Abstract
PurposeThe current hospital policy for this study is stringent regarding the storage of radioactive sentinel lymph node (SLN) specimens, which requires the storage time of 24 hours before being handled by Pathology. Additional labeling along with separate containment of these specimens can be forgone if negligible radiation levels are found. The objective of this study was to determine whether the storage time needed for resected radioactive breast and primary site specimens to decay to twice the background radiation levels is less than 24 hours. MethodsThe investigators retrieved breast and primary site SLN specimens from the Pathology department on the same day of the biopsy. A dose calibrator was used to measure the dose, specimen, and concurrent background radioactivity in Megabecquerels (MBq). Radioactive decay calculations were used to further investigate when specimen activities reached twice the background levels. A retrospective analysis was performed using a one-sample t-test to determine if the time to reach double the background activity was significantly different from 24 hours. This study pertained to workflow optimization; thus, general procedure consent forms were sufficient. Both patient confidentiality and privacy were protected. The investigators followed the necessary radiation safety measures. ResultsThe mean time for specimens to reach twice the background level of radioactivity was 3.99 hours, significantly less than current storage time of 24 hours (p < 0.001). The mean time point for the SLNs to reach 1/16th of the original activity was 7.78 hours (p < 0.001). The average node activity was 0.14 MBq. ConclusionThe average sentinel node activity was less than 1 exemption quantity and the time to reach less than twice the background levels was significantly less than 24 hours, meaning that radioactive labels are not needed, and the 24-hour overnight specimen storage can be mitigated.
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