A compact DD neutron generator-based NAA system to quantify manganese (Mn) in bone in vivo

A State-of-the-Science Review on Metal Biomarkers

PURPOSE OF REVIEW

Biomarkers are commonly used in epidemiological studies to assess metals and metalloid exposure and estimate internal dose, as they integrate multiple sources and routes of exposure. Researchers are increasingly using multi-metal panels and innovative statistical methods to understand how exposure to real-world metal mixtures affects human health. Metals have both common and unique sources and routes of exposure, as well as biotransformation and elimination pathways. The development of multi-element analytical technology allows researchers to examine a broad spectrum of metals in their studies; however, their interpretation is complex as they can reflect different windows of exposure and several biomarkers have critical limitations. This review elaborates on more than 500 scientific publications to discuss major sources of exposure, biotransformation and elimination, and biomarkers of exposure and internal dose for 12 metals/metalloids, including 8 non-essential elements (arsenic, barium, cadmium, lead, mercury, nickel, tin, uranium) and 4 essential elements (manganese, molybdenum, selenium, and zinc) commonly used in multi-element analyses.

RECENT FINDINGS

We conclude that not all metal biomarkers are adequate measures of exposure and that understanding the metabolic biotransformation and elimination of metals is key to metal biomarker interpretation. For example, whole blood is a good biomarker of exposure to arsenic, cadmium, lead, mercury, and tin, but it is not a good indicator for barium, nickel, and uranium. For some essential metals, the interpretation of whole blood biomarkers is unclear. Urine is the most commonly used biomarker of exposure across metals but it should not be used to assess lead exposure. Essential metals such as zinc and manganese are tightly regulated by homeostatic processes; thus, elevated levels in urine may reflect body loss and metabolic processes rather than excess exposure. Total urinary arsenic may reflect exposure to both organic and inorganic arsenic, thus, arsenic speciation and adjustment for arsebonetaine are needed in populations with dietary seafood consumption. Hair and nails primarily reflect exposure to organic mercury, except in populations exposed to high levels of inorganic mercury such as in occupational and environmental settings. When selecting biomarkers, it is also critical to consider the exposure window of interest. Most populations are chronically exposed to metals in the low-to-moderate range, yet many biomarkers reflect recent exposures. Toenails are emerging biomarkers in this regard. They are reliable biomarkers of long-term exposure for arsenic, mercury, manganese, and selenium. However, more research is needed to understand the role of nails as a biomarker of exposure to other metals. Similarly, teeth are increasingly used to assess lifelong exposures to several essential and non-essential metals such as lead, including during the prenatal window. As metals epidemiology moves towards embracing a multi-metal/mixtures approach and expanding metal panels to include less commonly studied metals, it is important for researchers to have a strong knowledge base about the metal biomarkers included in their research. This review aims to aid metals researchers in their analysis planning, facilitate sound analytical decision-making, as well as appropriate understanding and interpretation of results.

The association of bone and blood manganese with motor function in Chinese workers

Manganese (Mn) is an essential element. However, Mn overexposure is associated with motor dysfunction. This cross-sectional study assessed the association between bone Mn (BnMn) and whole blood Mn (BMn) with motor function in 59 Chinese workers. BnMn and BMn were measured using a transportable in vivo neutron activation analysis system and inductively coupled plasma mass spectrometry, respectively. Motor function (manual coordination, postural sway, postural hand tremor, and fine motor function) was assessed using the Coordination Ability Test System (CATSYS) and the Purdue Pegboard. Relationships between Mn biomarkers and motor test scores were analyzed with linear regression models adjusted for age, education, current employment, and current alcohol consumption. BMn was significantly inversely associated with hand tremor intensity (dominant hand (β=-0.04, 95 % confidence interval (CI):-0.07, -0.01; non-dominant hand β=-0.05, 95 % CI:-0.08, -0.01) hand tremor center frequency (non-dominant hand β=-1.61, 95 % CI:-3.03, -0.19) and positively associated with the Purdue Pegboard Assembly Score (β = 4.58, 95 % CI:1.08, 8.07). BnMn was significantly inversely associated with finger-tapping performance (non-dominant hand β=-0.02, 95 % CI:-0.04,-0.004), mean sway (eyes closed and foam β=-0.68, 95 % CI:-1.31,-0.04), and positively associated with hand tremor center frequency (dominant hand, β = 0.40, 95 % CI:0.002, 0.80). These results suggest BMn is related to better postural hand tremor and fine motor control and BnMn is related to worse motor coordination and postural hand tremor but better (i.e., less) postural sway. The unexpected positive results might be explained by choice of biomarker or confounding by work-related motor activities. Larger, longitudinal studies in this area are recommended.

