Procedure guideline for therapy of thyroid disease with (131)iodine.

Oral administration of 131I has been a commonly accepted procedure for treatment of benign and malignant conditions of the thyroid since the 1940s. Physicians responsible for treating such patients should have an understanding of the clinical pathophysiology and natural history of the disease processes, should be familiar with alternate forms of therapy, and should be able to collaborate closely with other physicians involved in the management of the patient’s condition. The treating physician should either see patients in consultation with the physician assuming overall management of the patient’s condition or be prepared to assume that role. In the United States, the treating physician should be board certified in Nuclear Medicine, Radiology, or Radiation Oncology, or be able to document equivalent training, competency, and experience in the safe use and administration of therapeutic amounts of 131I. In Europe, the treating physician should be board certified in Nuclear Medicine or Radiation Oncology. Licensure to possess 131I and regulations regarding the release of patients treated with radioiodine vary from jurisdiction to jurisdiction. Physicians engaged in therapy with 131I must be knowledgeable about and in compliance with all applicable laws and regulations. The facility in which treatment is performed must have appropriate personnel, radiation safety equipment, and procedures available for waste handling and disposal, monitoring personnel for accidental contamination, and controlling spread of volatilized 131I.