Radioguided Surgery of Breast Cancer: Radiation Protection Survey

Abstract

The aim of this study was to estimate the radioactive risk for surgical staff performing radioguided sentinel lymph node (SN) biopsy and to calculate the contamination level in the operating room for assessment of the possible need for specific radiation protection procedures. We studied 20 patients who were selected for quadrantectomy and SN biopsy. The day before surgery a volume of 0.15 mL of 99mTc-nanocoll was injected: the activity was 3.11 +/- 0.85 MBq in group A (15 pts) and 11.6 +/- 0.6 MBq in group B (5 pts). External radiation to staff was evaluated by measuring the exposure rate in air one hour after radiopharmaceutical administration. The air KERMA rate during surgery was estimated considering the physical decay of 99mTc. Contamination of disposable materials and surgical instruments in the operating room was measured using a contamination monitor, whereas the residual activity in the SN and the injection site was measured with a gamma probe. The exposure rate at 20 cm from the injection site was 0.75 microSv/h when the most radioactive patients (group B) were treated. Contamination in the operating room proved to be negligible. Considering the number of radioguided treatments carried out by a surgeon in one year, an equivalent effective dose of 0.075 mSv was estimated; the recommended dose limit according to the relevant Italian law, DL 230/95, is 1 mSv/yr. Surgical staff therefore do not require a classification of "exposed workers" and there is no need to supply the operating room with special containers for radioactive waste.

Musculoskeletal injuries among operating room nurses: results from a multicenter survey in Rome, Italy

“…During their activities, nursing personnel are exposed to various kinds of risks: biological risks, pathologies linked to allergies, chemical risks because of environmental smog produced by anaesthetic gas and by the numerous categories of detergents and disinfectants in use (ISPESL 2005), the physical risk of using ionizing radiation (Motta et al 2000) required in some forms of surgery and X-ray machinery among the many other electrical apparatus used in the operating room.…”

A novel method for sentinel lymph node mapping using magnetite in patients with non–small cell lung cancer

“…In fact, the detection rate of SLNs in patients with NSCLC using isosulfan blue dye is quite low. 8 In the breast cancer field, numerous investigators have reported that when using a radioactive tracer, the radiation risk to surgeons, pathologists, and other medical staff to radiation is minimal, [15][16][17] and the risk to patients is no greater than with numerous other medical procedures. 16 The radiation levels in the waste are also low.…”

“…16 The radiation levels in the waste are also low. 15 Nevertheless, radioactive materials always need to be handled with care to avoid secondary contamination; for example, Waddington and coworkers 16 reported that surgical swabs can contain up to 22% of the administered activity. Awareness of and adherence to radiation safety regulations are strongly recommended to minimize exposure and to safely apply the technique.…”