Should Patients of Hyperthyroidism be made to wait in the Department Post Low-Dose I-131 Therapy?
DOI:
https://doi.org/10.21276/94aswm30Keywords:
Low-dose I-131 therapy, Hyperthyroidism, Radiation exposureAbstract
Background: Patients of hyperthyroidism are usually sent home immediately after oral administration of Low Dose Iodine Therapy (LDIT) without taking into account socio-economic conditions, psychological aspects of patients and mode of travel undertaken by patient when going home. These patients may then become a source of unnecessary exposure to family members and general public which comes in the close proximity of the patients. Our study evaluated the minimum time hyperthyroidism patients should be made to wait in the isolation room of the department after LDIT in order to reduce the radiation exposure to family members and general public.
Methods: A total of 51 patients of hyperthyroidism treated with LDIT during the period of Feb 2019–Aug 2020 were included and divided into two different groups with Group 1 comprising of patients administered 5-15mCi of I-131 and Group 2 comprising of patients administered 16-29mCi of I-131. Radiation exposure rate was measured at 1-meter distance with ionization based survey meter at 5min, 1hour and 2hour post I-131 administration.
Results: Mean radiation exposure rate at 1metre distance for Group 1 at 5min, at 1hour and 2hours was 1.63mR/hr, 1.5mR/hr & 1.35mR/hr respectively whereas for Group 2 it was 3.80mR/hr, 3.60mR/hr & 3.45mR/hr respectively. Significant difference was observed in exposure level taken at 5min, at 1hour and 2hours time interval (p value <0.01).
Conclusion: Hence, we recommend patient should wait minimum of 2 hours in isolation room of the department post LDIT in order to further reduce radiation exposure to their family members and general public.
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References
Iagaru A, McDougall IR. Treatment of thyrotoxicosis. J Nucl Med. 2007;48(3):379-89.
De Leo S, Lee SY, Braverman LE. Hyperthyroidism. Lancet. 2016;388(10047):906-18.
Tripathi KD. Essential of Medical Pharmacology. 7th edition. Jaypee Brothers Medical Publishers (P) Ltd; 2013.
Reiners C, Schneider P. Radioiodine therapy of thyroid autonomy. Eur J Nucl Med Mol Imaging. 2002;29(2):471-8.
Reinhardt MJ, Joe A, Mallek D et al. Dose selection for radioiodine therapy of borderline hyperthyroid patients with multifocal and disseminated autonomy on the basis of 99mTc-pertechnetate thyroid uptake. Eur J Nucl Med. 2002;29:480–85.
Muhammad W, Faaruq S, Matiullah, Hussain A, Khan AA. Release criteria from hospitals of 131I thyrotoxicosis therapy patients in developing countries--case study. Radiat Prot Dosimetry. 2006;121(2):136-9.
Council of the European Union. Directive on the Health Protection of Individuals against the dangers of ionising radiation in relation to medical exposures. 97/43/Euratom OJ. 1997; 180:22-27.
Buchan RCT, Brindle JM. Radioiodine therapy to outpatients- the contamination hazard. Br J Radiol 1970; 43(511): 479-482.
Nishizawa K, Ohara K, Ohshima M, Maekoshi H, Orito T, Watanabe T. Monitoring of I excretions and used materials of patients treated with 131I. Health Phys. 1980 Apr;38(4):467-81.
IAEA Basic Safety Standards. International basic safety standards for protection against ionizing radiations and for the safety of radiation sources. IAEA BSS No. 115 (Vienna: IAEA) (1996).
Tandon P. Radiation Safety in Nuclear Imaging and Radionuclide Therapy. Indian J Nucl Med. 2007;22:122.
Silberstein EB, Alavi A, Balon HR, Clarke SE, Divgi C et. al. The SNMMI practice guideline for therapy of thyroid disease with 131I 3.0. J Nucl Med 2012;53(10):1633-51.
Padma S, Sundaram P S. Radioiodine as an adjuvant therapy and its role in follow-up of differentiated thyroid cancer. J Can Res Ther. 2016;12:1109-13.
Jacobson AP, Plato PA, Toeroek D. Contamination of home environment by patients treated with iodine-I31:initial results. Am J Pub Health. 1978;68:225-30.
NCRP. Precautions in the Management of Patients who have Received Therapeutic Amounts of Radionuclides. National Council on Radiation Protection and Measurements, Washington DC, Report No. 37, 1970:20.
Mountford PJ, Coakley AJ. Radioactive patients. Br Med J. 1989; 298:1538 -9.
Sisson JC, Freitas J, McDougall IR, Dauer T, James R, Hurley JD, et al. Radiation safety in the treatment of patients with thyroid diseases by radioiodine 131: practice recommendations of the American thyroid association. Thyroid. 2011; 21(4):335–46.
Morganti S, Ceda GP, Saccani M. Milli B, Ugolotti D, Prampolini R, et al. Thyroid diseases in the elderly: sex related difference in clinical experience. J Endocrinol Invest. 2005;28(1):101–4.
Cui S, Jiao L, Tan J, Zhang G, Zhang H, Long W et al. Estimating radiation absorbed dose of individuals nearby iodine-131 treated hyperthyroid patient. Health Phys. 2014; 106(3):365-69.
Salman K, Wagieh S, Bakhsh A, Al-Monshy T, Talaat O, Al- Malki M, et al. Measurement of cumulative radiation exposure to children and adolescent in contact with outpatients treated with low dose radioactive iodine-131. J Egypt Natl Canc Inst. 2020; 32(1):1-7.
Salman KH, Wagieh S, Munshi T, Almalki M, Zatari S, Zahid KH, et al. measurement of radiation exposure to household contacts of patients with Graves’s disease treated with low dose radioactive iodine-131 on outpatient basis. Egypt J Radiol Nucl Med. 2018; 49(4):1125-30.
Shah AS, Hameedullah, Farrukh S, Shah KA, Khan AU, Khattak MR. Radiation doses from 131I treated hyperthyroidism patients versus life style: - a survey. Int J Radiat Res. 2015;13(1):67-72.
Mattar E, Salih MA, Alsafi K, Suliman II. Radiation protection in the release of patients receiving131I treatment. Radiat Prot Dosimetry. 2019;187(4):499-508.
Vazquez AM, Castillo DC, Flores UH, Cespedes CL, Morgan NC, Sifuentes DY, et al. Exposure rate measurement and radiation control in post therapy with 131-I. Int J of Res in Engg and Sci. 2015;3(10):29–31.
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