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Purpose: Hyperthermic isolated limb perfusion (HILP) is an effective method in the treatment of recurrent melanomas and soft tissue sarcomas. To avoid systemic toxicity, leakage from the limb perfusate into the systemic circulation is real-time monitored by administration of a radioactive agent to the limb circuit. This has made HILP safe for the patient. However, the radiation exposure to the surgical staff has never been measured and could be a limiting factor for the use of HILP. The purpose of the present study was to measure and evaluate the radiation exposure to the surgical staff performing HILP with 99mTechnetium labeled red blood cells. Materials and methods: Thirteen patients had HILP performed in 11 lower limbs and two upper limbs at our inpatient clinic between October 2006 and February 2007. The surgeon and nurse had thermoluminescence dosimetry (TLD) chips attached to the finger pulp and to the ring area of the left fourth finger, as well as an electronic dosimeter attached to the anterior lining of the trousers. The anesthesiologist and perfusion technologist also carried electronic dosimeters. Results: The surgeon had the highest radioactive exposure with an average dose per procedure to the finger pulp of 16.2 µSv, to the ring area of 8.5 µSv, and to the abdominal wall of 4.2 ± 0.6 µSv. Conclusions: HILP with 99mtechnetium-labeled red blood cells does not constitute a safety risk to the operating team with respect to radioactive exposure. Routine dose monitoring of the staff or special precautions for fertile women are not necessary. [ABSTRACT FROM AUTHOR]

Dermal alterations due to chronic UVR exposure may influence dermal ultrasound echogenicity, and a subepidermal low-echogenic band has been proposed as a marker of photoaging. The aim of this study was to determine whether dermal echogenicity could be used as a biological UVR dosimeter. We included 201 subjects (138 healthy volunteers, 31 patients with basal cell carcinoma, and 32 patients with cutaneous malignant melanoma). The number of low-echogenic pixels in the upper dermis relative to the lower dermis (LEPu/l) was determined in sun-exposed and sun-protected skin. Individual UVR exposure data were collected retrospectively and prospectively using a questionnaire and electronic personal UVR dosimeters. Age, but not sex, skin type, constitutive pigmentation or smoking, correlated significantly with LEPu/l at all body sites. Different measures of individual UVR exposure were significantly positively correlated with LEPu/l (together r2=0.39, dorsal forearm), but separately the correlations were poor (r2=0.04–0.19). LEPu/l was higher in the dorsal forearm in a group with high UVR exposure compared to a low-exposure group (P=0.007). Skin cancer patients in general had a lower LEPu/l than healthy subjects. The results indicate that the age-related increase in LEPu/l might be attributed mainly to UVR exposure, and that the methods used to obtain the UVR exposure data might not be sufficiently sensitive or specific. Genetic factors might also influence LEPu/l. We consider LEPu/l to be a sensitive and specific marker for UVR exposure at the dorsal aspect of the forearm in healthy subjects. [ABSTRACT FROM AUTHOR]