•  He could most likely be treated as an outpatient: Correct.

•  He must be treated as an inpatient: Incorrect.

•  He cannot be treated with this amount of radiation: Incorrect.

Essential Facts

•  Because the patient is being dosed with > 30 µCi of iodine 131, a written directive (signed prescription) is required from an authorized user.

•  A written directive is also required for administration of any therapeutic dose of unsealed by-product material or any therapeutic dose of radiation from by-product material.

•  Diagnostic studies performed with other forms of I131, such as I131-MIBG, do not require a written directive, even if the dose is > 30 µCi.

•  The Nuclear Regulatory Commission no longer requires hospitalization for patients treated with high-dose I131, and a patient may be released from the department based on several criteria (covered under 10 CFR 35.75):

•  A given dose is < 33 mCi or a patient external measurement of < 7 mR/h at 1 m.

•  Alternatively, patient-specific dose calculations can be made. These are based on the dose given and estimated occupancy factor for that patient (E). The total annual projected dose to an individual member of the public from a released patient cannot exceed 0.5 rem