Department of Nuclear Medicine, Netherlands Cancer Institute, Amsterdam, The Netherlands;
Department of Nuclear Medicine, Netherlands Cancer Institute, Amsterdam, The Netherlands.
J Nucl Med Technol. 2021 Dec;49(4):334-338. doi: 10.2967/jnmt.121.262161. Epub 2021 Jul 30.
The aim of this study was to estimate and subsequently measure the occupational radiation exposure for all personnel involved in producing, administering, or performing imaging or surgery with [Tc]Tc-PSMA-I&S, which has been introduced for identification of tumor-positive lymph nodes during salvage prostate cancer surgery. The effective dose was estimated and subsequently measured with electronic personal dosimeters for the following procedures and personnel: labeling and quality control by the radiopharmacy technologist, syringe preparation by the nuclear medicine laboratory technologist, patient administration by the nuclear medicine physician, patient imaging by the nuclear medicine imaging technologist, and robot-assisted laparoscopic salvage lymph node dissection attended by an anesthesiology technologist, scrub nurse, surgical nurse, and surgeon. The dose rate of the patient was measured immediately after administration of [Tc]Tc-PSMA-I&S, after imaging, and after surgery. The estimated dose per procedure ranged from 1.59 × 10 μSv (imaging technologist) to 9.74 μSv (scrub nurse). The measured effective dose ranged from 0 to 5 μSv for all personnel during a single procedure with [Tc]Tc-PSMA-I&S. The highest effective dose was received by the scrub nurse (3.2 ± 1.3 μSv), whereas the lowest dose was measured for the surgical nurse (0.2 ± 0.5 μSv). If a single scrub nurse were to perform as many as 100 procedures with [Tc]Tc-PSMA-I&S in a year, the total effective dose would be 320 μSv/y. Immediately after administration, the dose rate at 50 cm from the patient was 18.5 ± 1.6 μSv/h, which dropped to 1.8 ± 0.3 μSv/h after imaging the following day, reducing even further to 0.56 ± 0.33 μSv/h after surgery. The effective dose for personnel involved in handling [Tc]Tc-PSMA-I&S is comparable to that of other Tc-radiopharmaceuticals and therefore safe for imaging and radioguided surgery.
本研究旨在估算并随后测量所有参与生产、管理或进行成像或手术的人员的职业辐射暴露，这些人员使用 [Tc]Tc-PSMA-I&S 进行识别前列腺癌术后阳性淋巴结。通过电子个人剂量计估算并随后测量以下程序和人员的有效剂量：由放射药剂师进行标记和质量控制，由核医学实验室技术员进行注射器准备，由核医学医师进行患者管理，由核医学成像技术员进行患者成像，以及由麻醉技术师、刷手护士、外科护士和外科医生参加的机器人辅助腹腔镜前列腺癌术后淋巴结清扫术。在给予 [Tc]Tc-PSMA-I&S 后、成像后和手术后立即测量患者的剂量率。每个程序的估计剂量范围为 1.59×10μSv（成像技术员）至 9.74μSv（刷手护士）。在单个 [Tc]Tc-PSMA-I&S 程序中，所有人员的测量有效剂量范围为 0 至 5μSv。刷手护士接受的有效剂量最高（3.2±1.3μSv），而外科护士测量的剂量最低（0.2±0.5μSv）。如果单个刷手护士在一年内执行多达 100 次 [Tc]Tc-PSMA-I&S 程序，则总有效剂量将为 320μSv/y。给予后立即，距离患者 50 cm 处的剂量率为 18.5±1.6μSv/h，第二天成像后降至 1.8±0.3μSv/h，手术后进一步降至 0.56±0.33μSv/h。处理 [Tc]Tc-PSMA-I&S 的人员的有效剂量与其他 Tc 放射性药物相当，因此对于成像和放射性引导手术是安全的。
