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Increasing radiation from sentinel node specimens in pathology over time.

Andrew A Renshaw¹, Richard Kish, Edwin W Gould

¹Dept. of Pathology, Baptist Hospital of Miami, Miami, FL 33176, USA.

American Journal of Clinical Pathology

|July 28, 2010

Summary

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Radioactivity in sentinel node specimens has significantly increased, necessitating routine radiation monitoring in pathology labs. This finding challenges previous recommendations for handling these radioactive samples safely.

Area of Science:

Pathology
Nuclear Medicine
Oncology

Background:

Previous studies suggested no special radiation precautions for handling sentinel node specimens.
Pathology laboratories handle sentinel node and primary resection specimens for diagnostic purposes.

Purpose of the Study:

To assess trends in radioactivity levels of sentinel node specimens over a 7-year period.
To determine if current handling protocols for radioactive specimens in pathology labs are adequate.

Main Methods:

A retrospective review of 2,902 sentinel node and primary resection specimens handled between 2003 and 2009.
Measurement of radioactivity levels in specimens using a radiation survey meter.
Statistical analysis to identify trends and correlations between radioactivity and administered radiation dose.

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Main Results:

The percentage of specimens exceeding background radiation (> or =0.2 mrem/h) rose from 6.3% to 34.8% (P < .001).
Specimens with >10 mrem/h increased from 0.0% to 9.3% (P < .001), with four specimens reaching 100 mrem/h.
Higher administered radiation doses correlated with increased specimen radioactivity (P = .02).

Conclusions:

Radioactivity levels in sentinel node specimens have significantly increased over time.
Current practices may not adequately address the rising radiation levels in pathology specimens.
Routine measurement of radioactivity for all sentinel node specimens is recommended for laboratory safety.