RESUMO
The design and implementation of a mobile gamma spectrometry system to in vivo measure the accumulated activity of 131I in whole body and thyroid of patients with thyroid diseases are presented in this work. This system may be used for both pre-therapeutic and post-therapeutic dosimetry calculations. It consists of a detector and a movable support that allows its movement from one place to another.
Assuntos
Radioisótopos do Iodo/análise , Radiometria/instrumentação , Espectrometria gama/instrumentação , Doenças da Glândula Tireoide/radioterapia , Adulto , Desenho de Equipamento , Feminino , Humanos , Hipertireoidismo/metabolismo , Hipertireoidismo/radioterapia , Radioisótopos do Iodo/farmacocinética , Pessoa de Meia-Idade , Imagens de Fantasmas , Radiometria/estatística & dados numéricos , Dosagem Radioterapêutica , Planejamento da Radioterapia Assistida por Computador , Espectrometria gama/estatística & dados numéricos , Doenças da Glândula Tireoide/metabolismo , Glândula Tireoide/metabolismo , Glândula Tireoide/efeitos da radiação , Neoplasias da Glândula Tireoide/metabolismo , Neoplasias da Glândula Tireoide/radioterapiaRESUMO
BACKGROUND: There is little information about the individual safety instructions provided by healthcare professionals to patients receiving radioactive iodine (I-131) therapy for the treatment of benign and malignant thyroid disorders or about whether these instructions are consistent across medical specialties. Currently, no national guidelines exist to standardize safety instructions related to I-131 administration. Here, we examine the spectrum of I-131 safety practices in contemporary use. METHODS: Members of major societies of physicians and allied specialists who treat patients with thyroid disorders were invited to complete a 27-question online survey about safety practices related to I-131 administration. Data from questionnaires were analyzed by type of safety recommendation and grouped according to provider specialty and geographic location. RESULTS: A total of 311 endocrinologists, surgeons, nuclear medicine radiologists, and allied health professionals completed questionnaires. They indicated that patients often receive instruction from more than one treating specialist. The decision to hospitalize a patient for treatment and the length of stay were determined by the patient's social situation and the dose of I-131 administered. Starting at I-131 doses between 259 and 1073 MBq (7 and 29 mCi), over 60% of respondents advised avoiding contact with children, sexual activity, and breastfeeding, with the latter recommendation continuing beyond 48 hours after treatment. Personal hygiene, laundry, and meal preparation precautions varied across respondents. Over 90% of respondents used serum or urine testing to screen for pregnancy status. Precautions to delay parenthood were given more often to female than male patients (90% vs. 60%), with a minimum recommended delay of 6 months. About 20% of respondents considered insurance coverage as a factor in selecting outpatient versus inpatient I-131 therapy, and this consideration varied geographically. CONCLUSION: A wide variety of safety recommendations are given to patients who receive I-131. To our knowledge, this survey represents the first organized inquiry into safety practices related to I-131 administration. The diversity of responses suggests an opportunity for multispecialty collaboration in defining more uniform recommendations for patient safety instructions during and after I-131 treatment.