The Evolving Role of 131I for the Treatment of Differentiated Thyroid Carcinoma

The use of radioactive iodine ( 1 3 1 I) for the treatment of thyroid carcinoma has changed over the past 50 y. These changes are based on increasing awareness of the biophysical properties of 1 3 1 I and new discoveries concerning the biology of iodine handling by thyroid cells. The therapeutic administration of 1 3 1 I for thyroid remnant ablation and for metastases requires an appreciation of iodine clearance kinetics, of factors that can alter the occupancy time of 1 3 1 I within lesions, and of the role of thyroid-stimulating hormone in stimulating the sodium-iodide symporter. The potential complications and adverse events associated with 1 3 1 I are discussed. 1 3 1 I will continue to be a major weapon in the fight against metastatic thyroid carcinoma. Its future role will be modified by expanding knowledge of its relative risks and benefits.

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