Radioprotezione nell'impiego dei traccianti nella chirurgia radioguidata della mammella

Translated title of the contribution: Radiation protection in radioguided breast surgery with tracers

Mahila Ferrari, Marta Cremonesi, Enzo Sacco, Annalisa Rossi, Lorenzo Leonardi, Alberto Luini, Giovanni Paganelli, Giampiero Tosi

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Purpose. Recent techniques in nuclear medicine have permitted to implement new procedures useful in surgery. Among these, the procedures for locating sentinel lymph nodes and nonpalpable breast lesions are of great interest. The protocols for the location of the sentinel lymph node and for the radioguided location of occult lesions developed at the European Institute of Oncology (IEO, Milan) are based on the administration of radiopharmaceuticals labelled with Technetium-99m (99mTc). We evaluated the dosimetric data relative to patients and hospital personnel to assess whether specific radiation protection procedures are needed. Material and methods. Fifty patients with nonpalpable breast lesions and 50 patients with suspected lymph node involvement were enrolled in this study. All the patients underwent surgery the day after in-loco administration of the radiopharmaceutical (11 MBq of 99mTc). The absorbed dose to the hospital personnel was estimated from the air kerma a rate measured by ionization chamber at different distances from the patients at 0 and 16 hours after the radiopharmaceutical administration. In order to evaluate radiation protection for patients, absorbed doses were measured positioning thermoluminescent dosimeters on the patient's skin for about 16 hours. In the operating room, activity was measured on some excised tissues (lymph nodes and tumors) and on surgical instruments. Results. Absorbed doses were very low for the clinical staff also in case of prolonged patient assistance. After 100 cases, the surgeon mean absorbed dose to the hands and mean effective dose were .45 mGy and .09 mGy, respectively. These values correspond to 1% of the annual dose limit to the hands and to 10% of the annual equivalent effective dose recommended for the population (ICRP 60 and law by decree 230/95). The absorbed dose to healthy tissues of the patients were lower than 1 mGy (mean values: contralateral breast: .9 mGy; abdomen .45 mGy). The mean activity detected in the excised tissues was 9 kBq and 900 kBq in the sentinel lymph nodes and in the tumor lesions (injection site), respectively. The activity detected on the surgical instruments, higher on gauzes (

Original languageItalian
Pages (from-to)607-611
Number of pages5
JournalRadiologia Medica
Volume96
Issue number6
Publication statusPublished - Dec 1998

Fingerprint

Radiation Protection
Breast
Radiopharmaceuticals
Hospital Personnel
Surgical Instruments
Hand
Lymph Nodes
Nuclear Medicine
Technetium
Operating Rooms
Ambulatory Surgical Procedures
Abdomen
Neoplasms
Air
Skin
Injections

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Radioprotezione nell'impiego dei traccianti nella chirurgia radioguidata della mammella. / Ferrari, Mahila; Cremonesi, Marta; Sacco, Enzo; Rossi, Annalisa; Leonardi, Lorenzo; Luini, Alberto; Paganelli, Giovanni; Tosi, Giampiero.

In: Radiologia Medica, Vol. 96, No. 6, 12.1998, p. 607-611.

Research output: Contribution to journalArticle

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abstract = "Purpose. Recent techniques in nuclear medicine have permitted to implement new procedures useful in surgery. Among these, the procedures for locating sentinel lymph nodes and nonpalpable breast lesions are of great interest. The protocols for the location of the sentinel lymph node and for the radioguided location of occult lesions developed at the European Institute of Oncology (IEO, Milan) are based on the administration of radiopharmaceuticals labelled with Technetium-99m (99mTc). We evaluated the dosimetric data relative to patients and hospital personnel to assess whether specific radiation protection procedures are needed. Material and methods. Fifty patients with nonpalpable breast lesions and 50 patients with suspected lymph node involvement were enrolled in this study. All the patients underwent surgery the day after in-loco administration of the radiopharmaceutical (11 MBq of 99mTc). The absorbed dose to the hospital personnel was estimated from the air kerma a rate measured by ionization chamber at different distances from the patients at 0 and 16 hours after the radiopharmaceutical administration. In order to evaluate radiation protection for patients, absorbed doses were measured positioning thermoluminescent dosimeters on the patient's skin for about 16 hours. In the operating room, activity was measured on some excised tissues (lymph nodes and tumors) and on surgical instruments. Results. Absorbed doses were very low for the clinical staff also in case of prolonged patient assistance. After 100 cases, the surgeon mean absorbed dose to the hands and mean effective dose were .45 mGy and .09 mGy, respectively. These values correspond to 1{\%} of the annual dose limit to the hands and to 10{\%} of the annual equivalent effective dose recommended for the population (ICRP 60 and law by decree 230/95). The absorbed dose to healthy tissues of the patients were lower than 1 mGy (mean values: contralateral breast: .9 mGy; abdomen .45 mGy). The mean activity detected in the excised tissues was 9 kBq and 900 kBq in the sentinel lymph nodes and in the tumor lesions (injection site), respectively. The activity detected on the surgical instruments, higher on gauzes (",
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AU - Rossi, Annalisa

AU - Leonardi, Lorenzo

AU - Luini, Alberto

AU - Paganelli, Giovanni

AU - Tosi, Giampiero

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