JOURNAL DESCRIPTION
The Medical Radiology and Radiation Safety journal ISSN 1024-6177 was founded in January 1956 (before December 30, 1993 it was entitled Medical Radiology, ISSN 0025-8334). In 2018, the journal received Online ISSN: 2618-9615 and was registered as an electronic online publication in Roskomnadzor on March 29, 2018. It publishes original research articles which cover questions of radiobiology, radiation medicine, radiation safety, radiation therapy, nuclear medicine and scientific reviews. In general the journal has more than 30 headings and it is of interest for specialists working in thefields of medicine¸ radiation biology, epidemiology, medical physics and technology. Since July 01, 2008 the journal has been published by State Research Center - Burnasyan Federal Medical Biophysical Center of Federal Medical Biological Agency. The founder from 1956 to the present time is the Ministry of Health of the Russian Federation, and from 2008 to the present time is the Federal Medical Biological Agency.
Members of the editorial board are scientists specializing in the field of radiation biology and medicine, radiation protection, radiation epidemiology, radiation oncology, radiation diagnostics and therapy, nuclear medicine and medical physics. The editorial board consists of academicians (members of the Russian Academy of Science (RAS)), the full member of Academy of Medical Sciences of the Republic of Armenia, corresponding members of the RAS, Doctors of Medicine, professor, candidates and doctors of biological, physical mathematics and engineering sciences. The editorial board is constantly replenished by experts who work in the CIS and foreign countries.
Six issues of the journal are published per year, the volume is 13.5 conventional printed sheets, 88 printer’s sheets, 1.000 copies. The journal has an identical full-text electronic version, which, simultaneously with the printed version and color drawings, is posted on the sites of the Scientific Electronic Library (SEL) and the journal's website. The journal is distributed through the Rospechat Agency under the contract № 7407 of June 16, 2006, through individual buyers and commercial structures. The publication of articles is free.
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Medical Radiology and Radiation Safety. 2023. Vol. 68. № 5
DOI:10.33266/1024-6177-2023-68-5-82-87
E.K. Azimova1, 2, Sh.Sh. Abdulloeva1, F.N. Usov1,
A.D. Zikiryakhodzhaev1, 3 ,4, E.I. Egina1
Variants of Sentinel Lymph Node Research Protocols in Breast Cancer
1 P.A. Herzen Moscow Research Oncology Institute, Moscow, Russia
2Tashkent State Dental Istitute, Tashkent, Uzbekistan
3Peoples’ Friendship University of Russia (RUDN University), Moscow, Russia
4I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
Contact person: E.K. Azimova, e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
ABSTRACT
Purpose: To study the advantages of the technique of administering a radiopharmaceutical according to the “two-day protocol” for determining the sentinel lymph node in breast cancer. Compare the methods of introducing radiopharmaccutical according to the “two-day protocol” and the “one-day protocol”. To identify the advantages of using the “two-day protocol” method over the “one-day protocol” method.
Material and methods: In order to improve the diagnosis and treatment of breast cancer by means of a sentinel lymph node biopsy (SLNB) using the technique of introducing a radiopharmaceutical a day before surgical treatment, we analyzed 76 patients with various molecular biological types and stage of breast cancer disease who underwent examination and treatment in the conditions of the P.A. Herzen Moscow State Medical Institute. This cohort of patients was divided into 2 comparable groups: 1 group of patients who underwent SLNB according to a two-day protocol (n=38), the 2nd group of patients who underwent SLNB according to a one-day protocol (n=38). The ambient equivalent dose rate of photon radiation was measured using the MKS-08P dosimeter on the day of RP administration and on the day of surgery.
Results: On average, the dose rate of photon radiation 0.5 m from the injection point on the day of radiopharmaccutical administration (according to the “one-day protocol”) and on the day of surgery (according to the “two-day protocol”) was 46.9±23.1(11.0‒85.4) and 2.2±1.1(1.0‒6.4) μSv/h, respectively. The average value of thedose rate directly in the colloid injection zone two hours after administration is equal to 185.1±25.7 (138.9‒258.0) μSv/h, a day later ‒ 9.8±3.8 (6.5‒27) μSv/h. In the first group, when using the “two-day protocol”, when scanning the SPECT/CT in 34/38 (89.5 %) patients revealed 83 lymph nodes, in the second in 30/38 (78.9 %) patients – 72; the total number of removed lymph nodes ‒ 147 and 156, respectively. With an urgent cytological examination, adenogenic metastases were detected in 8 cases in the first group, in 11 cases in the second. In 11/38 (29.0 %) patients, according to the “two-day protocol”, the number of detected and removed lymph nodes is equal, “according to the one-day protocol” ‒ in 5/38 (13.2 %). The scan did not reveal any SLN in the first group – 5/38 (13.2 %), in the second – 7/38 (18.4 %).
Conclusions: The advantage of using the “two-day protocol” was revealed, consisting in an 18-fold decrease in background radiation. And also, a faster and more accurate determination of the sentinel lymph node in the surgical field using a gamma detector, associated with a minimum number of cases of scattered radiation in the area of regional lymph outflow, in contrast to the weak accumulation of “sentinel” lymph nodes and strong background radiation outside the nodes when a radioisotope is injected on the day of surgery. The “two-day protocol” greatly facilitates the work of the oncologist surgeon, contributes to a more accurate determination and biopsy of the sentinel lymph node, reduces the radiation load on medical staff during surgery.
Keywords: breast cancer, sentinal lymph node, SPECT/CT, gamma-probe, biopsy, one-day protocol, two-day protocol, radiation
situation
For citation: Azimova EK, Abdulloeva ShSh, Usov FN, Zikiryakhodzhaev AD, Egina EI.Variants of Sentinel Lymph Node Research Protocols in Breast Cancer. Medical Radiology and Radiation Safety. 2023;68(5):82–87. (In Russian). DOI:10.33266/1024-6177-2023-68-5-82-87
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PDF (RUS) Full-text article (in Russian)
Conflict of interest. The authors declare no conflict of interest.
Financing. The study had no sponsorship.
Contribution. A.D. Zikiryakhodjaev: concept and design of the study;
E.K. Azimova, Sh.Sh. Abdulloeva, E.I. Egina: collection and processing of the material; E.K. Azimova: writing the text; F.N. Usov: editing.
Article received: 20.04.2023. Accepted for publication: 27.05.2023.