Organ and fetal absorbed dose estimates from 99mTc-sulfur colloid lymphoscintigraphy and sentinel node localization in breast cancer patients Journal Article

  


Authors: Pandit-Taskar, N.; Dauer, L. T.; Montgomery, L.; St. Germain, J.; Zanzonico, P. B.; Divgi, C. R.
Article Title: Organ and fetal absorbed dose estimates from 99mTc-sulfur colloid lymphoscintigraphy and sentinel node localization in breast cancer patients
Abstract: The purpose of this retrospective study was to determine whether lymphoscintigraphy (LSG) for sentinel lymph node (SNL) mapping in a woman with a breast mass presents an unacceptable risk to her fetus. We assessed radiation-absorbed dose to various organs from 99mTc-sulfur colloid (TSC) LSG using standard internal absorbed dose assessment methodologies for both reference phantoms as well as for phantom models using the specific patient population characteristics such as total body and injected organ mass. The study also projected the radiation-absorbed dose to the fetus from LSG for SLN mapping. Methods: Data from 1,021 nonpregnant women with early-stage breast cancer who underwent SLN mapping and biopsy procedures were analyzed. Patients had a single-site intradermal injection of unfiltered TSC in 0.05 mL normal saline: 3.7 MBq (0.1 mCi) on the morning of surgery (1-d protocol) or 18.5 MBq (0.5 mCi) on the afternoon before surgery (2-d protocol). A standard internal dose calculation methodology was used to calculate absorbed doses to various organs and to a modeled fetus at 3-, 6-, and 9-mo gestation from the injection site as well as from systemic activity. Results: The highest estimated absorbed doses were observed for the reference 9-mo-pregnant model under the 2-d protocol. Absorbed doses of 14.9, 0.214, 0.062, 0.151, 0.004, 0.163, 0.075, and 0.014 mGy were received by the injected breast, heart, liver, lung, ovaries, thymus, total body, and fetus, respectively. Effective doses from the 2-d protocol were estimated to be 0.460, 0.186, and 0.245 mSv for the reference population, the total Memorial Sloan-Kettering Cancer Center (MSKCC) study patient population, and childbearing-age MSKCC patient population (i.e., <45 y old), respectively. Conclusion: SLN procedures lead to a negligible dose to the fetus of 0.014 mGy or less. This is much less than the National Council on Radiation Protection and Measurements limit to a pregnant woman. Calculations using actual patient population characteristics resulted in lower organ dose estimates than more conservative reference models. Copyright © 2006 by the Society of Nuclear Medicine, Inc.
Keywords: adult; controlled study; major clinical study; cancer patient; radiation dose; methodology; sentinel lymph node mapping; lymphoscintigraphy; breast cancer; breast; tumor biopsy; standard; ovary; liver; injection; tissue distribution; thymus; lung; pregnancy; fetus; phantom; dose calculation; heart; technetium sulfur colloid tc 99m; radiation detection; absorbed dose; sentinel lymp node
Journal Title: Journal of Nuclear Medicine
Volume: 47
Issue: 7
ISSN: 0161-5505
Publisher: Society of Nuclear Medicine  
Date Published: 2006-07-01
Start Page: 1202
End Page: 1208
Language: English
PROVIDER: scopus
PUBMED: 16818956
DOI/URL:

http://www.scopus.com/inward/record.url?eid=2-s2.0-33747139438&partnerID=40&md5=09fee8b768c05a74303e824095a4611a
Notes: --- - "Cited By (since 1996): 31" - "Export Date: 4 June 2012" - "CODEN: JNMEA" - "Source: Scopus"
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MSK Authors
  1. Chaitanya Divgi
    163 Divgi
  2. Leslie L Montgomery
    50 Montgomery
  3. Neeta Pandit-Taskar
    342 Pandit-Taskar
  4. Pat B Zanzonico
    355 Zanzonico
  5. Lawrence Dauer
    170 Dauer
  6. Jean M St Germain
    61 St Germain
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