title: 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.
authors.affiliation: UOA Medicina Nucleare, Biella, Italy. Asl12mm@biella.alpcom.it
authors.forename: C
authors.initials: C
authors.lastname: Motta
authors.forename: A
authors.initials: A
authors.lastname: Turra
authors.forename: B
authors.initials: B
authors.lastname: Farina
authors.forename: A
authors.initials: A
authors.lastname: Ostan
authors.forename: S
authors.initials: S
authors.lastname: Ramella
authors.forename: G L
authors.initials: GL
authors.lastname: Cartia
mesh_terms: D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery*; D005260:Female; D015902:Gamma Cameras; D006801:Humans; D008197:Lymph Node Excision / Q000379:methods*; D008198:Lymph Nodes / Q000000981:diagnostic imaging* / Q000601:surgery*; D008207:Lymphatic Metastasis / Q000000981:diagnostic imaging; D015412:Mastectomy, Segmental / Q000379:methods*; D017744:Medical Waste Disposal / Q000379:methods; D016273:Occupational Exposure / Q000009:adverse effects / Q000517:prevention & control*; D011832:Radiation Injuries / Q000209:etiology / Q000517:prevention & control*; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals / Q000009:adverse effects; D021701:Sentinel Lymph Node Biopsy / Q000379:methods; D013668:Technetium Tc 99m Aggregated Albumin / Q000009:adverse effects*
chemical_list: D017744:Medical Waste Disposal; D019275:Radiopharmaceuticals; D013668:Technetium Tc 99m Aggregated Albumin; C083602:technetium Tc 99m nanocolloid