Sentinel node detection in malignant melanoma patients: radiation safety considerations

Dermatol Surg. 2003 Feb;29(2):141-5. doi: 10.1046/j.1524-4725.2003.29036.x.

Abstract

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.

MeSH terms

  • Anesthesiology
  • Female
  • General Surgery
  • Humans
  • Lymphatic Metastasis
  • Male
  • Melanoma / diagnostic imaging*
  • Melanoma / pathology
  • Melanoma / surgery
  • Occupational Exposure*
  • Radiometry
  • Radionuclide Imaging
  • Sentinel Lymph Node Biopsy*
  • Skin Neoplasms / diagnostic imaging*
  • Skin Neoplasms / pathology
  • Skin Neoplasms / surgery*