Journal of the Korea Academia-Industrial cooperation Society (한국산학기술학회논문지)

The Korea Academia-Industrial cooperation Society (한국산학기술학회)
권호 표지
DOI QR코드

DOI QR Code

Suggestion of A Practical Simple Calculation Method for Safe Transportation Time after Radioactive Iodine Treatment in Patients with Thyroid Cancer

갑상선암 환자에서 방사성옥소치료 후 안전하게 이동할 수 있는 시간을 계산하기 위한 실용적인 간편계산법 제안

  • Park, Seok-Gun (Department of Nuclear Medicine, Dankook University Medical College)
  • 박석건 (단국대학교의과대학 핵의학교실)
  • Received : 2015.02.10
  • Accepted : 2015.06.11
  • Published : 2015.06.30
Download PDF
⟨ Previous Next ⟩

Abstract

When a patient with thyroid cancer is released from isolation after I-131 treatment and return to home using a vehicle, travel time should be controlled to reduce the amount of radiation to accompanying person. As the calculation of appropriate travel time is difficult, there is no patient-specific guideline until now. If we assume that there is no excretion and no physical decay during the relatively short travel time, calculation become quite simple; total radiation dose = dose rate ${\times}$ travel time. Results of this simple calculation and conventional calculation were compared using datum from 120 patients. Travel time calculated by simple method was 56% of conventional method in 0.3 m, 91% in 0.5 m and 96% in 1 m. Simple method was safe. It can be applied easily and also can be applied to the patients with hyperthyroidism treated by I-131.

방사성옥소 치료를 받은 환자가 격리 후 차량으로 귀가할 때 동승자가 받는 방사선 피폭량을 줄이기 위해서는 동승하는 시간을 적절하게 제한해야 한다. 계산 방법이 어렵기 때문에 현재까지 일반적인 가이드라인은 있어도 환자 개개인의 상태를 반영하는 기준은 없었다. 그런데 비교적 짧은 이동시간 동안에는 소변을 통한 배출이 없고 물리적인 붕괴도 없다는 가정을 하면 총선량 = 선량율 ${\times}$ 이동시간이라는 아주 간편한 계산을 할 수 있다. 입원했던 환자 120명의 데이터를 활용하여 이 간편계산법과 표준적인 계산법으로 계산한 결과를 비교하였다. 이동가능 시간을 계산했을 때 간편계산의 결과는 표준적인 방법에 비해 0.3 m 거리에서는 56%, 0.5 m 거리에서는 91%, 1 m 거리에서는 96%였다. 간편계산법은 안전한 방법이며, 방사선안전관리 방법으로 쉽게 적용할 수 있을 것이다. 또한 방사성옥소 치료를 받는 갑상선기능항진증 환자에서도 적용이 가능하다.

