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

Wed Oct 1 13:39:14 EDT 2025

Do you want to treat  Thyroid Carcinoma patient in renal failure, snd on
Dialysis?  It has been done.  If there are no other good trratment options.
I developed  a Protocol in conjunction  with the nephrology while at Kaiser
in Southern ern CA.  there have also been  other procedures.

precautions were taken to protect the staff, (gowns, gloves, limit exposure
time, etc). the attachments to the dialysis were contaminated and put into
long term decay.  the machine itself was put into storage also as a
precaution.  A video camera was placed in the room to monitor the dialysis
machine and patient remotely so that stsff was not in thr room during
dialysis.  The nurses, techs and  physician were monitored. exposures were
all low or zero.

A diaysis schedule was set to match the normal rate of elimination.  a few
patients were treared while I covered that hospital.
Kaiser should still have the protocol, i probably also have a copy.  Also a
poster at the 2015 (I think) AAPM. In Anaheim.

You might try contacting Mary Ellen Jafari, SO Cal Medical Physics and
Regional RSO.
The one slight regret is that I do not know how it turned out for those
patoents.

On Tue, Sep 16, 2025, 13:14 Michael Masiar via Intl_dxmedphys_wd_osu_list <
intl_dxmedphys_wd_osu_list at lists.osu.edu> wrote:

> The procedure in question has been cancelled for the time being by the
> referring provider, but thank you to everyone for the super informative
> responses! Michael Masiar MS DABR Certified Medical Physicist Therapy
> Physics, Inc. 2501 Cherry Ave
> <https://urldefense.com/v3/__https://www.google.com/maps/search/2501*Cherry*Ave?entry=gmail&source=g__;Kys!!KGKeukY!xYD86elAQpvME_j3O2gc_WVfgJs1o8kzJnxn2pL0praM2SlEuAA8ra2PGfFm-wsFJBPJQvbMQ2BC4EOhYiRyAr5SlUXQrxdT5hDaD1d2Y3Neew$ >.
> ,
> The procedure in question has been cancelled for the time being by the
> referring provider, but thank you to everyone for the super informative
> responses!
>
> Michael Masiar MS DABR
> Certified Medical Physicist
> Therapy Physics, Inc.
> 2501 Cherry Ave., Suite 270
> <https://urldefense.com/v3/__https://www.google.com/maps/search/2501*Cherry*Ave.,*Suite*270*Signal*Hill,*CA*90755?entry=gmail&source=g__;KysrKysrKys!!KGKeukY!xYD86elAQpvME_j3O2gc_WVfgJs1o8kzJnxn2pL0praM2SlEuAA8ra2PGfFm-wsFJBPJQvbMQ2BC4EOhYiRyAr5SlUXQrxdT5hDaD1eVBTJlBg$ >
> Signal Hill, CA 90755
> <https://urldefense.com/v3/__https://www.google.com/maps/search/2501*Cherry*Ave.,*Suite*270*Signal*Hill,*CA*90755?entry=gmail&source=g__;KysrKysrKys!!KGKeukY!xYD86elAQpvME_j3O2gc_WVfgJs1o8kzJnxn2pL0praM2SlEuAA8ra2PGfFm-wsFJBPJQvbMQ2BC4EOhYiRyAr5SlUXQrxdT5hDaD1eVBTJlBg$ >
> email: mmasiar at gmail.com
> cell: 310-625-9906
> office: 562-317-0650
>
>
>
> On Tue, Sep 16, 2025 at 7:17 AM Hoy, Andrew via Intl_dxmedphys_wd_osu_list
> <intl_dxmedphys_wd_osu_list at lists.osu.edu> wrote:
>
>> 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
>>
>> 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>
>> 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>
>> 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
>> <https://urldefense.com/v3/__https://www.google.com/maps/search/2501*Cherry*Ave.,*Suite*270**A0D*0A**A0D*0A**A0D*0A*Signal*Hill,*CA*90755?entry=gmail&source=g__;KysrKyslJSslJSslJSsrKys!!KGKeukY!xYD86elAQpvME_j3O2gc_WVfgJs1o8kzJnxn2pL0praM2SlEuAA8ra2PGfFm-wsFJBPJQvbMQ2BC4EOhYiRyAr5SlUXQrxdT5hDaD1dHnfTELQ$ >
>>
>> Signal Hill, CA 90755
>> <https://urldefense.com/v3/__https://www.google.com/maps/search/2501*Cherry*Ave.,*Suite*270**A0D*0A**A0D*0A**A0D*0A*Signal*Hill,*CA*90755?entry=gmail&source=g__;KysrKyslJSslJSslJSsrKys!!KGKeukY!xYD86elAQpvME_j3O2gc_WVfgJs1o8kzJnxn2pL0praM2SlEuAA8ra2PGfFm-wsFJBPJQvbMQ2BC4EOhYiRyAr5SlUXQrxdT5hDaD1dHnfTELQ$ >
>>
>> email: mmasiar at gmail.com
>>
>> cell: 310-625-9906
>>
>> <https://urldefense.com/v3/__https://www.google.com/maps/search/2501*Cherry*Ave.,*Suite*270**A0D*0A**A0D*0A**A0D*0A*Signal*Hill,*CA*90755?entry=gmail&source=g__;KysrKyslJSslJSslJSsrKys!!KGKeukY!xYD86elAQpvME_j3O2gc_WVfgJs1o8kzJnxn2pL0praM2SlEuAA8ra2PGfFm-wsFJBPJQvbMQ2BC4EOhYiRyAr5SlUXQrxdT5hDaD1dHnfTELQ$ >
>>
>> <https://urldefense.com/v3/__https://www.google.com/maps/search/2501*Cherry*Ave.,*Suite*270**A0D*0A**A0D*0A**A0D*0A*Signal*Hill,*CA*90755?entry=gmail&source=g__;KysrKyslJSslJSslJSsrKys!!KGKeukY!xYD86elAQpvME_j3O2gc_WVfgJs1o8kzJnxn2pL0praM2SlEuAA8ra2PGfFm-wsFJBPJQvbMQ2BC4EOhYiRyAr5SlUXQrxdT5hDaD1dHnfTELQ$ >
>>
>> office: 562-317-0650
>>
>> <https://urldefense.com/v3/__https://www.google.com/maps/search/2501*Cherry*Ave.,*Suite*270**A0D*0A**A0D*0A**A0D*0A*Signal*Hill,*CA*90755?entry=gmail&source=g__;KysrKyslJSslJSslJSsrKys!!KGKeukY!xYD86elAQpvME_j3O2gc_WVfgJs1o8kzJnxn2pL0praM2SlEuAA8ra2PGfFm-wsFJBPJQvbMQ2BC4EOhYiRyAr5SlUXQrxdT5hDaD1dHnfTELQ$ >
>>
>>
>>
>>
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