Radioactive concentration of 131I in the air of treatment workplaces for differentiated thyroid cancer with sodium iodide 131I oral solution / 中国辐射卫生

Objective To study the radioactive concentration of 131I in the air of workplaces where sodium iodide [131I] oral solution was administrated for patients with differentiated thyroid cancer (DTC) in the Department of Nuclear Medicine, and to estimate the internal radiation dose to the staff. Methods Workplaces of radioiodine 131I therapy for DTC patients in the Department of Nuclear Medicine of a hospital were investigated. Air samples in 131I administration areas and treatment wards were collected respectively and were measured by low-background gamma-ray spectrometry to calculate the activity concentration of 131I in the air and to further estimate the internal radiation dose to staffs. Results The activity concentration in the 131I administration area within the first 3 h of administration was 3～187 Bq/m3. During administration and within the first 3 h of administration, the staff exposed in the administration area for 5～30 min received an internal radiation dose of 0.08～0.50 μSv and 0.00～0.04 μSv, respectively. The highest activity concentration of 131I in the air of the ward was measured on the day of administration, reaching 3091 Bq/m3. After patients were discharged, the activity concentration in the ward gradually decreased to 10～242 Bq/m3 within 48 h. Within 48 h after patients were discharged, the staff exposed in the ward for 5～30 min received an internal radiation dose of 0.01～14.11 μSv. Conclusion A high activity concentration of 131I in the air was recorded during administration for DTC patients in radioiodine 131I therapy, and thus we recommend remote instructed administration or administration through a shielded window. We also recommend that non-treatment related personnel except medical staffs should not enter the ward during patients’ hospitalization at which the activity concentration of 131I in the ward was the highest. After patients were discharged, a delayed entry into the ward is recommended to reduce the internal radiation dose.

Characteristics of hyperthyroid heart disease and radioiodine-131 treatment strategy / 实用医学杂志

Objective To discuss the clinical characteristics of hyperthyroid heart disease(HHD)and ex-plore the strategy to guarantee radioiodine-131 therapy(RAI)safety. Methods Clinical data and treatment regi-mens of 40 HHD patients admitted into our department from 2012-2016 were analyzed. Common complications as atrial fibrillation,heart failure,liver damage incidences and their characteristics were concluded. Curative effects of radioiodine-131 was evaluated. Results The incidence of atrial fibrillation(AF)was 45.0%. Heart failure (HF)of left ventricular ejection fraction(LVEF)was 80.0%.Severity of HF was accompanied with serum brain na-triuretic peptide(BNP)increase and LVEF decrease.Liver function was moderate-medium impaired(61.5%).De-gree of HF was positively correlated with direct bilirubinhe(R = 0.390,P = 0.012). The RAI one-dose cure rate for hyperthyroidism was 77.5%.ATD use before RAI has no effect on the cure rate. Four patients who can′t be treated with ATD deteriorated after RAI,two of them died because of seriously infection and HF,the other two re-covered with saturated solution of potassium iodide or lithium. Conclusion HHD treatment should be made fa-miliar. ATD before RAI treatment can avoid thyroid function impairment. If anti-thyroid medication can not be used on patients,glucocorticoids,saturated solution of potassium iodide or lithium can be applied according to the patients′conditions.

Aplicaciones clínicas del radioyodo 131 (I131) en las enfermedades del tiroides / Clinical applications of radioiodine 131 (I131) in the thyroid diseases

El radioyodo 131 es un isótopo radioactivo que se emplea exitosamente en el diagnóstico y tratamiento de las enfermedades benignas y malignas del tiroides. Su propiedad de integrarse selectivamente al metabolismo del tiroides y emitir una señal, le permite describir el funcionamiento glandular mediante estudios de captación, y delimitar la morfología y localización de los tejidos que capten yodo, a través de la gammagrafía. Es además una radioterapia sencilla, segura y coste-efectiva, usada como primera línea terapéutica en el control del hipertiroidismo, cuya dosis y momento de aplicación debería individualizarse según la etiología y la clínica de cada paciente. El radioyodo 131 ofrece una alternativa eficaz para reducir el tamaño del bocio no tóxico; además, respalda el tratamiento quirúrgico del carcinoma diferenciado del tiroides, y destruye a dosis ablativa los restos tisulares y las lesiones metastásicas que puede identificar durante el seguimiento gammagráfico. El empleo de radioyodo 131 está sujeto al cumplimiento de regulaciones de protección contra la radioactividad(AU)

Radioiodine 131 is a radioactive isotope that is successfully used for the diagnosis and the treatment of benign and malignant thyroid diseases. Its quality of selectively integrating to the thyroid metabolism and emitting a signal allows it to describe the gland functioning through capture studies, and to delimit the morphology and location of the tissues that capture iodine by means of gammagraphy. It is also a simple, safe and cost-effective radiotherapy used as first-line therapeutics in the control of hyperthyroidism. The dose and right time of application should be individualized according to the etiology and the clinic of each patient. Radioiodine 131 offers an efficient alternative to reduce the size of non-toxic goiter in addition to supporting the surgical treatment of the differentiated thyroid carcinoma and destroying with ablative doses the tissular remains and the metastatic lesions that can be detected during the gammagraphic follow-up. Radioiodine 131 depends on the fulfillment of safety regulations against radioactivity(AU)

Radioiodine ~(131) treatment is effective for Graves' disease / 中国实用内科杂志

Radioiodine 131 treatment for Graves' hyperthyroidism began nearly 70 years ago,and it has been recognized as the mainstream therapy for Graves' hyperthyroidism in western countries due to its simplicity and high cure rate.Indications of radioiodine 131 treatment have been changing during the past decades,now its main indication is Graves' hyperthyroidism of adult patients,especially when the patients were complicated with heart disease,leucocytopenia or hepatic damage.In Western countries,the cure rate of radioiodine 131 treatment is approximately 100%,yet the incidence of hypothyroidism is above 50%.Now hypothyroidism is accepted as an inevitable outcome for many patients after radioiodine 131 treatment.Evidence-based experiments during the past 70 years also showed that the therapy did not increase incidences of malignancies or leukemia,and had no influence on genetics or reproduction.