Keywords

References

  1. Marcus Middendorp, MD, and Frank Grunwald, MD. Update on Recent Developments in the Therapy of Differentiated Thyroid Cancer. Semin Nucl Med 40:145-152, 2010. DOI: http://dx.doi.org/10.1053/j.semnuclmed.2009.10.006
  2. Hee Jeong Park, Geum-Cheol Jeong, Seong Young Kwon, Jung-Joon Min, Hee-Seoung Bom, Ki Seong Park, Sang-Geon Cho, Sae-Ryung Kang, Jahae Kim, Ho-Chun Song, Ari Chong, Su Woong Yoo. Stimulated Serum Thyrogolbulin Level at the Time of First Dose of Radioactive Iodine Therapy is the Most Predictive Factor for Therapeutic Failure in Patients with Papillary Thyroid Carcinoma. Nucl Med Mol Imaging 48:255-261, 2014. DOI: http://dx.doi.org/10.1007/s13139-014-0282-4
  3. Release of Patients after Therapy with Unsealed Radionuclides. ICRP Publication 94. Ann. ICRP 34(2). 2004.
  4. Leonard R, Coover, Edward B. Silberstein, Phyllis J. Kuhn, and Mark W. Graves. Therapeutic $^{131}I$ in Outpatients: A Simplified Method Conforming to the Code of Federal Regulations, Title 10, Part 35.75. J Nucl Med 41:1868-1875, 2000.
  5. Sungmin Kang, MD, Byung Il Kim, MD, In-Ju Kim, MD, Hee-Seung Bom, MD, Ga Hee Lee MD, Jaetae Lee, MD, Woong Youn Chung, MD, and Jae Hoon Chung, MD. Radiation Safety in the Treatment of Patients with Thyroid Disease by $^{131}I$. J Korean Thyroid Assoc 5:6-20, 2012. DOI: http://dx.doi.org/10.11106/jkta.2012.5.1.6
  6. Jai Hyuen Lee, Seok Gun Park. Estimation of the Release Time from Isolation for Patients with Differentiated Thyroid Cancer Treated with High-dose I-131. Nuc Med Mol Imaging 44:241-245, 2010. DOI: http://dx.doi.org/10.11106/jkta.2012.5.1.6
  7. Cheryl M, Culver and Howard J. Dworkin. Radiation Safety Considerations for Post-Iodine-131 Thyroid Cancer Therapy. J Nucl Med 33:1402-1405, 1992.
  8. Hee-Myung Park, MD., Jung Woong Jang, NMT., Hee Chul Yang, NMT., and Young Gook Kim, NMT. Outpatient Radioablation Therapy for Thyroid Cancer Patients with Minimal Radiation Exposure to the Family Members. Nucl Med Mol Imaging 41: 218-225, 2007.
  9. Sally F. Barrington, Michaell J. O'Doherty, Andrew G. Kettlee, William H. Thomson, Peter J. Mountford, David N. Burrell, Robert J. Farrell, Stanley Bachelor, Paul Seed, L. keith Harding. Radiation Exposure of the Families of Outpatients Treated with Radioiodine (iodine-131) for Hyperthyroidism. Eur J Nucl Med 26:686-692, 1999. https://doi.org/10.1007/s002590050438
  10. Siegel JA, Marcus CS, Stabin MG. Licensee Over-relaiance on Conservatisms in NRC Guidance Regarding the Release of Patients Treated with I-131. Health Phys 93:667-677, 2007. DOI: http://dx.doi.org/10.1097/01.HP.0000270300.34270.44
  11. James C. Sisson, John Freitas, Ian Ross McDougall, Lawrence T. Dauer, James R. Hurley, James D. Brierley, Charlotte H. Edinboro, David Rosenthal, Michael J. Thomas, Mira A. Wexler, Ernest Asamoah, Anca M. Avram, Mira Milas, and Carol Greenlee. Radiation Safety in the Treatment of Patients with Thyroid Diseases by Radioiodine $^{131}I$: Practice Recommendations of the American Thyroid Association. The Americal Thyroid Association Taskforce on Radiation Safety. Thyroid 21:355-346, 2011. https://doi.org/10.1089/thy.2010.0315
  12. Coover LR, Silberstein EB, Kuhn PJ, Graves MW. Therapeutic $^{131}I$ in outpatients: A Simplified Method Conforming to the Code of Fedreral Regulations, Title 10, Part 35.75. J Nucl Med 41:1868-75, 2000.
  13. David L. North, Douglas R. Shearer, James V. Hennessy, and Glenn L. Donovan. Effective Half-life of $^{131}I$ in Thyroid Cancer Patients. Health Phys 81:325-329, 2001. DOI: http://dx.doi.org/10.1097/00004032-200109000-00013
  14. Markus Luster, Steven I. Sherman, Monica C. Skarulis, James R. Reynolds, Michael Lassmann, Heribert Hanscheid, Christoph Reiners. Comparison of Radioiodine Biokinetcs following the Administration of Recombinant Human Thyroid Stimulating Hormone and after Thyroid Hormone withdrawal in Thyroid Carcinoma. Eur J Nucl Med Mol Imaging 30:1371-1377, 2003. DOI: http://dx.doi.org/10.1007/s00259-003-1230-1
  15. Berg GE., Michanek AM., Holmberg EC., Fink M. Iodine-131 Treatment of Hyperthyroidism: Significance of Effective Half-life Measurements. J Nucl Med 37:228-232, 1996.