Lung dosimetry of thorotrast patients

Deposits of intravascularly injected Thorotrast in the reticulo-endothelial system of Thorotrast patients are a continuous source of 220Rn. In this study, we modeled the transport of 220Rn from these deposits through the body into the lungs, exhalation of 220Rn from the lungs, production of 220Rn progeny in the lungs and their exhalation, and mucociliary clearance of 220Rn progeny deposited on airway surfaces. The injection of 1 mL Thorotrast produces annual doses of 0.48 mGy y-1 to the bronchial epithelium and 0.95 mGy y-1 to pulmonary tissue. Based on a mean injected volume of about 25 mL and an average exposure time of 30 y, German Thorotrast patients received a mean bronchial lifetime dose of 357 mGy. Despite these relatively high doses, comparable to exposure in uranium miners, no excess lung cancers could be observed in the epidemiologic follow-up study. This apparent discrepancy between predicted and observed bronchial tumors may have important implications for lung dosimetry and risk assessment of inhaled 222Rn progeny.