Surgeon and Staff Radiation Exposure During Radioguided Parathyroidectomy at a High-Volume Institution
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Radioguided parathyroidectomy (RGP) uses technetium-99 m sestamibi causing gamma ray emission during RGP to aid dissection and confirm parathyroid excision. Source (the patient) proximity and exposure duration determine degree of exposure. The purpose of this study was to quantify surgeon and staff radiation exposure during RGP.
Surgeons and assistants wore radiation dosimeters during RGP procedures at a high-volume endocrine surgery practice. Area dosimeters measured personnel potential exposure. Data were prospectively collected. Provider exposures were corrected for both duration of exposure and case volume. Institutional safety requirements uses 100 mrem/year as an indicator for radiation safety training, 500 mrem/year for personal monitoring, and a maximum allowed exposure of 4,500 mrem/year.
A total of 120 RGP were performed over 6 months. Badges were worn in 82 cases (68 %). Three faculty and four assistants were included. Primary hyperparathyroidism was the diagnosis for 95 %. Median case volume per provider was 13 cases (range 6–45), with median exposure of 18 h (range 9–70). Mean provider deep dose exposure (DDE) was 22 ± 10 mrem. Corrected for exposure duration, mean DDE was 0.6 ± 0.2 mrem/h. Corrected for case volume, mean DDE was 0.8 ± 0.2 mrem/case. Anesthesia exposure was minimal, while mayo stand exposure was half to two thirds that of the surgeon and assistant. Based on institutional guidelines and above data, 125 RGP/year warrants safety training, 625 RGP/year warrants monitoring, whereas >5,600 RGP/year may result in maximum allowed radiation exposure to the surgeon.
Surgeon and staff radiation exposure during RGP is minimal. However, high-volume centers warrant safety training.
- 7.Noureldine SI, Abbas A, Tufano RP, et al. The impact of surgical volume on racial disparity in thyroid and parathyroid surgery. Ann Surg Oncol. Mar 17 2014.Google Scholar
- 11.Bartal G, Vano E, Paulo G, Miller DL (2014). Management of patient and staff radiation dose in interventional radiology: current concepts. Cardiovasc Interv Radiol. 2014;37:289–98.Google Scholar
- 14.Ullery BW, Landau B, Wang GJ, Faifrman RM, Woo EY (2014). Radiation dose to the interventionalist is directly affected by the operating position. Vascular. 2014;22:149–53.Google Scholar
- 16.U.S. Nuclear Regulatory Commission Regulations: Title 10, Code of Federal Regulations, Part 20, Standards for protection against radiation. http://www.nrc.gov/reading-rm/doc-collections/cfr/part020/. Accessed 14 Jan 2014.
- 18.Krag DN, Anderson SJ, Julian TB, et al. Sentinel-lymph-node resection compared with conventional axillary-lymph-node dissection in clinically node-negative patients with breast cancer: overall survival findings from the NSABP B-32 randomised phase 3 trial. Lancet Oncol. 2010;11(10):927–33.PubMedCrossRefPubMedCentralGoogle Scholar
- 27.Wisconsin Department of Health Services, Chapter 157 - Radiation Protection, Subchapter III- Standards for Protection from Radiation. https://docs.legis.wisconsin.gov/code/admin_code/dhs/110/157/III/22. Accessed 14 Jan 2014.