Heavy Metals in Acrylic Color Paints Intended for the School Children Use: A Potential Threat to the Children of Early Age

Heavy metals are the harmful elements, regarded as carcinogens. Nevertheless, owing to their physical and chemical properties, they are still used in the production of several commercial products. Utilization of such products increases the chance for the exposure of heavy metals, some of them are categorized as probable human carcinogens (Group 1) by the International Agency for Research on Cancer. Exposure of heavy metals to school children at early age can result severe life time health issues and high chance of emerging cancer. Thus, we have performed study relating to the presence of heavy metals in acrylic color paints commonly used by the school children. Acrylic paints of different colors were assayed for seven potential heavy metals manganese (Mn), cobalt (Co), nickel (Ni), zinc (Zn), arsenic (As), cadmium (Cd) and lead (Pb) using microwave digestion and iCAPQ inductively coupled plasma mass spectrometry (ICP-MS) system. The optimized method including paints digestion reagents nitric acid (HNO3, 65%, 5 mL) and hydrofluoric acid (HF, 40%, 2 mL) have offered excellent method performance with recovery values ranged between 99.33% and 105.67%. The elements were identified in all of the analyzed samples with concentrations ranged from 0.05 to 372.59 µg/g. Cd constitutes the lower percentage (0.05%), whereas Zn constitutes high ratio contribution which was tremendously high (68.33%). Besides, the paints contamination was also color specific, with considerably total heavy metal concentrations found in brunt umber (526.57 µg/g) while scarlet color (12.62 µg/g) contained lower amounts. The outcomes of our investigation highlight the necessity for guidelines addressing the heavy metals in acrylic color paints intended for the school children usage.

Structural and Secondary Electron Yield Properties of Titanium-Palladium Films with Laser-Treated Copper Substrate for Application in Neutron Generators

Secondary electron emission (SEE) of the oxygen-free high-conductivity copper (OFHC) target surface in neutron generators limits the stability and improvement of the neutron yield. A novel-type target of titanium–palladium films coated on laser-treated OFHC target substrate was proposed and explored in this work to obtain low secondary electron yield (SEY) without introducing any components. The combination of Ti–Pd films and laser-treated OFHC substrate can effectively suppress secondary electron emission and enhance the adsorption ability to hydrogen isotopes with the existence of Pd film. The surface morphologies, surface chemical states, and SEYs of Ti–Pd films with laser-treated OFHC substrate were studied systematically for the first time. The XPS results showed that the laser-treated OFHC substrate surface was basically covered by Pd film. However, the Pd film surface was partially oxidized, with percentages of 21.31 and 10.02% for PdO and PdO₂, respectively. The SEYs of Ti–Pd films with laser-treated OFHC substrate were all below 1 within the investigated primary energy range of 100–3000 eV, which would be sufficient for application in neutron generators. Specifically, the maximum SEY (δ_max) of laser-treated OFHC substrate coated by Ti–Pd films was 0.87 with corresponding incident electron energy of 400 eV.

Manganese Exposure and Neurologic Outcomes in Adult Populations

A review of published articles examining the effects of manganese exposure to workers and community residents shows adverse neurologic outcomes. Innovative biomarkers, including those from neuroimaging, were incorporated into many of these studies to assess both manganese exposure and neurologic outcomes. A variety of health effects were evaluated, including cognitive and motor impairments. Studies of community participants residing near manganese point sources show variability in outcomes, reflecting the complexities of exposure measurement, individual absorption, and assessment of neurologic effects. The aging population provides insight into the impacts of chronic exposure in younger populations.

In vivo neutron activation assembly design for quantification of trace elements using MCNP

BACKGROUND

Trace and essential elements both play a crucial role in maintaining normal cellular and organ functions in human, while abnormal exposure to some of them are also potentially related to diseases, e.g., manganism. To study the association between elemental intake and health outcomes, accurate assessment of elemental uptake and storage in the human body is essential.

OBJECTIVES

Neutron activation analysis based technology can be used for in vivo measurements of the trace elements given that the measurement system guarantees a low detection limit with an acceptable dose. This study aims to design and optimize a customized and portable deuterium-deuterium (DD) neutron generator-based irradiation assembly for neutron activation analysis of trace elements in vivo, using Monte Carlo simulations.

METHODS

The irradiation assembly includes a moderator, a fast neutron filter (FNF), reflector, and shielding. The human hand equivalent phantoms doped with manganese (Mn) and potassium (K) are used to determine the respective elements' system sensitivity and detection limit.

