Sentinel node navigation surgery with 99mTc-tin colloid in breast cancer: Radiation safety considerations

K. Ejiri, K. Minami, H. Toyama, Gen Kudo, Hidekazu Hattori, N. Kobayashi, Masaki Kato, Masanobu Ishiguro, H. Fujii, M. Kuroda, T. Utsumi, K. Iwase, K. Katada
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Abstract

Purpose: The incident at the Fukushima Daiichi nuclear power station in 2011 has again raised concerns with the public regarding radiation exposure, especially so in medical workers and patients undergoing treatment involving the use of radiation. Radioisotopes are currently used during sentinel node navigation surgery (SNNS) in operating rooms without radiation monitoring. To re-evaluate the safety issues, the potential effective dose (Epoten) from 99m Tc-tin (-Sn) colloid in breast cancer surgery was estimated and personal dose equivalents, Hp(10) and Hp(0.07), were measured during SNNS. Materials and methods: Seventeen breast cancer patients were enrolled. One day before SNNS, 99m Tc-Sn colloid was injected around the tumor and radiation exposure rates were measured using survey meters. Personal dose equivalents for the surgical workers were measured. Hp(10) and Hp(0.07) for the body and Hp(0.07) for the hands were recorded using semiconductor detectors and ring-type glass dosimeters. Results: The maximum Epoten was 29 μSv per 74 MBq injection. The maximum Hp(10) for the primary and assisting surgeons, nurse, and anesthetist was 3.7, 1.4, 0.3 and 0.6 μSv per SNNS, respectively. The maximum Hp(0.07) for the hands was 100 μSv. Maximum radiocontamination 20 times higher than background (0.05 μSv/h) was detected in bloody gauze. Conclusion: The workers' radiation dose exposure from SNNS was not high, although radiation management such as a temporary cooling off period may be required.
99mtc -锡胶体在乳腺癌前哨淋巴结导航手术中的放射安全性考虑
目的:2011年福岛第一核电站事件再次引起公众对辐射暴露的关注,特别是对医务工作者和接受涉及使用辐射治疗的患者的关注。放射性同位素目前在没有辐射监测的手术室中用于前哨淋巴结导航手术(SNNS)。为了重新评估安全性问题,我们估计了99m Tc-tin (-Sn)胶体在乳腺癌手术中的潜在有效剂量(Epoten),并测量了SNNS期间的个人剂量当量Hp(10)和Hp(0.07)。材料与方法:纳入17例乳腺癌患者。SNNS前1天,在肿瘤周围注射99m Tc-Sn胶体,用测量表测量辐射暴露率。测量了手术工人的个人剂量当量。用半导体探测器和环形玻璃剂量计分别记录了人体Hp(10)和手部Hp(0.07)。结果:epten最高为29 μSv / 74 MBq;主治和辅助外科医生、护士和麻醉师的最大Hp(10)分别为3.7、1.4、0.3和0.6 μSv / SNNS。手的最大Hp(0.07)为100 μSv。血纱布的最大放射性污染值为本底的20倍(0.05 μSv/h)。结论:工人受到SNNS的辐射剂量不高,但可能需要进行临时冷却期等辐射管理。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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