Mitigation of radiation exposure during surgical hepatectomy after yttrium-90 radioembolization.

Journal of Radiological Protection : Official Journal of the Society for Radiological Protection
Mary A DecoteauChristopher L Marsh

Abstract

Yttrium-90 (Y-90) radioembolization for the treatment of hepatocellular carcinoma can present safety challenges when transplanting recently treated Y-90 patients. To reduce surgeons' contact with radioactive tissue and remain within occupational dose limits, current guidelines recommend delaying transplants at least 14 days, if possible. We wanted to determine the level of radiation exposure to the transplant surgeon when explanting an irradiated liver before the recommended decay period. Anex-vivoradiation exposure analysis was conducted on the explanted liver of a patient who received Y-90 therapy 46 h prior to orthotopic liver transplant. To estimate exposure to the surgeon's hands, radiation dosimeter rings were placed inside three different surgical glove configurations and exposed to the explanted liver. Estimated radiation doses corrected for Y-90 decay were calculated. Radiation safety gloves performed best, with an average radiation exposure rate of 5.36 mSV h-1in the static hand position, an 83% reduction in exposure over controls with no glove (31.31 mSv h-1). Interestingly, non-radiation safety gloves also demonstrated reduced exposure rates, well below occupational regulation limits. Handling of Y-90 radiated organ...Continue Reading

References

Sep 19, 2006·International Journal of Radiation Oncology, Biology, Physics·Riad Salem, Russell D Hunter
Oct 20, 2012·Journal of Radiological Protection : Official Journal of the Society for Radiological Protection·Jonas HögbergPeter Bernhardt
Mar 21, 2013·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Riad SalemBruno Sangro
Apr 22, 2019·HPB : the Official Journal of the International Hepato Pancreato Biliary Association·Ismail LabgaaEmmanuel Melloul

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