RESULTS

The calculated detection limit is 0.16 g Mn per gram dry bone (ppm) for Mn and 17 ppm for K, with an equivalent dose of 36 mSv to the hand for a 10 min irradiation.

CONCLUSION

This more sensitive in vivo neutron activation analysis system will detect trace elements in vivo.

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

OBJECTIVES

Aluminum (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).

METHODS

We 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.

RESULTS

Median (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.

CONCLUSIONS

Bone 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.

Elemental analysis in living human subjects using biomedical devices

Today, patients undergoing dialysis are at low risk for aluminum-induced dementia. Workers are unlikely to experience cadmium-induced emphysema and the public's exposure to lead is an order of magnitude lower than in 1970. The research field of in vivo elemental analysis has played a role in these occupational and environmental health improvements by allowing the effects of people's chronic exposure to elements to be studied using non-invasive, painless, and relatively low-cost technology. From the early 1960s to the present day, researchers have developed radiation-based systems to measure the elemental content of organs at risk or storage organs. This reduces the need for (sometimes painful) biopsy and the risk of infection. Research and development has been undertaken on forty-nine in vivo measurement system designs. Twenty-nine different in vivo elemental analysis systems, measuring 22 different elements, have been successfully taken from design and testing through to human measurement. The majority of these systems employ either neutron activation analysis or x-ray fluorescence analysis as the basis of the measurement. In this review, we discuss eight of the successful systems, explaining the rationale behind their development, the methodology, the health data that has resulted from application of these tools, and provide our opinion on potential future technical developments of these systems. We close by discussing four technologies that may lead to new directions and advances in the whole field.

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.

Monte Carlo simulations of elemental imaging using the neutron-associated particle technique

PURPOSE

The purpose of this study is to develop and employ a Monte Carlo (MC) simulation model of associated particle neutron elemental imaging (APNEI) in order to determine the three-dimensional (3D) imaging resolution of such a system by examining relevant physical and technological parameters and to thereby begin to explore the range of clinical applicability of APNEI to fields such as medical diagnostics, intervention, and etiological research.

METHODS

The presented APNEI model was defined in MCNP by a Gaussian-distributed and isotropic surface source emitting deuterium + deuterium (DD) neutrons, iron as the target element, nine iron-containing voxels (1 cm³ volume each) arranged in a 3-by-3 array as the interrogated volume of interest, and finally, by high-purity germanium (HPGe) gamma-ray detectors anterior and posterior to the 9-voxel array. The MCNP f8 pulse height tally was employed in conjunction with the PTRAC particle tracking function to not only determine the signal acquired from iron inelastic scatter gamma-rays but also to quantitate each of the nine target voxels' contribution to the overall iron signal - each detected iron inelastic scatter gamma-ray being traced to the source neutron which incited its emission.

RESULTS

With the spatial, vector, and timing information of the series of events for each relevant neutron history as collected by PTRAC, realistic grayscale images of the distribution of iron concentration in the 9-voxel array were simulated in both the projective and depth dimensions. With an overall 225 ps timing resolution, 6.25 mm² imaging plate pixels assumed to have well localized scintillation, and a DD neutron, Gaussian-distributed source spot with a diameter of 2 mm, projective and depth resolutions of < 1 cm and <3 cm are achievable, respectively, for iron-containing voxels on the order of 1,000 ppm Fe.

CONCLUSIONS

The imaging resolution offered by APNEI of target elements such as iron lends itself to potential applications in disease diagnosis and treatment planning (high resolution) as well as to ordnance and contraband detection (low resolution). However, experimental study beyond simulation is required to optimize the layout and electronic configuration of APNEI system components - including realistic shielding and phantom materials - for background signal reduction in order to accurately determine the detection limits and spatial resolution of iron and other elements of interest on a case-by-case basis.

In vivo measurement of bone manganese and association with manual dexterity: A pilot study

We used neutron activation analysis (NAA) to measure hand bone manganese (BnMn) in 19 adult males. Median BnMn was 0.89µg/g dry bone (interquartile range = 1.07). After adjustment for age and occupation, higher ln(BnMn) was significantly associated with lower manual dexterity based on the Purdue Pegboard assembly task: β = -1.77, standard error = 0.79, p = 0.04. Due to the small sample size, these results should be interpreted cautiously. BnMn appears to be a promising biomarker, and should be further studied.

