RADIOACTIVE IODINE THERAPY IN EUROPE - A SURVEY

Treatment with I-131 is a well known and widely accepted therapy for benign thyroid disease and thyroid cancer. High dose I-131 therapy for ablative reasons in well-differentiated thyroid cancer is done mostly in hospitals with controlled area and adequate equipment for radiation protection. Low-dose therapies, however, of hyperthyreoidism, thyroid autonomy and goiter may be done in out-patients in many countries. Limits of radioactivity administered for an ambulant therapy are varying. In Germany, I-131 therapy of out-patients is generally not permitted. As many patients are waiting for a therapy but capacity is too low, waiting lists up to several months exist. This leads to a kind of medical tourism into other countries where therapy of out-patients is possible. This is a crucial point with regard to optimal medical care as well to health economics. This paper presents the results of a questionnaire which was sent to the national EANM delegates of all European countries. There is a great variability among these countries which indicates the different views handling of radioactivity and radiation protection. A more detailed questionnaire about regulatory and administrative rules initiated by an EANM task group for risk assessment in nuclear medicine is on the way.