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An overlooked source of skin dose perturbation: Commercial tattoo inks in radiotherapy

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Elemental composition of selected Intenze tattoo inks compared to EU REACH regulatory limits. Multiple toxic metals, including Cr, Ni, Co, and Pb, exceed allowable thresholds in brown and orange inks, with Cr contamination observed across all three formulations. The brown ink exhibits the highest overall metal loading (Fe2O3-dominant at 88,400 ppm Fe, wet weight) and broadest compositional diversity, representing a conservative upper-bound scenario for dosimetric modeling.

Table 2

doi: https://doi.org/10.1371/journal.pone.0346501.t002