Sentinel node detection in malignant melanoma patients: radiation safety considerations.
BACKGROUND
The surgical management of malignant melanoma necessitates correct sentinel lymph node localization. The highest reported sensitivities are those of lymphoscintigraphy and intraoperative gamma-probe detection combined with a vital blue dye technique.


OBJECTIVE
Control of the radiation doses experienced by surgical personnel untrained in the use of unsealed radioactive materials.


METHODS
Sentinel lymph nodes were localized, and biopsies were performed in 25 patients with malignant melanoma. Radiation doses during surgery were determined with energy-compensated silicon pin diode detectors and LiF thermoluminescent ring dosimeters.


RESULTS
In 21 cases (24%), the measured doses were less than 1 microSv, but in 4 operations (16%), 1 to 4.5 microSv was received. The equivalent dose rate was generally less than 1 microSv/h. The finger-absorbed doses for the surgeon and the assistant surgeon were (mean+/-SD) 159+/-23 and 48+/-17 microGy per intervention, respectively.


CONCLUSIONS
Personal dosimetric survey and limitation of the number of surgical interventions do not appear to be essential.
Sera
Terez
T
Department of Nuclear Medicine, University of Szeged, Budapest, Hungary. serat@comser.szote.u-szeged.hu
Mohos
Gabor
G
Papos
Miklos
M
Osvay
Margit
M
Varga
Janos
J
Lazar
Mate
M
Kiss
Erika
E
Kapitany
Klara
K
Dobozy
Attila
A
Csernay
Laszlo
L
Pavics
Laszlo
L
D000776:Anesthesiology; D005260:Female; D013502:General Surgery; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008545:Melanoma / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D016273:Occupational Exposure; D011874:Radiometry; D011877:Radionuclide Imaging; D021701:Sentinel Lymph Node Biopsy; D012878:Skin Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery*