Normalisation with coherent scatter signal: improvements in the calibration procedure of the 57Co-based in vivo XRF bone-Pb measurement

The feasibility of a normalised calibration variable to account for interpatient variability for in vivo 57Co XRF (X-ray fluorescence) finger bone-lead measurements was assessed. Normalising the lead X-ray intensities to the coherent scatter signal was investigated by experiment and Monte Carlo simulation. The X-ray to coherent ratios for a fixed lead concentration were within 5–10% of the mean, within uncertainty, over a physiologically relevant range of finger bone sizes and overlying tissue thicknesses. This is an acceptable level of variation to introduce, as it is less than the uncertainty of a typical in vivo measurement. Normalisation has several advantages compared with the current method of correcting for interpatient variation, as it eliminates the need for transporting extensive equipment to on-site measurements, reduces the subject dose by a factor of two, and increases the objectivity of the bone-Pb assessment.