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Sentinel node detection in malignant melanoma patients: radiation safety considerations
Terez Sera1, Gabor Mohos, Miklos Papos
1Department of Nuclear Medicine, University of Szeged, Budapest, Hungary. serat@comser.szote.u-szeged.hu
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.
Conclusion:
Personal dosimetric survey and limitation of the number of surgical interventions do not appear to be essential.