Radiation dose of caregivers could be reduced in thyroid carcinoma patients requiring high dose of radioactive iodine: A case report

Undesired radiation exposure to caregivers is an important problem in radioiodine therapy in thyroid carcinoma patients, especially when patient is non-ambulatory. Special precautions are needed to keep the exposure to caregivers low when higher dose of radioiodine is necessary.
Here we present a case-report of a 74-year old male patient with papillary thyroid carcinoma with local invasion and distant metastases, who received 9250 MBq I-131. The patient was confined to bed and needed special assistance for nasogastric tube and urinary catheter. Two family members helped the patient for daily care under the supervision of nursing staff. Caregivers were instructed for radiation protection and lead aprons, lead collars, two pair of gloves and lead screen were used during close contact with the patient. The patient was given daily amount of 4 liter water to increase the urinary excretion of radioiodine. The patient stayed at the hospital for 2 days and discharged when dose rate fell below 30 mSv/h at 1 m. Caregivers at home used lead aprons and lead collars for 3 more days. Cumulative radiation dose measured at the 5th day for two caregivers was 1320 μSv (264 μSv/day), which is under the safety limit of 5 mSv given by ICRP.