Thorotrast is a suspension containing particles of the radioactive compound thorium dioxide, ThO2; it was used as a radiocontrast agent in clinical radiography in the 1930s to 1950s. It is no longer used clinically. 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. 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, angiosarcomas, hepatocellular carcinoma and hepatic fibrosis 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. 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. Thorotrast was used in Portugal from 1930 to 1955. Epidemiological studies from Portugal showed a link between Thorotrast use and risk of developing leukaemia was significant and went so far as describing it as the most potent leukaemogen reported. They also noted very high levels of haemangioendotheliomas normally of the liver and they were very rarely seen in controls. 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. Thorotrast exposure has also been associated with the development of angiosarcoma. German patients exposed