# Release of patients after radionuclide therapy or a permanent implant: criteria, instructions and records

Source: https://onco.cc/protocols/radionuclide-therapy-patient-release-criteria/  
OnCo record `radionuclide-therapy-patient-release-criteria` (Protocol). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

After some treatments with radioactive medicines or seeds, you give off a little radiation for a while. Before you go home, the team checks that the people around you will receive only a small, safe dose, taking your home and family into account, and gives you written instructions. If that is not yet possible you stay in a single room until it is.

## Summary

Release is governed by dose to other people. Members of the public are subject to the public dose limit (1 mSv a year); family and friends who knowingly help are carers and comforters, whose exposure is controlled by a dose constraint, commonly 5 mSv per episode for an adult and 1 mSv for children and for the embryo or fetus of a pregnant carer, with more lenient values possible for elderly people (IAEA SSG-46 para 2.49). Before release, the medical physicist or radiation protection officer establishes that retained activity is low enough to stay within those limits and constraints, for example by integrating the measured dose rate over the activity, energy and effective half-life, taking into account the patient's living conditions, children and pregnant women at home, excreta and incontinence; the assumptions must match the written instructions given (SSG-46 4.247, 5.258). Carers must have received and understood information on radiation risks before they provide care (GSR Part 3 para 3.153, quoted in SSG-46). Written instructions go to the patient or guardian (SSG-46 4.248; UK IR(ME)R 2017 reg 12(6) and (7), before leaving).

The US rule allows release when no other individual is likely to receive more than 5 mSv, requires written instructions when anyone could receive more than 1 mSv, and requires breastfeeding guidance when a nursing infant could exceed 1 mSv (10 CFR 35.75); the basis for release must be recorded when it uses retained activity, an occupancy factor below 0.25 at 1 m, an effective half-life or tissue shielding, and kept for 3 years (35.2075). A patient who cannot be released is kept in a private room with a private toilet, the door posted, visitor time noted and items leaving the room surveyed or treated as radioactive waste (35.315), by staff given annual radiation safety instruction (35.310). Many countries also use a retained-activity limit for iodine-131 (most EU member states 400 to 600 MBq; Germany 250 MBq; Japan 500 MBq or under 30 microsieverts an hour at 1 m) (IAEA SRS-63). The IAEA and ICRP advise that the decision is individual and that dose limits and constraints, not secondary limits such as retained activity, should drive it; SSG-46 notes that systematic dose monitoring of family members is not necessary. Permanent implants follow the same framework (SSG-46 5.257 to 5.261), with a wallet card and advice about seed expulsion, later surgery and death.

## Fields

- Kind: Protocol
- Last checked: 2026-11-11
- Also known as: patient release criteria; discharge after radionuclide therapy; release after radioiodine; release after Lutathera; release after Pluvicto; 10 CFR 35.75; dose constraints for carers and comforters; retained activity limit; radioactive patient discharge; release of patients with permanent implants

## Connected records

- protocols: [Radiation precautions at home after permanent prostate seed brachytherapy](https://onco.cc/protocols/permanent-prostate-seed-brachytherapy-home-radiation-safety/), [Radiation safety at home after lutetium-177 PSMA or dotatate therapy](https://onco.cc/protocols/lutetium-177-therapy-home-radiation-safety/), [Radiation safety at home after radioactive iodine (I-131) for thyroid cancer](https://onco.cc/protocols/radioiodine-therapy-home-radiation-safety/)
- technologies: [Low-dose-rate seed brachytherapy](https://onco.cc/technologies/ldr-seed-brachytherapy/), [Lutetium-177 radioligand therapy](https://onco.cc/technologies/lu177-radioligand-therapy/), [MIBG imaging and 131I-MIBG therapy](https://onco.cc/technologies/mibg-theranostics/), [Radioiodine therapy and whole-body iodine scanning](https://onco.cc/technologies/radioiodine-therapy/), [Radioligand therapy (beta emitters)](https://onco.cc/technologies/radioligand-therapy/)
- drugs: [Lutetium-177 dotatate](https://onco.cc/drugs/lutathera/), [Lutetium-177 vipivotide tetraxetan](https://onco.cc/drugs/pluvicto/), [Radioactive iodine (I-131)](https://onco.cc/drugs/radioactive-iodine/), [Radium-223 dichloride](https://onco.cc/drugs/radium-223/)
- institutions: [International Atomic Energy Agency: Rays of Hope](https://onco.cc/institutions/iaea/)
- terms: [Radioiodine therapy (I-131)](https://onco.cc/terms/radioiodine-term/)

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