RADIOPHARMACEUTICAL THERAPY

Prior to the administration of any radiopharmaceutical therapy procedure, the authorized user shall sign and date an order which specifies the patient, the radiopharmaceutical, the dosage, and the route of administration.

A negative serum beta HCG pregnancy test must be documented in the medical chart for all potentially pregnant females treated therapeutically with radiopharmaceuticals.

I¹³¹ THERAPY PROCEDURES

Definition of Major and Minor Therapies 

Minor therapies of I¹³¹ are single doses of 30 mCi or less.
Major therapies of I¹³¹ are single doses greater than 30 mCi.

Handling Instructions

All I¹³¹ should be opened under a fume hood prior to administration to a patient to allow for escape of vapor in the vial. The activity of each dosage shall be measured in a dose calibrator and verified to be within 10% of the prescribed dose.

Since the exposure rate on the outside of the lead pig and shipping box may be quite high, adequate precautions must be taken when transporting sources.

Minor Therapies

Minor therapies at the Georgia Health Sciences University Health Inc may be performed in the Nuclear Medicine Department. The actual administration of the I¹³¹ is made by an approved physician or by a radiology resident, nuclear pharmacist or nuclear medicine technologist when under the supervision of an approved physician. Nuclear Medicine personnel (technologists or physicians) are responsible for disposing of contaminated articles and performing a survey of the area after the administration. Any contaminated area must be immediately decontaminated. Radiation Safety should be called to supervise and monitor the cleanup if necessary.

     Minor therapeutic doses at the Georgia Radiation Therapy Center are administered by a Radiation Therapy Resident or Staff Physician in the presence of a representative from the Radiation Safety Office or a therapy physicist. The Radiation Safety representative is responsible for monitoring the area, decontaminating the areas, if necessary, and disposing of all radioactive waste.

Major Therapies

Patients receiving major therapeutic doses of I¹³¹ must be admitted to the hospital. The patient must have a private room and bath. The room must also be approved by the Radiation Safety Office, taking into consideration areas adjacent to, above, and below where radiation levels must be within certain limits. Before the dose is administered, the room must be prepared by Radiation Safety. This involves covering the floor with plastic or absorbent paper and covering various articles the patient may touch such as the telephone, TV control, etc.

The dose is usually administered with the patient sitting on the edge of the bed. The bedside table should be covered with an absorbent pad. A physicist or technician from Radiation Safety must be present during administration and is responsible for disposing of the waste.

The patient must remain hospitalized until the activity is less than 30 mCi or the measured dose rate at one meter from the patient is less than five millirems per hour.

The nursing instruction form contains specific rules for care of the patient by nurses, visitors restrictions, and handling waste, linens, and eating utensils.

Patient rooms used for major therapies may not be released for use by other patients until documented surveys by Radiation Safety staff demonstrate that there is no removable contamination in excess of 200 dpm/100 cm2.

Bioassays

Individuals involved in operations which use, at any one time, more than 30 millicuries of I¹³¹ must have bioassays performed.

The Radiation Safety Officer or the Subcommittee, at the time of authorization or at other times, may determine the necessity for bioassays beyond those required above.

OTHER THERAPY PROCEDURES (P32, Sr89, etc.)

A syringe shield must be used during any radiopharmaceutical therapy injection, unless the use is medically contraindicated.

Radiopharmaceutical therapy procedures at the Medical College of Georgia Health Inc are performed in the Nuclear Medicine Department. The actual administration is made by an approved physician or by a radiology resident, nuclear pharmacist, or nuclear medicine technologist when under the supervision of an approved physician. Nuclear Medicine personnel (technologists or physicians) are responsible for disposing of contaminated articles and performing a survey of the area after the administration. Any contaminated area must be immediately decontaminated. Radiation Safety should be called to supervise and monitor the cleanup if necessary.

Radiopharmaceutical therapy doses at the Georgia Radiation Therapy Center are administered by a Radiation Therapy Resident or Authorized User in the presence of a representative from the Radiation Safety Office or a therapy physicist. The Radiation Safety representative is responsible for monitoring the area, decontaminating the areas, if necessary, and disposing of all radioactive waste.

Sr89 must be ordered and administered only in unit doses.