Sentinel Node Detection in Malignant Melanoma Patients: Radiation Safety Considerations

Abstract

Personal dosimetric survey and limitation of the number of surgical interventions do not appear to be essential.

Sentinel node biopsy in skin melanoma patients—measurements of absorbed doses of radiation to the hands of medical staff

“…Previous authors have been concerned about the safety of medical staff engaged in the SNB procedure due to radiation exposure [8][9][10][11][12][13]. However, the reported doses absorbed by the hands of the medical staff were generally higher than observed in the present study.…”

“…Our calculation concerning the safety of the surgeon was based on ICRP limits for the extremities of a member of the general public, since the surgeon is not a radiation worker (according to our results, surgeon may safely perform 2,150 procedures in 1 year). When the results published by Sera et al [8] were recalculated using limits for a member of the general public, which is the standard used by our study, the number of procedures which could be performed under current ICRP standards appeared to be only one-tenth the number indicated by our study. This difference could be attributable to the higher activity of radiotracer used by Sera et al [8].…”

“…However, the reported doses absorbed by the hands of the medical staff were generally higher than observed in the present study. Sera et al [8] observed that a surgeon can safely perform 2,474 SNBs in skin melanoma patients during 1 year. However, this calculation was based on ICRP dosage limits for the extremities of a radiation worker.…”

The Biology and Clinical Relevance of Sentinel Lymph Nodes in Melanoma

“…Additionally, the risk of radiation has been studied in physicians injecting the radiotracer as well as the surgeons removing the nodes. The maximum recorded dose of radiation recorded was 1900 times smaller than the current 1 year dose limit recommended by the International Commission on Radiological Protection, and no limitations are needed in the number of surgical interventions performed yearly (Nejc et al, 2006;Sera et al, 2003).…”

Clinical results of vulvar cancer treatment in early stages based on sentinel lymph node biopsy and classic surgical treatment in the Institute of Onco­logy of Vilnius University between 2011 and 2013

“…Average exposure levels to the surgeon, anaesthetist, scrub nurses and operating room nurses were measured with digital dosimeters and reached up to 1 µSv/hour. According to published sources, the average exposure levels to operating-room staff were less than 1 µSv per one procedure during sentinel lymph node biopsy of patients with skin melanoma or breast cancer (9)(10)(11). The recommendations of the European Society of Nuclear Medicine state that the monitoring of operating room staff for professional exposure and additional measures of screening from ionizing radiation are not necessary.…”