Practical Realignment of an Existing Regional I-131 Service with Best Radiation Protection Practice.
Abstract
Purpose
Access to nuclear medicine services provides significant benefit to regional patients but is often limited by the availability of staff with specialist expertise. This can result in gaps between existing practice and contemporary radiation protection standards, with potential implications for patient and staff safety. Orange Health Service has provided I-131 therapy for thyroid carcinoma through a public–private partnership since 2013. In late 2023, deficiencies in service support were identified. This work describes a physics-led, multidisciplinary clinical project undertaken to align a regional I-131 therapy service with Australian best-practice radiation protection standards.
Methods
Local radiation oncology physicists escalated identified radiation protection concerns to hospital executive management. An external nuclear medicine physics consultant conducted a comprehensive site review, and a multidisciplinary working group was established. Key initiatives included implementing remote monitoring, bed management processes to support safe dual use with the general ward, development of local procedures, emergency and incident response protocols, and procurement of appropriate radiation monitoring equipment and personal protective equipment.
Results
Practical and sustainable solutions were implemented using locally available resources to address identified gaps in the I-131 service. Staff were trained and supported to safely manage room turnover and clearance for general ward use following therapy. Clear procedures were established for routine operations and radiation incidents, resulting in improved compliance with radiation protection principles. These changes also contributed to a measurable improvement in local radiation safety awareness and culture.
Conclusion
This project demonstrates that a physics-led, multidisciplinary approach can successfully improve the safety and quality of a I-131 therapy service in a regional setting, even in the absence of on-site nuclear medicine physics expertise. This provides a framework for other regional centres to support similar nuclear medicine services, through clear procedures, training, empowering local staff, ensuring continued access to essential cancer treatment for regional communities.