乳房放射性前哨淋巴結檢查對有關人員之輻射安全

Radiation Safety with Breast Sentinel Lymph Node Lymphoscintigraphy

林玉鈴(Yu-Ling Lin) ； 游冬齡(Dong-Ling You) ； 余本隆(Ben-Long Yu) ； 莊璦瑛(Ai-Ying Chuang) ； 施乃綺(Nai-Chi Shih) ； 曹美華(Mei-Hua Tsou) ； 李佩瑛(Pei-Ing Lee) ； 黃玉儀(Yu-Yi Huang)

《核子醫學雜誌》 20卷1期 (2007/03) Pp. 15-19

https://doi.org/10.6332/ANMS.2001.003

摘要

目的：探查本院核醫科、外科、病檢科箏工作人員有關之輻射曝露。
方法：本研究共包含10位乳癌病人，年齡介於37~61歲，平均年齡49.4歲。所有病人手術前皆皮下注射0.4~0.6毫居里放射性同位鎝－99m-硫膠體進行放射性前哨淋巴結檢查。使用蓋革偵檢器於病人乳房注射處、淋巴結化驗檢體與乳房切除化驗檢體分別以3公分、30公分、100公分、300公分等不同距離進行測量，分別代表核醫科、外科、病檢科工作人員手部及軀體輻射曝露率。對照測量之平均輻射曝露率與法現年劑量限值，以推算相關工作人員每天可執行放射性前哨淋巴結檢查之病人數量。
結果：放射性前哨淋巴結檢查對於相關工作人員平均輻射曝露率：(l)平均輻射曝露來自乳房注射處：核醫科醫師與外科醫師手部平均輻射曝露率分別為117.6及66微西弗／小時；核醫科醫師、技術師、護士、外科醫師、麻醉技術師及刷手護士軀體平均輻射曝露率分別為5.56、0.86、0.16、3.24、0.57及0.16微西弗／小時。(2)平均輻射曝露來自淋巴結化驗檢體：外科醫師及病檢科醫師手部平均輻射曝露率分別為0.83及0.72微西弗／小時；外科醫師、病檢科醫師及病檢師軀體平均輻射曝露率分別為0.72、0.14及0.1微西弗／小時。(3)平均輻射曝露來自乳房切除化驗檢體：外科醫師及病檢科醫師手部平均輻射曝露率分別為57.6及43.6微西弗／小時；外科醫師、病檢科醫師及病檢師軀體平均輻射曝露率分別為2.12、1.78及0.26微西弗／小時。
結論：放射性前哨淋巴結檢查對於核醫科、外科、病檢科相關工作人員平均輻射曝露遠低於法規限值。

關鍵字

輻射安全 ； 前哨淋巴結 ； 乳癌

並列摘要

Background: The purpose of this study was to evaluate the radiation dose rate of lymphoscintigraphy to nuclear medicine personnel, operating room personnel and pathology personnel in our hospital.
Methods: Ten female patients with breast cancer who received lymphoscintigraphy were included in our study. (superscript 99m)Tc-sulfur colloid ((superscript 99m)Tc-SC; 0.4-0.6 mCi) was administered via subdermal injections in all patients. The dose rate to nuclear medicine personnel, operation room personnel and pathology personnel was measured with a calibrated Geiger-M1er counter at 3cm, 30cm and 100cm from the injection site, Sentinel lymph node (SLN) and lumpectomy specimen respectively. The measured radiation dose rate was compared with radiation dose each radiation personnel may receive in one year.
Results: The mean dose rate from injection site, SLN and lumpectomy specimen to all involved personnel were as follows: The mean dose rate to the hands of nuclear medicine physician and surgeon were 117.6 μSv/h and 66 μSv/h, respectively. The mean dose rate to the body of nuclear medicine physician, nuclear medicine techonologist, nuclear medicine nurse, surgeon, anesthesiologist and scrubing nurse were 5.56 μSv/h, 0.86 μSv/h, 0.16 μSv/h, 3.24 μSv/h, 0.57 μSv/h and 0.16 μSv/h, respectively. The mean dose rate to the hands of the surgeon and pathologist were 0.83 μSv/h and 0.72 μSv/h, respectively. The mean dose rate to the body of the surgeon, pathologist and pathology technologist were 0.12 μSv/h, 0.14 μSv/h and 0.1 μSv/h, respectively. The mean dose rate to the hands of the surgeon and pathologist were 57.6 μSv/h and 43.6 μSv/h, respectively. The mean dose rate to the body of the surgeon, pathologist and pathology technologist were 2.12 μSv/h, 1.78 μSv/h and 0.26 μSv/h, respectively.
Conclusion: Our results showed that the mean dose rate of lympscintography to the nuclear medicine, surgery, and pathology personnel is very low.

並列關鍵字

radiation safety ； sentinel lymph node ； breast cancer