comparable to ex vivo results for various bones in the adult skeleton reported in the literature. Dosimetry was performed for these irradiation conditions. The equivalent dose for each phantom measurement was determined to be 30 mSv. The effective dose was however low, 35 µSv, which is comparable to other clinical diagnostic tools. The MDL, relatively low radiation dose and non-invasiveness indicate the suitability of this method for routine in vivo analysis of bone-fluorine content. This prompted us to perform a trial study in human subjects. A preliminary human study on 34 participants was completed, with 33 of the 34 measurements proving to be successful. The in vivo MDL based on the improved timing method was determined to be 0.69 mg F/g Ca for the 33 successful human measurements. In our opinion, this technique has been demonstrated to be a suitable method for in vivo assessment of fluorine bone-burden.

Bone manganese as a biomarker of manganese exposure: A feasibility study

There is a need for a diagnostic tool with the ability to measure cumulative exposure to manganese (Mn) in the workplace. Measuring bone Mn levels with in vivo neutron activation analysis (IVNAA) could serve as a biomarker of past exposure. Bone Mn levels of welders were measured and compared to the levels found in subjects without exposure to the element. Forty subjects (30 welders and 10 controls) were recruited. An occupational history was obtained and subjects underwent IVNAA bone Mn measurements. The mean bone Mn levels were (2.9 +/- 0.4) and (0.1 +/- 0.7) microg Mn/g Ca for welders and controls, respectively (P < 0.05). This project, the first of its kind, reports differences in bone Mn between Mn-exposed welders and non-occupationally exposed subjects. It appears that bone Mn levels do reflect differences in the occupational exposure of welders.

Body composition changes in female adolescents with anorexia nervosa

Background: Body weight provides limited information about nutritional status of patients with anorexia nervosa (AN).Objectives: Our objectives were to determine body composition (BC) changes, to find clinical predictors and endocrine correlates of total body protein (TBPr) depletion, and to compare results on fat mass (FM) obtained with anthropometry (skinfold measurements) and dual-energy X-ray absorptiometry (DXA) in patients with AN.Design: Body weight, body mass index (BMI; in kg/m2), BC (with DXA and skinfold measurements), and TBPr [with in vivo neutron activation analysis (IVNAA)] was assessed in 50 AN patients (15.2 y) and 40 healthy sex- and age-matched controls. In 47 AN patients and 22 controls, hormone concentrations were measured.Results: In AN patients, body weight (44.4 ± 5.5 kg), BMI (16.7 ± 1.6), and FMDXA (7.0 ± 3.4 kg) were lower than in controls. Lean tissue mass by DXA (LTMDXA) was similar in AN patients and controls (35.7 ± 4.3 compared with 35.8 ± 4.5 kg), but TBPr was 87% of that of controls (8.1 ± 1.0 compared with 9.2 ± 1.2 kg; P < 0.001). Cortisol was high, testosterone was unchanged, and estradiol and insulin-like growth factor I were low. Severe protein depletion measured by IVNAA seen in 17 AN patients could not be identified with simpler methods. All except 1 of 26 AN patients with a BMI > 16.5 had normal TBPr. The difference in individual percentage of body fat measured with DXA and skinfold measurements came up to 9%.Conclusion: The severe protein depletion in 34% of AN patients was not accurately identified by LTMDXA or simpler methods, but a BMI > 16.5 indicated normal TBPr. Future studies need to compare DXA and skinfold measurements with a reference technique to assess FM in AN patients.

In vivo measurement of bone aluminum in population living in southern Ontario, Canada

The harmful biological effect of excessive aluminum (Al) load in humans has been well documented in the literature. Al stored in bone, for instance due to dialysis treatment or occupational exposure, can interfere with normal bone remodeling leading to osteodystrophy, osteoarthritis, or osteomalacia. On the other hand, the relationship between chronic Al exposure and the risk of Alzheimer's disease remains controversial. In this work, the feasibility of in vivo neutron activation analysis (IVNAA) for measuring Al levels in the human hand bone, using the thermal neutron capture reaction 27Al(n, gamma)28 Al, is reported. This noninvasive diagnostic technique employs a high beam current Tandetron accelerator based neutron source, an irradiation/shielding cavity, a 47pi NaI(Tl) detector system, and a new set of hand bone phantoms. The photon spectra of the irradiated phantom closely resemble those collected from the hands of nonexposed healthy subjects. A protocol was developed using the newly developed hand phantoms, which resulted in a minimum detectable limit (MDL) of 0.29 mg Al in the human hand. Using the ratio of Al to Ca as an index of Al levels per unit bone mass, the MDL was determined as 19.5 +/- 1.5 microg Al/g Ca, which is within the range of the measured levels of 20-27 microg Al/g Ca [ICRP Report of the Task Group on Reference Man, Publication 23 (Pergamon, Oxford, 1975)] found in other in vivo and in vitro studies. Following the feasibility studies conducted with phantoms, the diagnostic technique was used to measure Al levels in the hand bones of 20 healthy human subjects. The mean hand bone Al concentration was determined as 27.1 +/- 16.1 (+/-1 SD) microg Al/g Ca. The average standard error (1sigma) in the Al/Ca is 14.0 microg Al/g Ca, which corresponds to an average relative error of 50% in the measured levels of Al/Ca. These results were achieved with a dose equivalent of 17.6 mSv to a hand and an effective dose of 14.4 microSv. This effective dose is approximately half of that received in a chest radiograph examination. It is recommended to investigate the use of the bone Al IVNAA diagnostic technique for in vivo measurements of patients with documented overload of Al in bone.

In vivoassessment of magnesium status in human body using accelerator-based neutron activation measurement of hands: A pilot study

Magnesium (Mg) is an element essential for many enzymatic reactions in the human body. Various human and animal studies suggest that changes in Mg status are linked to diseases such as cardiac arrhythmia, coronary heart disease, hypertension, premenstrual syndrome, and diabetes mellitus. Thus, knowledge of Mg levels in the human body is needed. A direct measurement of human blood serum, which contains only 0.3% of the total body Mg, is generally used to infer information about the status of Mg in the body. However, in many clinical situations, Mg stored in large levels, for example in bones, muscles, and soft tissues, needs to be monitored either to evaluate the efficacy of a treatment or to study the progression of diseases associated with the deficiency of total body Mg. This work presents a feasibility study of a noninvasive, in vivo neutron activation analysis (IVNAA) technique using the 26Mg (n, gamma) 27Mg reaction to measure Mg levels in human hands. The technique employs the McMaster University high beam current Tandetron accelerator hand irradiation facility and an array of eight NaI (T1) detectors arranged in a 4 pi geometry for delayed counting of the 0.844 and 1.014 MeV gamma rays emitted when 27Mg decays in the irradiated hand. Mg determination in humans using IVNAA of hands has been demonstrated to be feasible, with effective doses as low as one-quarter of those delivered in chest x rays. The overall experimental uncertainty in the measurements is estimated to be approximately 5% (1 sigma). The results are found to be in the range of the in vitro measurements reported for other cortical bones collected from different sites of the human skeleton, which confirms that this technique mainly provides a measure of the amount of Mg in hand bones. The average concentration of Mg determined in human hands is 10.96 +/- 1.25 (+/- 1 SD) mg Mg/g Ca. The coefficient of variation (11%) observed in this study is comparable with or lower than several studies using in vitro measurements reported in the literature and therefore allows for a quantitative intersubject comparison, even if to a limited extent. The features of the developed technique such as its simplicity, rapidity, accuracy, robustness, noninvasive nature, and very effective use of radiation doses, present the technique as a viable diagnostic tool available for trial in a clinical environment.