HF 7047

Treatment with High Dose I-131 

What is high dose I-131?

High dose I-131 is radioactive iodine used to treat some cancers. There are different types like 131-I Metaiodobenzylguanidine (MIBG) and CLR131. High dose I-131 sends radiation to the cancer cells. We give it to your child through an intravenous catheter (IV). It is a clear liquid that looks like water.

What can I expect before high dose I-131?

1-2 weeks before high dose I-131: 

  • You will have a clinic visit at the American Family Children’s Hospital (AFCH) Pediatric Hematology/Oncology Clinic. 

  • You meet our radiotherapy doctor, nurse practitioner, social worker and other members of the care team. 

  • We review with you about your child’s cancer. 

  • We talk with you about the treatment. 

  • We talk with you about radiation safety.

  • You have a chance to ask questions.

What can I expect when my child receives high dose I-131?

The day before or day of high dose I-131: 

  • Bring as little with you as you can. 

  • Bring toys that can be thrown away for your child to play with during the treatment. 

  • Do not bring any special toys or clothes. If they become contaminated they need to be thrown away. 

  • Your child may need to take special medicine to protect healthy cells from high dose I-131.

  • Radiation safety staff cover surfaces in your child’s room with plastic to prevent contamination. 

  • You meet with a child life specialist and other members of the team. We talk with you about a plan for distraction and comfort during treatment. 

  • Your child may need a foley catheter (small flexible tube to collect urine) to protect your child’s bladder from radiation in the urine.

  • A nuclear medicine technologist brings the high dose I-131 to your child’s room in a syringe. It is brought in on a cart with a lead shield around it. The lead shield protects others from radiation in the syringe.

  • The nuclear medicine technologist gives the high dose I-131 as an infusion. Your nurse and other members of the care team monitor your child during and after the infusion.

What can I expect after high dose I-131?

You help care for your child. You help your child take medicines, eat, and provide things to do. Most of your time should be in the caregiver room (right next to your child’s room) or behind the lead shield in the room. There is a video and audio monitor for you to see and talk to your child even when you are in the caregiver room.

Your child must stay in or near the bed. Your child may play video games, watch TV, or play with toys. Your child is not able to leave the room until his radiation level is safe. Young children may find staying in bed hard. Your child’s care team can talk with you about ways to keep your child comfortable. 

We ask you to follow radiation safety precautions.

  • Do not eat or drink in your child’s room.

  • Wear protective clothing.

  • Take off protective clothing when leaving the room.

  • Wear a dosimeter to keep track of your radiation exposure when in your child’s room.

  • Do not use the toilet or shower in the room.

  • Do not take anything out of your child’s room.

When does my child go home? 

Your child’s care team and radiation safety staff decide when it’s safe for your child to go home. At home your child will need to follow special instructions for two weeks.

How do I care for my child at home after high dose I-131?

  • The greater distance you are away from your child, the less radioactive exposure you will have.

  • Keep giving your child potassium iodide (SSKI) until the stop date.

  • Flush the toilet twice after use for the next 7 days.

  • If your child wears diapers, use disposable diapers. Put them in an outdoor garbage can at least once a day. 

  • Use disposable gloves while changing diapers.

  • Even though you wore gloves, wash your hands with soap and water after changing diapers or handling urine, vomit or stool.

  • Bathe your child daily.

  • For the first week after treatment avoid close contact (more than 15 minutes per day). Do not nap with or hold your child on your lap if you can.

  • Your child may not hold a baby for one month after the treatment, to prevent radiation exposure to the baby.

What do I do in public places? 

  • Avoid close contact with anyone other than caregivers. Keep a distance of at least 3 feet between your child and people in public places.

  • Decrease the items or surfaces that your child touches.

  • Flush the toilet 5 times after use. 

  • Do not let your child sit on your lap.

  • During transport, decrease the number of people seated next to your child. 

Information for Medical Providers

Patient Name _________________

Date of MIBG treatment_____________

Date of discharge after MIBG treatment _____________

NOTE: This patient has been released according to the regulatory requirements under Wisconsin Department of Health Services, DHS 157.62(8). Instructions have been provided to the patient and his/her caregivers on how to keep public radiation exposure from the patient as low as reasonably achievable, i.e. maintain a prudent distance (~1-meter) and minimal time. This patient may have trace amounts of radioactivity in the body fluids. Standard precautions when handling blood or body fluids are required.

Contact your institutional Radiation Safety Department should clinical samples be needed or if patient is admitted within one week of discharge date.

American Family Children's Hospital Pediatric Oncology Office (608) 263-6200

UW Hospital Radiation Health Physicist (608) 890-6485

If you are a patient receiving care at UnityPoint – Meriter, Swedish American or a health system outside of UW Health, please use the phone numbers provided in your discharge instructions for any questions or concerns.