Comprehensive evaluation of occupational radiation exposure to intraoperative and perioperative personnel from 18F-FDG radioguided surgical procedures

Purpose  The purpose of the current study was to comprehensively evaluate occupational radiation exposure to all intraoperative and perioperative personnel involved in radioguided surgical procedures utilizing ¹⁸F-fluorodeoxyglucose (¹⁸F-FDG). Methods  Radiation exposure to surgeon, anesthetist, scrub technologist, circulating nurse, preoperative nurse, and postoperative nurse, using aluminum oxide dosimeters read by optically stimulated luminescence technology, was evaluated during ten actual radioguided surgical procedures involving administration of ¹⁸F-FDG. Results  Mean patient dosage of ¹⁸F-FDG was 699 ± 181 MBq (range 451–984). Mean time from ¹⁸F-FDG injection to initial exposure of personnel to the patient was shortest for the preoperative nurse (75 ± 63 min, range 0–182) followed by the circulating nurse, anesthetist, scrub technologist, surgeon, and postoperative nurse. Mean total time of exposure of the personnel to the patient was longest for the anesthetist (250 ± 128 min, range 69–492) followed by the circulating nurse, scrub technologist, surgeon, postoperative nurse, and preoperative nurse. Largest deep dose equivalent per case was received by the surgeon (164 ± 135 μSv, range 10–580) followed by the anesthetist, scrub technologist, postoperative nurse, circulating nurse, and preoperative nurse. Largest deep dose equivalent per hour of exposure was received by the preoperative nurse (83 ± 134 μSv/h, range 0–400) followed by the surgeon, anesthetist, postoperative nurse, scrub technologist, and circulating nurse. Conclusion  On a per case basis, occupational radiation exposure to intraoperative and perioperative personnel involved in ¹⁸F-FDG radioguided surgical procedures is relatively small. Development of guidelines for monitoring occupational radiation exposure in ¹⁸F-FDG cases will provide reassurance and afford a safe work environment for such personnel.