Radiation Dose to the Surgeon During Plaque Brachytherapy

Classic, Kelly; Furutani, Keith M.; Stafford, Scott L.; Pulido, José S.

doi:10.1097/iae.0b013e3182509827

Cited by 11 publications

(24 citation statements)

References 22 publications

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“…Thermoluminescent dosimeters from the dominant index finger and thumb measured the dose, and the data from 16 cases corroborated an average exposure to the hand of 0.0013 mSv of iodine-125. This study concluded that an ocular oncologist could perform over 1,000 plaque brachytherapy procedures annually before exceeding the regulatory radiation limits [5]. …”

Section: Discussionmentioning

confidence: 99%

“…However, to account for additional exposure during patient follow-up examinations, they recommended an annual limit of 100 ruthenium plaque administrations and 50 iodine ones [7]. A 2012 study evaluated the radiation exposure to a surgeon’s hand during the administration of iodine-125 plaques in patients with uveal melanomas [5]. Thermoluminescent dosimeters from the dominant index finger and thumb measured the dose, and the data from 16 cases corroborated an average exposure to the hand of 0.0013 mSv of iodine-125.…”

Section: Discussionmentioning

confidence: 99%

“…Iodine, ruthenium, and palladium radioisotopes are commonly utilized for treating uveal melanoma and may also be used for treating invasive squamous cell carcinoma, metastatic choroidal lesions, retinoblastoma, and some benign retinal and choroidal tumors [3, 4]. The total dose to which the surgeon is exposed depends upon the plaque type, overall radiation dose loaded in the plaque, surgical time with the active “hot” plaque, and proximity to the unshielded side of the plaque [5, 7]. The key components in radiation protection are operative duration, distance, and shielding [3].…”

Section: Introductionmentioning

confidence: 99%

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Trends in Radiation Practices for Female Ocular Oncologists in North America: A Collaborative Study of the International Society of Ocular Oncology

et al. 2018

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Background: The aim of this study was to determine the known radiation exposure, attitudes, and consequent risk modifications among female ocular oncologists in North America who routinely administer radioactive plaque brachytherapy treatment and are members of the International Society of Ocular Oncology. Methods: Nineteen female ocular oncologists completed an anonymous 17-question radiation exposure survey. Results: Eleven of the participants chose to routinely wear lead protection during surgery; 8 did not. Fifteen of 19 participants reported using an unloaded “nonactive” template to prepare for plaque implantation. During pregnancy, 11 of 13 participants continued to perform plaque brachytherapy. Eight of these 11 undertook measures to decrease radiation exposure self-reported as lead wear and other. The average reported anxiety regarding fertility was 2.1 (SD, 2.2) on a scale from 1 to 10. Conclusion: This study corroborates prior literature that surgeons’ exposure to radiation during plaque brachytherapy is minimal. Nonetheless, there remains some anxiety regarding exposure risk to women, due to potential effects on fertility and fetal health. We found variability in exposure monitoring, required training, and precautions during pregnancy amongst this group of surgeons. Improved education and clearer pregnancy guidelines may equip female ocular oncologists with optimal knowledge regarding risk of radiation exposure.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Trends in Radiation Practices for Female Ocular Oncologists in North America: A Collaborative Study of the International Society of Ocular Oncology

et al. 2018

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“…Irradiation dose to the surgeon's fingers during implantation is low. 211 Pterygium is a benign proliferation of the conjunctiva over the cornea. Locally applied 90 Sr decreases the rate of recurrence following surgery to as low as 0.5%, 212 using doses varying from 20 to 60 Gy in 1 to 6 fractions.…”

Section: Techniques and Modalitiesmentioning

confidence: 99%

Brachytherapy

Holloway¹,

O’Farrell²,

Devlin³

et al. 2016

Clinical Radiation Oncology

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“…13 Treatments with other radionuclides including 60 Co, 106 Ru/ 106 Rh, 125 I, 103 Pd,198 Au, 90 Sr/ 90 Y, and 131 Cs in the plaque sources have also been reported. [14][15][16][17][18][19][20][21][22][23][24][25][26] Modern plaques typically utilize low-energy photon-emitting brachytherapy seeds ( 125 I, 103 Pd, 131 Cs) assembled inside a gold alloy or stainless steel backing, or beta particle-emitting ( 106 Ru, 90 Sr) silver plaques. 11 The Collaborative Ocular Melanoma Study (COMS) was initiated in 1985 as a multi-institution clinical trial that provided a standardized approach for tumor diagnosis, plaque design, and 125 I plaque dosimetry.…”

Section: Introductionmentioning

confidence: 99%

AAPM recommendations on medical physics practices for ocular plaque brachytherapy: Report of task group 221

et al. 2020

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The American Association of Physicists in Medicine (AAPM) formed Task Group 221 (TG-221) to discuss a generalized commissioning process, quality management considerations, and clinical physics practice standards for ocular plaque brachytherapy. The purpose of this report is also, in part, to aid the clinician to implement recommendations of the AAPM TG-129 report, which placed emphasis on dosimetric considerations for ocular brachytherapy applicators used in the Collaborative Ocular Melanoma Study (COMS). This report is intended to assist medical physicists in establishing a new ocular brachytherapy program and, for existing programs, in reviewing and updating clinical practices. The report scope includes photon-and beta-emitting sources and source:applicator combinations. Dosimetric studies for photon and beta sources are reviewed to summarize the salient issues and provide references for additional study. The components of an ocular plaque brachytherapy quality management program are discussed, including radiation safety considerations, source calibration methodology, applicator commissioning, imaging quality assurance tests for treatment planning, treatment planning strategies, and treatment planning system commissioning. Finally, specific guidelines for commissioning an ocular plaque brachytherapy program, clinical physics practice standards in ocular plaque brachytherapy, and other areas reflecting the need for specialized treatment planning systems, measurement phantoms, and detectors (among other topics) to support the clinical practice of ocular brachytherapy are presented. Expected future advances and developments for ocular brachytherapy are discussed.

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Radiation Dose to the Surgeon During Plaque Brachytherapy

Abstract: Using these data, a surgeon would need to perform more than 1,000 cases each year to approach or exceed the annual regulatory radiation dose limits for the extremities.

Cited by 11 publications

References 22 publications

Trends in Radiation Practices for Female Ocular Oncologists in North America: A Collaborative Study of the International Society of Ocular Oncology

Trends in Radiation Practices for Female Ocular Oncologists in North America: A Collaborative Study of the International Society of Ocular Oncology

Brachytherapy

AAPM recommendations on medical physics practices for ocular plaque brachytherapy: Report of task group 221

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