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I-131 Thyroid Cancer Therapy
Paige Bennett, MD
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KEY FACTS

  • Terminology

    • Preprocedure

      • Procedure

        TERMINOLOGY

        • Definitions

          • Radioactive iodine (RAI) treatment with I-131
            • I-131 ablates residual thyroid gland and thyroid cancer with high-energy beta emissions (0.606 MeV)
            • Effective for papillary and follicular thyroid cancers and their variants
              • Anaplastic and medullary thyroid cancers are not RAI avid
            • Goal of RAI therapy ("successful ablation")
              • Thyroglobulin level < 2 ng/mL (670 kDa glycoprotein made by follicular cells in normal thyroid tissue and differentiated thyroid cancer)
              • Negative whole-body RAI scan or US

        PREPROCEDURE

        • Indications

          • Contraindications

            • Getting Started

              • Stratify Patients for Risk of Recurrence per American Thyroid Association Guidelines

                PROCEDURE

                • Equipment Preparation

                  • Procedure Steps

                    • Alternative Procedures/Therapies

                      POST PROCEDURE

                      • Things To Do

                        • Side Effects

                          OUTCOMES

                          • Complications

                            Selected References

                            1. Makita K et al: Treatment intensity and control rates in combining external-beam radiotherapy and radioactive iodine therapy for metastatic or recurrent differentiated thyroid cancer. Int J Clin Oncol. ePub, 2020
                            2. Abe K et al: Low-dose radioiodine therapy for patients with intermediate- to high-risk differentiated thyroid cancer. Ann Nucl Med. ePub, 2019
                            3. Tuttle RM et al: Updated American Joint Committee on Cancer/Tumor-Node-Metastasis Staging System for Differentiated and Anaplastic Thyroid Cancer (Eighth Edition): What Changed and Why? Thyroid. 27(6):751-6, 2017
                            4. Haugen BR et al: 2015 American Thyroid Association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: the American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer. Thyroid. 26(1):1-133, 2016
                            5. Nakada K et al: Does lemon candy decrease salivary gland damage after radioiodine therapy for thyroid cancer? J Nucl Med. 46(2):261-6, 2005
                            Related Anatomy
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                            Related Differential Diagnoses
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                            References
                            Tables

                            Tables

                            KEY FACTS

                            • Terminology

                              • Preprocedure

                                • Procedure

                                  TERMINOLOGY

                                  • Definitions

                                    • Radioactive iodine (RAI) treatment with I-131
                                      • I-131 ablates residual thyroid gland and thyroid cancer with high-energy beta emissions (0.606 MeV)
                                      • Effective for papillary and follicular thyroid cancers and their variants
                                        • Anaplastic and medullary thyroid cancers are not RAI avid
                                      • Goal of RAI therapy ("successful ablation")
                                        • Thyroglobulin level < 2 ng/mL (670 kDa glycoprotein made by follicular cells in normal thyroid tissue and differentiated thyroid cancer)
                                        • Negative whole-body RAI scan or US

                                  PREPROCEDURE

                                  • Indications

                                    • Contraindications

                                      • Getting Started

                                        • Stratify Patients for Risk of Recurrence per American Thyroid Association Guidelines

                                          PROCEDURE

                                          • Equipment Preparation

                                            • Procedure Steps

                                              • Alternative Procedures/Therapies

                                                POST PROCEDURE

                                                • Things To Do

                                                  • Side Effects

                                                    OUTCOMES

                                                    • Complications

                                                      Selected References

                                                      1. Makita K et al: Treatment intensity and control rates in combining external-beam radiotherapy and radioactive iodine therapy for metastatic or recurrent differentiated thyroid cancer. Int J Clin Oncol. ePub, 2020
                                                      2. Abe K et al: Low-dose radioiodine therapy for patients with intermediate- to high-risk differentiated thyroid cancer. Ann Nucl Med. ePub, 2019
                                                      3. Tuttle RM et al: Updated American Joint Committee on Cancer/Tumor-Node-Metastasis Staging System for Differentiated and Anaplastic Thyroid Cancer (Eighth Edition): What Changed and Why? Thyroid. 27(6):751-6, 2017
                                                      4. Haugen BR et al: 2015 American Thyroid Association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: the American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer. Thyroid. 26(1):1-133, 2016
                                                      5. Nakada K et al: Does lemon candy decrease salivary gland damage after radioiodine therapy for thyroid cancer? J Nucl Med. 46(2):261-6, 2005