[Intl_DxMedPhys] [EXTERNAL] Re: I-131 dialysis question

Tue Sep 16 10:11:32 EDT 2025

Hopefully this doesn’t get lost due to all the attachments, but I found these helpful in the past when this question came up.

We have had two ESRD / I-131 therapy patients in the last few years with one being in-patient and one out patient based on living situations.  My experience was fairly similar to Gretchen’s.   It was certainly an interesting situation with a lot of preparation and work, but it is definitely doable.  We also went with a modified dialysis schedule and even a modified Thyrogen dosing as that is also effected by the ESRD.

I found the AMRSO listserve to be helpful on this topic also.

Thank you,
Andrew

Andrew R. Hoy, PhD, DABR
Radiation Safety Officer
Diagnostic Medical Physicist
Office (605) 312-1429
Cell: (480) 329-5552
Sanford USD Medical Center
Sioux Falls, SD

From: Intl_dxmedphys_wd_osu_list <intl_dxmedphys_wd_osu_list-bounces+andrew.hoy=sanfordhealth.org at lists.osu.edu> On Behalf Of Bill Erwin via Intl_dxmedphys_wd_osu_list
Sent: Tuesday, September 16, 2025 8:36 AM
To: Gretchen Raterman Bell <gretchen.raterman at gmail.com>
Cc: intl_dxmedphys_wd_osu_list at lists.osu.edu
Subject: [EXTERNAL] Re: [Intl_DxMedPhys] I-131 dialysis question

We treated a patient with ESRD on dialysis a few years ago. We did a dosimetry study first, and based the post-Tx dialysis schedule on the attached JNM article (a study of 6 such patients treated). On Mon, Sep 15, 2025 at 4: 36 PM Gretchen Raterman
We treated a patient with ESRD on dialysis a few years ago.  We did a dosimetry study first, and based the post-Tx dialysis schedule on the attached JNM article (a study of 6 such patients treated).

On Mon, Sep 15, 2025 at 4:36 PM Gretchen Raterman Bell via Intl_dxmedphys_wd_osu_list <intl_dxmedphys_wd_osu_list at lists.osu.edu<mailto:intl_dxmedphys_wd_osu_list at lists.osu.edu>> wrote:
We actually encountered this earlier this year. It took a lot of planning -- and a little help from the list! We wound up treating the patient as inpatient in order to ensure that they were dialyzed at specific intervals. The nephrologist involved
We actually encountered this earlier this year.  It took a lot of planning -- and a little help from the list!  We wound up treating the patient as inpatient in order to ensure that they were dialyzed at specific intervals.  The nephrologist involved found a paper about clearance rates after different dialysis schedules and decided upon one.  Apologies, I can't find the paper at the moment and don't remember specifics.  But it was something like 1st session after 12 hours, then 2nd 12 hours after that.  For preparedness, I met with the oncology nurses and dialysis manager, and we went through a dry run in the actual room prior to administration.  Facilities was also involved.  There was a septic output that they used for the fluids leaving, so that connection was tested thoroughly.  We put absorbent paper under any place where there was a connection that may leak or may drip when disconnecting any tubing (in addition to the horrible blue saran wrap sticky paper).

When the RSO and I went and surveyed the room, we did find contamination where the dialysis team disconnected a few tubes.  We designated a whole trash bin specifically for "dialysis trash" which contained the tubing, so that was pretty hot.  The dialysis machine itself had zero contamination.  After it was all said and done, we had a TON to decay in storage.  But the equipment and room itself was pretty unscathed.  In fact, the only pesky contamination was the usual suspect - the bathroom sink drain.

Gretchen R. Bell, M.S., DABR
Diagnostic Imaging Physicist
Ochsner Medical Center
(504)842-8506

On Mon, Sep 15, 2025 at 4:21 PM Michael Masiar via Intl_dxmedphys_wd_osu_list <intl_dxmedphys_wd_osu_list at lists.osu.edu<mailto:intl_dxmedphys_wd_osu_list at lists.osu.edu>> wrote:
Hi all, I am not sure how to answer the below question from a client of mine. Any advice or relevant sample policies/procedure would be appreciated! We have a I-131 therapy, but the patient is on dialysis . I do not think we can do him because
Hi all,

I am not sure how to answer the below question from a client of mine. Any advice or relevant sample policies/procedure would be appreciated!

We have a I-131 therapy, but the patient is on dialysis . I do not think we can do him because the dose is 150mCI and this would contaminate the machine as well as being in close proximity to the tech/nurse.
Do you agree.

Michael Masiar MS DABR
Certified Medical Physicist
Therapy Physics, Inc.
2501 Cherry Ave., Suite 270
Signal Hill, CA 90755
email: mmasiar at gmail.com<mailto:mmasiar at gmail.com>
cell: 310-625-9906
office: 562-317-0650

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