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Radiation protection procedures in 131I treatments for thyroid cancer in patients requiring hemodialysis

Fioroni, Federicaa; Sghedoni, Robertoa; Grassi, Elisaa; Piccagli, Vandoa; Sollini, Martinab; Filice, Angelinab; Versari, Annibaleb; Iori, Mauroa

Nuclear Medicine Communications:
doi: 10.1097/MNM.0000000000000095
Original Articles
Abstract

Background: Hemodialysis is essential for patients with renal failure, and iodine-131 (131I) administration is the standard of care in thyroid carcinoma treatment. Although the need for hemodialysis during 131I treatment is very rare, it raises some concerns due to the involvement of personnel not exposed to radiation and to the contamination of devices used for other patients. In this paper, a radioprotection protocol to perform hemodialysis safely on patients during 131I treatment has been presented.

Patients and methods: The exposure of personnel who assisted 13 patients over the course of 10 years was monitored: external exposure was measured through electronic dosimeters, and internal contamination was checked by thyroid uptake and urine sample gamma spectrometry.

Over this period, room layout was optimized to allow an improvement of radioprotection procedures.

Two nurses were involved in patient assistance.

Results: After hemodialysis, measurements of internal contamination were below the minimum detectable activity and external exposure was in the range of 1–82 μSv in terms of Hp(10).

A reduction in personnel exposure was observed after hospitalization room renovation: Hp(10) normalized to the activity administered to the patient was about halved.

Conclusion: The data show that hemodialysis can be performed safely during 131I treatments when appropriate radioprotection actions are implemented.

Author Information

aMedical Physics Unit

bNuclear Medicine Unit, Arcispedale Santa Maria Nuova – IRCCS, Reggio Emilia, Italy

Correspondence to Roberto Sghedoni, PhD, Medical Physics Unit, Arcispedale Santa Maria Nuova – IRCCS, Viale Risorgimento 80, 42123 Reggio Emilia, Italy Tel: +39 052 229 5882; fax: +39 052 229 6392; e-mail: roberto.sghedoni@asmn.re.it

Received July 16, 2013

Accepted January 26, 2014

© 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins