Radiation dose exposure during Sentinel Lymph node biopsy
Association of Breast Surgery ePoster Library. Poonawala S. 05/15/17; 166333; P176
Shabbier Poonawala
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Abstract
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Introduction
The adoption of sentinel lymph node biopsy techniques in breast cancer patients exposes operating personnel to ionising radiation. SLNB technique is regulated by Ionising Radiation Regulations 1999 and the EANM and SNMMI guidelines 2013. Formal risk assessment of radiation exposure is mandatory. Exposure is dependent on many factors; previous studies have assessed dose equivalents following immediate pre-operative or peri-operative injection. We have determined our intra-operative dose equivalents following injection on the pre-operative day.
Method
Our unit protocol for SLNB isotope injection, standardises a peri-areolar injection of 0.5ml Technetium-99 nano-colloid emitting150MBq. All injections are performed between 16:00 and 17:00 on the pre-operative day. All consecutive SLNB cases over a 3 month period were monitored for a single operator and assistant to reduce variability of results. A personal dosimeter was worn at chest and abdominal level. The results obtained were compared to the control dosimeter.
Results
A total of 25 cases were analysed, 14 combined WLE and SLNB, 8 mastectomy and SLNB and 3 SLNB alone. The primary operating surgeon measured dose at waist height, the assistant at chest height. Results were obtained for the superficial (SDE) and deep dose equivalent (DDE). The surgeons' SDE was 0.03mSv and DDE 0.03mSv, the assistants SDE was 0.11mSv and DDE 0.13; compared to control SDE 0.25mSv and DDE 0.25mSv.
Conclusions
SLNB has a patient dose of 0.3μSv compared to CXR 0.04μSv and CT Chest 8.3μSv. Maximum employee DDE dose limit is 100mSv over 5 years. Our DDE falls significantly below this cumulative dose and confirms safety of our technique.
The adoption of sentinel lymph node biopsy techniques in breast cancer patients exposes operating personnel to ionising radiation. SLNB technique is regulated by Ionising Radiation Regulations 1999 and the EANM and SNMMI guidelines 2013. Formal risk assessment of radiation exposure is mandatory. Exposure is dependent on many factors; previous studies have assessed dose equivalents following immediate pre-operative or peri-operative injection. We have determined our intra-operative dose equivalents following injection on the pre-operative day.
Method
Our unit protocol for SLNB isotope injection, standardises a peri-areolar injection of 0.5ml Technetium-99 nano-colloid emitting150MBq. All injections are performed between 16:00 and 17:00 on the pre-operative day. All consecutive SLNB cases over a 3 month period were monitored for a single operator and assistant to reduce variability of results. A personal dosimeter was worn at chest and abdominal level. The results obtained were compared to the control dosimeter.
Results
A total of 25 cases were analysed, 14 combined WLE and SLNB, 8 mastectomy and SLNB and 3 SLNB alone. The primary operating surgeon measured dose at waist height, the assistant at chest height. Results were obtained for the superficial (SDE) and deep dose equivalent (DDE). The surgeons' SDE was 0.03mSv and DDE 0.03mSv, the assistants SDE was 0.11mSv and DDE 0.13; compared to control SDE 0.25mSv and DDE 0.25mSv.
Conclusions
SLNB has a patient dose of 0.3μSv compared to CXR 0.04μSv and CT Chest 8.3μSv. Maximum employee DDE dose limit is 100mSv over 5 years. Our DDE falls significantly below this cumulative dose and confirms safety of our technique.
Introduction
The adoption of sentinel lymph node biopsy techniques in breast cancer patients exposes operating personnel to ionising radiation. SLNB technique is regulated by Ionising Radiation Regulations 1999 and the EANM and SNMMI guidelines 2013. Formal risk assessment of radiation exposure is mandatory. Exposure is dependent on many factors; previous studies have assessed dose equivalents following immediate pre-operative or peri-operative injection. We have determined our intra-operative dose equivalents following injection on the pre-operative day.
Method
Our unit protocol for SLNB isotope injection, standardises a peri-areolar injection of 0.5ml Technetium-99 nano-colloid emitting150MBq. All injections are performed between 16:00 and 17:00 on the pre-operative day. All consecutive SLNB cases over a 3 month period were monitored for a single operator and assistant to reduce variability of results. A personal dosimeter was worn at chest and abdominal level. The results obtained were compared to the control dosimeter.
Results
A total of 25 cases were analysed, 14 combined WLE and SLNB, 8 mastectomy and SLNB and 3 SLNB alone. The primary operating surgeon measured dose at waist height, the assistant at chest height. Results were obtained for the superficial (SDE) and deep dose equivalent (DDE). The surgeons' SDE was 0.03mSv and DDE 0.03mSv, the assistants SDE was 0.11mSv and DDE 0.13; compared to control SDE 0.25mSv and DDE 0.25mSv.
Conclusions
SLNB has a patient dose of 0.3μSv compared to CXR 0.04μSv and CT Chest 8.3μSv. Maximum employee DDE dose limit is 100mSv over 5 years. Our DDE falls significantly below this cumulative dose and confirms safety of our technique.
The adoption of sentinel lymph node biopsy techniques in breast cancer patients exposes operating personnel to ionising radiation. SLNB technique is regulated by Ionising Radiation Regulations 1999 and the EANM and SNMMI guidelines 2013. Formal risk assessment of radiation exposure is mandatory. Exposure is dependent on many factors; previous studies have assessed dose equivalents following immediate pre-operative or peri-operative injection. We have determined our intra-operative dose equivalents following injection on the pre-operative day.
Method
Our unit protocol for SLNB isotope injection, standardises a peri-areolar injection of 0.5ml Technetium-99 nano-colloid emitting150MBq. All injections are performed between 16:00 and 17:00 on the pre-operative day. All consecutive SLNB cases over a 3 month period were monitored for a single operator and assistant to reduce variability of results. A personal dosimeter was worn at chest and abdominal level. The results obtained were compared to the control dosimeter.
Results
A total of 25 cases were analysed, 14 combined WLE and SLNB, 8 mastectomy and SLNB and 3 SLNB alone. The primary operating surgeon measured dose at waist height, the assistant at chest height. Results were obtained for the superficial (SDE) and deep dose equivalent (DDE). The surgeons' SDE was 0.03mSv and DDE 0.03mSv, the assistants SDE was 0.11mSv and DDE 0.13; compared to control SDE 0.25mSv and DDE 0.25mSv.
Conclusions
SLNB has a patient dose of 0.3μSv compared to CXR 0.04μSv and CT Chest 8.3μSv. Maximum employee DDE dose limit is 100mSv over 5 years. Our DDE falls significantly below this cumulative dose and confirms safety of our technique.
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