Radio-guided occult lesion localisation using iodine-125 seeds (ROLLIS) for surgical removal of impalpable breast lesions has been increasingly used as an alternative to hook-wire localisation. This technique involves implanting a low-level radioactive seed into the lesion, followed by excision of the lesion guided using a hand-held gamma probe. Although the level of radiation exposure from this procedure is low, there has not been an appropriate method to quantify the organ dose. This study aims to provide a simple technique to estimate the mean absorbed dose to the breast in patients undergoing the ROLLIS procedure. The transverse plane dose rates as a function of distance for the I-125 seed were used to calculate the dose rate to voxels in a breast modelled as a hemisphere. The dose rate to each voxel was assumed to arise from an isotropic point source, and calculated using a linear interpolation of the dose rate data and the radial distance of each voxel from the seed position. Two scenarios were simulated: (i) One seed at the centre of the lesion; and (ii) Two seeds bracketing the lesion. The mean absorbed dose was calculated by excluding the volume of lesion and surgical margin which are modelled as a sphere with its centre at the centre of the lesion. Mean absorbed doses were calculated for a range of breast and lesion sizes. The calculated dose rate factors from the ROLLIS procedure ranged from 0.0097 to 0.0477 mGy · h−1 · MBq−1 depending on many factors including breast size, lesion size, seed number, seed activity and the time in situ. Lookup tables were compiled to allow a convenient way to calculate the mean absorbed dose for future ROLLIS patients. Based on clinical data collected at our institution, the mean absorbed dose to the breast for a typical ROLLIS patient would be approximately 0.50 mGy.

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Performing a chest CT scan with arms up can occasionally result in an abnormal appearance to the humerus due to photon starvation artefact. Familiarity with this artefact is essential to avoid misinterpretation.