title: Radiation protection procedures in 131I treatments for thyroid cancer in patients requiring hemodialysis.
abstract: BACKGROUND
  Hemodialysis is essential for patients with renal failure, and iodine-131 ((131)I) administration is the standard of care in thyroid carcinoma treatment. Although the need for hemodialysis during (131)I treatment is very rare, it raises some concerns due to the involvement of personnel not exposed to radiation and to the contamination of devices used for other patients. In this paper, a radioprotection protocol to perform hemodialysis safely on patients during (131)I treatment has been presented.
  
  
  METHODS
  The exposure of personnel who assisted 13 patients over the course of 10 years was monitored: external exposure was measured through electronic dosimeters, and internal contamination was checked by thyroid uptake and urine sample gamma spectrometry. Over this period, room layout was optimized to allow an improvement of radioprotection procedures.Two nurses were involved in patient assistance.
  
  
  RESULTS
  After hemodialysis, measurements of internal contamination were below the minimum detectable activity and external exposure was in the range of 1-82 μSv in terms of H(p)(10). A reduction in personnel exposure was observed after hospitalization room renovation: H(p)(10) normalized to the activity administered to the patient was about halved.
  
  
  CONCLUSIONS
  The data show that hemodialysis can be performed safely during I treatments when appropriate radioprotection actions are implemented.
authors.affiliation: aMedical Physics Unit bNuclear Medicine Unit, Arcispedale Santa Maria Nuova - IRCCS, Reggio Emilia, Italy.
authors.forename: Federica
authors.initials: F
authors.lastname: Fioroni
authors.forename: Roberto
authors.initials: R
authors.lastname: Sghedoni
authors.forename: Elisa
authors.initials: E
authors.lastname: Grassi
authors.forename: Vando
authors.initials: V
authors.lastname: Piccagli
authors.forename: Martina
authors.initials: M
authors.lastname: Sollini
authors.forename: Angelina
authors.initials: A
authors.lastname: Filice
authors.forename: Annibale
authors.initials: A
authors.lastname: Versari
authors.forename: Mauro
authors.initials: M
authors.lastname: Iori
mesh_terms: D006801:Humans; D007457:Iodine Radioisotopes / Q000009:adverse effects / Q000627:therapeutic use; D016273:Occupational Exposure / Q000517:prevention & control; D011835:Radiation Protection / Q000379:methods* / Q000592:standards; D006435:Renal Dialysis; D012449:Safety; D013964:Thyroid Neoplasms / Q000532:radiotherapy*
chemical_list: D007457:Iodine Radioisotopes