Customized compact neutron activation analysis system to quantify manganese (Mn) in bone in vivo

OBJECTIVE

In the US alone, millions of workers, including over 300 000 welders, are at high risk of occupational manganese (Mn) exposure. Those who have been chronically exposed to excessive amount of Mn can develop severe neurological disorders similar, but not identical, to the idiopathic Parkinson's disease. One challenge of identifing the health effects of Mn exposure is to find a reliable biomarker for exposure assessment, especially for long-term cumulative exposure.

APPROACH

Mn's long biological half-life as well as its relatively high concentration in bone makes bone Mn (BnMn) a potentially valuable biomarker for Mn exposure. Our group has been working on the development of a deuterium-deuterium (D-D)-based neutron generator to quantify Mn in bone in vivo. Main results and significance: In this paper, we report the latest advancements in our system. With a customized hand irradiation assembly, a fully characterized high purity germanium (HPGe) detector system, and an acceptable hand dose of 36 mSv, a detection limit of 0.64 µg Mn/g bone (ppm) has been achieved.

New generation non-stationary portable neutron generators for biophysical applications of Neutron Activation Analysis

BACKGROUND

Neutron sources are increasingly employed in a wide range of research fields. For some specific purposes an alternative to existing large-scale neutron scattering facilities, can be offered by the new generation of portable neutron devices.

SCOPE OF REVIEW

This review reports an overview for such recently available neutron generators mainly addressed to biophysics applications with specific reference to portable non-stationary neutron generators applied in Neutron Activation Analysis (NAA).

MAJOR CONCLUSIONS

The review reports a description of a typical portable neutron generator set-up addressed to biophysics applications.

GENERAL SIGNIFICANCE

New generation portable neutron devices, for some specific applications, can constitute an alternative to existing large-scale neutron scattering facilities. Deuterium-Deuterium pulsed neutron sources able to generate 2.5MeV neutrons, with a neutron yield of 1.0×10⁶n/s, a pulse rate of 250Hz to 20kHz and a duty factor varying from 5% to 100%, when combined with solid-state photon detectors, show that this kind of compact devices allow rapid and user-friendly elemental analysis. "This article is part of a Special Issue entitled "Science for Life" Guest Editor: Dr. Austen Angell, Dr. Salvatore Magazù and Dr. Federica Migliardo".

The study of in vivo quantification of aluminum (Al) in human bone with a compact DD generator-based neutron activation analysis (NAA) system

The feasibility and methodology of using a compact DD generator-based neutron activation analysis system to measure aluminum in hand bone has been investigated. Monte Carlo simulations were used to simulate the moderator, reflector, and shielding assembly and to estimate the radiation dose. A high purity germanium (HPGe) detector was used to detect the Al gamma ray signals. The minimum detectable limit (MDL) was found to be 11.13 μg g(-1) dry bone (ppm). An additional HPGe detector would improve the MDL by a factor of 1.4, to 7.9 ppm. The equivalent dose delivered to the irradiated hand was calculated by Monte Carlo to be 11.9 mSv. In vivo bone aluminum measurement with the DD generator was found to be feasible among general population with an acceptable dose to the subject.

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.

Manganese Toxicity Upon Overexposure: a Decade in Review

Exposure to manganese (Mn) causes clinical signs and symptoms resembling, but not identical to, Parkinson's disease. Since our last review on this subject in 2004, the past decade has been a thriving period in the history of Mn research. This report provides a comprehensive review on new knowledge gained in the Mn research field. Emerging data suggest that beyond traditionally recognized occupational manganism, Mn exposures and the ensuing toxicities occur in a variety of environmental settings, nutritional sources, contaminated foods, infant formulas, and water, soil, and air with natural or man-made contaminations. Upon fast absorption into the body via oral and inhalation exposures, Mn has a relatively short half-life in blood, yet fairly long half-lives in tissues. Recent data suggest Mn accumulates substantially in bone, with a half-life of about 8-9 years expected in human bones. Mn toxicity has been associated with dopaminergic dysfunction by recent neurochemical analyses and synchrotron X-ray fluorescent imaging studies. Evidence from humans indicates that individual factors such as age, gender, ethnicity, genetics, and pre-existing medical conditions can have profound impacts on Mn toxicities. In addition to body fluid-based biomarkers, new approaches in searching biomarkers of Mn exposure include Mn levels in toenails, non-invasive measurement of Mn in bone, and functional alteration assessments. Comments and recommendations are also provided with regard to the diagnosis of Mn intoxication and clinical intervention. Finally, several hot and promising research areas in the next decade are discussed.

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 (19)F(n,γ)(20)F 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   ×   10(8) 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.