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Radioactive Iodine: A Living History.

Gilbert H Daniels1, Douglas S Ross1

  • 1Thyroid Unit, Endocrine Tumor Center, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA.

Thyroid : Official Journal of the American Thyroid Association
|June 12, 2023
PubMed
Summary
This summary is machine-generated.

Radioactive iodine (RAI) revolutionized Graves' hyperthyroidism and thyroid cancer treatment. Once a primary therapy, its use is now more selective due to safety concerns and evolving medical advancements.

Keywords:
hyperthyroidismradioactive iodinethyroid cancer

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Area of Science:

  • Nuclear Medicine
  • Endocrinology
  • Oncology

Background:

  • Historically, surgery was the main treatment for Graves' hyperthyroidism, carrying significant risks.
  • The concept of using radioactive isotopes for metabolic studies emerged in the 1930s.
  • Early 20th-century treatments for thyroid conditions lacked targeted efficacy and safety.

Purpose of the Study:

  • To trace the historical development and application of radioactive iodine (RAI) in treating thyroid disorders.
  • To evaluate the transition of RAI from a bench discovery to a bedside therapy.
  • To discuss the evolving role and future prospects of RAI in endocrinology and oncology.

Main Methods:

  • Review of historical medical literature and clinical reports on radioactive iodine therapy.
  • Analysis of the interdisciplinary collaboration leading to RAI's clinical implementation.
  • Examination of trends in RAI utilization for Graves' hyperthyroidism and thyroid cancer.

Main Results:

  • Radioactive iodine (RAI) was successfully applied to treat Graves' hyperthyroidism by 1942.
  • RAI uptake was demonstrated in differentiated thyroid cancer metastases, later enhanced by TSH stimulation.
  • RAI use for Graves' disease and thyroid cancer has become more selective over time.
  • Concerns regarding thyroid eye disease exacerbation, radiation exposure, and hypothyroidism impact current RAI use.

Conclusions:

  • RAI represents a pioneering theranostic approach, transitioning from scientific research to clinical practice.
  • The future of RAI may be influenced by novel therapies targeting TSH receptor antibodies and oncogenesis.
  • Redifferentiation techniques offer potential to enhance RAI efficacy in refractory thyroid cancer.