Radioiodine-131 (RAI) is an isotope of the chemical element iodine and is commonly used for hyperthyroidism, including Graves’ disease. It is given orally, and its concentration in the thyroid gland. The RAI transport involves a natrium iodide symporter (NIS) role that brings two cations sodium (Na+) and one anion of iodide (I-) across the membrane. The process is facilitated by the enzyme Na+/K+ ATPase. RAI is a beta (β) and gamma (γ) particles emitter. β particle is used for therapy and γ particle for imaging (theranostic). β particle inhibits cell growth by inducing cell death through apoptosis or necrosis of some of the sufficient thyroid cells. The aim of RAI therapy in Graves’ disease is to control hyperthyroidism and render the patient hypothyroidism. It is easier to manage patients with hypothyroidism with levothyroxine and fewer complications. This review will focus on RAI’s therapeutic approach in Graves’ disease, including patient preparation, selecting activity dose, adverse events, contraindication, controversies issues such as malignancy and fertility, the follow-up to ensuring the patient remains euthyroid or need a replacement therapy if they become hypothyroidism. RAI therapy is safe as definitive therapy and cost-effective for Graves’ disease therapy.
Part of the book: Graves' Disease
Nuclear medicine plays a role in oncology. It uses tracers (radiopharmaceuticals) to study physiological processes and treat diseases. The radiopharmaceuticals can be formed as radionuclides alone or radionuclides labeled with other molecules as a drug, a protein, or a peptide. The radiopharmaceutical is introduced into the body and accumulates in the target tissue of interest for therapy or imaging purposes. It offers to study cancer biology in vivo to optimize cancer therapy. Another advantage of radiopharmaceutical therapy is a tumor-targeting agent that deposits lethal radiation at tumor sites. This review outlines radiopharmaceuticals agents in current cancer therapy.
Part of the book: Radiopharmaceuticals
Thyroid cancer incidence has rapidly increased in high-income countries for the past 30 years. The increase in thyroid cancer cases may be due to improved diagnostic methods or exposure to unknown risk factors. Even though new thyroid cancer cases have increased, the mortality rate is relatively stable. Most thyroid cancer is differentiated thyroid cancer (DTC). Conventional management of DTC consists of near-total thyroidectomy followed by ablation therapy with radioiodine-131 (RAI). RAI was first used nearly 80 years ago to treat thyroid cancer and still plays a pivotal role in managing DTC. There are three RAI therapy options: remnant ablation, adjuvant therapy, and known disease treatments. After thyroid resection, radioactive Iodine-131 (RAI) is recommended for patients with intermediate to high risk of recurrent disease or distant metastases. Long-term follow-up is needed to detect a persistence or recurrence of the disease after initial RAI administration. RAI effectively improves treatment efficiency and reduces the risk of cancer recurrence and metastasis post-thyroid resection. Clinical outcome prediction is ultimately defined by appropriate management. This article will review some factors to consider when planning RAI therapy for DTC and subsequent surveillance after the therapy.
Part of the book: Thyroid Cancer