Radiation dose rates from patients receiving iodine-131 therapy for carcinoma of the thyroid. 1996

S F Barrington, and A G Kettle, and M J O'Doherty, and C P Wells, and E J Somer, and A J Coakley
Department of Nuclear Medicine, Kent and Canterbury Hospital, Ethelbert Road, Canterbury CT1 3NG, UK.

Patients treated with radioiodine present a radiation hazard and precautions are necessary to limit the radiation dose to family members, nursing staff and members of the public. The precautions advised are usually based on instantaneous dose rates or iodine retention and do not take into account the time spent in close proximity with a patient. We have combined whole-body dose rate measurements taken from 86 thyroid cancer patients after radioiodine administration with published data on nursing and social contact times to calculate the cumulative dose that may be received by an individual in contact with a patient. These dose estimates have been used to calculate restrictions to patients behaviour to limit received doses to less than 1 mSv. We have also measured urinary iodide excretion in 19 patients to estimate the potential risk from the discharge of radioiodide into the domestic drainage system. The dose rate decay was biexponential for patients receiving radioiodine to ablate the thyroid after surgery (the ablation group, A) and monoexponential for these receiving subsequent treatments for residual or recurrent disease (the follow-up group, FU). The faster clearance in the follow-up patients generally resulted in less stringent restrictions than those advised for ablation patients. For typical activities of 1850 MBq for the ablation patients and 3700 MBq or 7400 MBq for the follow-up patients, the following restrictions were advised. Patients could travel in a private car for up to 8h on the day of treatment (for an administered activity of 1850 MBq in group A) or 4 and 2h (for activities of 3700 or 7400 MBq in group FU) respectively. Patients should remain off work for 3 days (1850 MBq/group A) or 2 days (up to 7400 MBq/group FU). Partners should avoid close contact and sleep apart for 16 days (1850 MBq/group A) or 4-5 days (3700 or 7400 MBq/group FU). Contact with children should be restricted according to their age, ranging from 16 days (1850 MBq/group A) or 4-5 days (3700 or 7400 MBq in group FU) for younger children, down to 10 days (1850 MBq/group A) or 4 days (up to 7400 MBq/group FU) for older children. The cumulative dose to nursing staff for the week after treatment was dependent on patient mobility and was estimated at 0.08 mSv for a self-caring patient to 6.3 mSv for a totally helpless patient (1840 MBq/group A). Corresponding doses to nurses looking after patients in group FU were 0.18-12.3 mSv (3700 MBq) or 0.36-24.6 mSv (7400 MBq). Sensible guidelines can be derived to limit the dose received by members of the public and staff who may come into contact with cancer patient treated with radioiodine to less than 1 mSv. The rapid clearance of radioiodine in patients treated on one or more than one occasion means that therapy could be administered at home to selected patients with suitable domestic circumstances. In most cases the restriction times, despite the high administered activities, are less than those for patients treated for thyrotoxicosis. The concentration of radioiodide in domestic drainage systems should not pose a significant risk.

