Bhatia Nisha, Dhingra Vandana K, Mittal Pulkit, Saini Sunil
Department of Nuclear Medicine, Cancer Research Institute, Swami Rama Himalayan University (SRHU), Dehradun, Uttarakhand, India.
Department of Nuclear Medicine, All India Institute of Medical Sciences (AIIMS), Rishikesh, Uttarakhand, India.
World J Nucl Med. 2023 Sep 6;22(3):203-207. doi: 10.1055/s-0043-1771285. eCollection 2023 Sep.
Our objective was to study the radiation exposure rate as function of time in the administration of radioiodine iodine-131 (I-131) for the treatment of thyrotoxicosis or Graves' disease and remnant ablation on an outpatient basis at the Department of Nuclear Medicine, and also, to study the impact of revised discharge criteria for radioiodine therapy enforced by the Atomic Energy Regulatory Board (AERB) of India. This study included patients who underwent low-dose radioiodine therapy using I-131. Patients were classified into two different groups, that is, group A and group B. Group A included patients receiving low dose I-131 for the treatment of thyrotoxicosis, whereas group B included patients receiving I-131 therapy for the ablation of residual thyroid tissue after total thyroidectomy. The radiation exposure rate was measured using a radiation detector in milli roentgen per hour (mR/h) at 5 cm distance of stomach and neck levels and with the patient standing at the distance of 1 m after oral administration of I-131 at 0, 1, and 2 hours. A total of 134 (17 males and 117 females) patients were included in the study. Group A comprised 102 (14 male and 88 females) patients and group B of 32 (3 males and 29 females) patients. At the neck level, the average exposure rate in group A versus group B after 0, 1, and 2 hours was observed to be 6.9 versus 22.27 mR/h, 33.67 versus 43.39 mR/h, and 41.75 versus 48.90 mR/h, respectively. At the stomach level, the exposure rate was 23.65 versus 71.32 mR/h, 13.27 versus 48.45 mR/h, and 9.91 versus 39.43 mR/h after 0, 1, and 2 hours, respectively. At a distance of 1 m, the exposure rate was 1.31 versus 2.99 mR/h, 1.05 versus 2.58 mR/h, and 0.92 versus 2.21 mR/h, respectively. Exposure rate measured for patients treated with up to 1,110 MBq (30 mCi) of I-131 was under permissible limits as per revised discharged limits, that is, 50 µSv/h (5 mR/h) prescribed by AERB, India. The patients undergoing radioiodine therapy I-131 (up to 1,110 MBq/30 mCi) can be discharged safely 2 hours postadministration following good work practice along with providing proper radiation safety instructions to patients.
我们的目的是研究在核医学科门诊给予放射性碘碘 - 131（I - 131）治疗甲状腺毒症或格雷夫斯病以及残余甲状腺组织消融时，辐射暴露率随时间的变化情况，同时研究印度原子能监管委员会（AERB）实施的放射性碘治疗修订后出院标准的影响。
本研究纳入了接受低剂量I - 131放射性碘治疗的患者。患者被分为两组，即A组和B组。A组包括接受低剂量I - 131治疗甲状腺毒症的患者，而B组包括接受I - 131治疗全甲状腺切除术后残余甲状腺组织消融的患者。在口服I - 131后0、1和2小时，让患者站在距离1米处，使用辐射探测器在距离胃部和颈部水平5厘米处测量辐射暴露率，单位为毫伦琴每小时（mR/h）。
共有134例患者（17例男性和117例女性）纳入本研究。A组有102例患者（14例男性和88例女性），B组有32例患者（3例男性和29例女性）。在颈部水平，A组和B组在0、1和2小时后的平均暴露率分别为6.9对22.27 mR/h、33.67对43.39 mR/h以及41.75对48.90 mR/h。在胃部水平，0、1和2小时后的暴露率分别为23.65对71.32 mR/h、13.27对48.45 mR/h以及9.91对39.43 mR/h。在距离1米处，暴露率分别为1.31对2.99 mR/h、1.05对2.58 mR/h以及0.92对2.21 mR/h。
按照印度AERB规定的修订后出院限值，即50微希沃特/小时（5 mR/h），接受高达1110兆贝克勒尔（30毫居里）I - 131治疗患者的测量暴露率在允许限值内。接受I - 131放射性碘治疗（高达1110兆贝克勒尔/30毫居里）的患者在给药后2小时，遵循良好操作规范并向患者提供适当的辐射安全指导后可安全出院。
