On Sat, 27 Oct 2018 23:37:59 -0400 archer75--- via Mercedes
<mercedes@okiebenz.com> wrote:

> One of the saddest cases of radiation poisoning in the 1930s was
> Thorotrast. It was an oral contrast medium that did a beautiful job of
> outlining and diagnosing the liver. Every single patient to whom it was
> given died; usually after about ten years of misery. Gerry

From https://en.wikipedia.org/wiki/Thorotrast :

Thorotrast is a suspension containing particles of the radioactive
compound thorium dioxide, ThO2, that was used as a radiocontrast agent in
medical radiography in the 1930s and 1940s. Use in some countries, such
as the U.S., continued into the 1950s.

Thorium compounds produce excellent images because of thorium's high
opacity to X-rays (it has a high cross section for absorption). However,
thorium is retained in the body, and it is radioactive, emitting harmful
alpha radiation as it decays. Because the suspension offered high image
quality and had virtually no immediate side-effects compared to the
alternatives available at the time, Thorotrast became widely used after
its introduction in 1931. António Egas Moniz contributed to its
development.[1] About 2 to 10 million patients worldwide have been
treated with Thorotrast. However, today it has shown an increase risk
in certain cancers such as cholangiocarcinomas and angiosarcomas of the
liver.

Safety

Even at the time of introduction, there was concern about the safety of
Thorotrast. Following injection, the drug is distributed to the liver,
spleen, lymph nodes, and bone, where it is absorbed. After this initial
absorption, redistribution takes place at a very slow pace. Specifically,
the biological half-life is estimated to be 22 years.[2] This means that
the organs of patients who have been given Thorotrast will be exposed to
internal alpha radiation for the rest of their lives. The significance of
this long-term exposure was not fully understood at the time of
Thorotrast's introduction in 1931.

Due to the release of alpha particles, Thorotrast was found to be
extremely carcinogenic. There is a high over-incidence of various cancers
in patients who have been treated with Thorotrast. The cancers occur some
years (usually 20-30) after injection of Thorotrast. The risk of
developing liver cancer (or bile duct cancer) in former Thorotrast
patients has been measured to be well above 100 times the risk of the
rest of the population. The risk of leukemia appears to be 20 times
higher in Thorotrast patients.[3] Thorotrast exposure has also been
associated with the development of angiosarcoma. German patients exposed
to Thorotrast had their median life-expectancy shortened by 14 years in
comparison to a similar non-exposed control group.[4]

Thorium is no longer used in X-ray contrast agents. Today, iodinated
hydrophilic (water-soluble) molecules are universally used as injected
contrast agents in X-ray procedures.

The Danish director Nils Malmros's movie, Facing the Truth (original
Danish title At Kende Sandheden) from 2002, portrays the dilemma that
faced Malmros's father, Richard Malmros, when treating his patients in
the 1940s. Richard Malmros was deeply concerned about the persistence of
Thorotrast in the body but was forced to use Thorotrast, because the only
available alternative (per-abrodil) had serious immediate side-effects,
suffered from image quality problems and was difficult to obtain during
the Second World War. The use of Thorotrast in Denmark ended in 1947 when
safer alternatives became available.

Current use

Thorotrast has also been used in research to stain neural tissue samples
for examination by historadiography.[5]

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