UI MeSH Term Description Entries
D007457 Iodine Radioisotopes Unstable isotopes of iodine that decay or disintegrate emitting radiation. I atoms with atomic weights 117-139, except I 127, are radioactive iodine isotopes. Radioisotopes, Iodine
D009741 Nursing Staff, Hospital Personnel who provide nursing service to patients in a hospital. Hospital Nursing Staff,Hospital Nursing Staffs,Nursing Staffs, Hospital,Staff, Hospital Nursing,Staffs, Hospital Nursing
D011829 Radiation Dosage The amount of radiation energy that is deposited in a unit mass of material, such as tissues of plants or animal. In RADIOTHERAPY, radiation dosage is expressed in gray units (Gy). In RADIOLOGIC HEALTH, the dosage is expressed by the product of absorbed dose (Gy) and quality factor (a function of linear energy transfer), and is called radiation dose equivalent in sievert units (Sv). Sievert Units,Dosage, Radiation,Gray Units,Gy Radiation,Sv Radiation Dose Equivalent,Dosages, Radiation,Radiation Dosages,Units, Gray,Units, Sievert
D011835 Radiation Protection Methods and practices adopted to protect against RADIATION. Protection, Radiation
D011874 Radiometry The measurement of radiation by photography, as in x-ray film and film badge, by Geiger-Mueller tube, and by SCINTILLATION COUNTING. Geiger-Mueller Counters,Nuclear Track Detection,Radiation Dosimetry,Dosimetry, Radiation,Geiger Counter,Geiger-Mueller Counter Tube,Geiger-Mueller Probe,Geiger-Mueller Tube,Radiation Counter,Counter Tube, Geiger-Mueller,Counter Tubes, Geiger-Mueller,Counter, Geiger,Counter, Radiation,Counters, Geiger,Counters, Geiger-Mueller,Counters, Radiation,Detection, Nuclear Track,Dosimetries, Radiation,Geiger Counters,Geiger Mueller Counter Tube,Geiger Mueller Counters,Geiger Mueller Probe,Geiger Mueller Tube,Geiger-Mueller Counter Tubes,Geiger-Mueller Probes,Geiger-Mueller Tubes,Probe, Geiger-Mueller,Probes, Geiger-Mueller,Radiation Counters,Radiation Dosimetries,Tube, Geiger-Mueller,Tube, Geiger-Mueller Counter,Tubes, Geiger-Mueller,Tubes, Geiger-Mueller Counter
D002648 Child A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL. Children
D004781 Environmental Exposure The exposure to potentially harmful chemical, physical, or biological agents in the environment or to environmental factors that may include ionizing radiation, pathogenic organisms, or toxic chemicals. Exposure, Environmental,Environmental Exposures,Exposures, Environmental
D005190 Family A social group consisting of parents or parent substitutes and children. Family Life Cycles,Family Members,Family Life Cycle,Family Research,Filiation,Kinship Networks,Relatives,Families,Family Member,Kinship Network,Life Cycle, Family,Life Cycles, Family,Network, Kinship,Networks, Kinship,Research, Family
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults

Related Publications

S F Barrington, and A G Kettle, and M J O'Doherty, and C P Wells, and E J Somer, and A J Coakley
March 2010, Radiation protection dosimetry,
S F Barrington, and A G Kettle, and M J O'Doherty, and C P Wells, and E J Somer, and A J Coakley
December 1990, Medical dosimetry : official journal of the American Association of Medical Dosimetrists,
S F Barrington, and A G Kettle, and M J O'Doherty, and C P Wells, and E J Somer, and A J Coakley
September 2000, Oncology nursing forum,
S F Barrington, and A G Kettle, and M J O'Doherty, and C P Wells, and E J Somer, and A J Coakley
March 1993, Nuclear medicine communications,
S F Barrington, and A G Kettle, and M J O'Doherty, and C P Wells, and E J Somer, and A J Coakley
July 1985, Journal of nuclear medicine : official publication, Society of Nuclear Medicine,
S F Barrington, and A G Kettle, and M J O'Doherty, and C P Wells, and E J Somer, and A J Coakley
October 1986, Journal of nuclear medicine : official publication, Society of Nuclear Medicine,
S F Barrington, and A G Kettle, and M J O'Doherty, and C P Wells, and E J Somer, and A J Coakley
July 1992, Journal of nuclear medicine : official publication, Society of Nuclear Medicine,
S F Barrington, and A G Kettle, and M J O'Doherty, and C P Wells, and E J Somer, and A J Coakley
November 1976, International journal of radiation biology and related studies in physics, chemistry, and medicine,
S F Barrington, and A G Kettle, and M J O'Doherty, and C P Wells, and E J Somer, and A J Coakley
April 1997, European journal of nuclear medicine,
S F Barrington, and A G Kettle, and M J O'Doherty, and C P Wells, and E J Somer, and A J Coakley
November 1994, Journal of nuclear medicine : official publication, Society of Nuclear Medicine,
Copied contents to your clipboard!