Iodine-131 - Medical and Pharmaceutical Uses

Medical and Pharmaceutical Uses

It is used in nuclear medicine therapeutically and can also be seen with diagnostic scanners if it has been used therapeutically. Use of the 131I as iodide salt exploits the mechanism of absorption of iodine by the normal cells of the thyroid gland. Examples of its use in radiation therapy are those where tissue destruction is desired after iodine uptake by the tissue.

Major uses of 131I include the treatment of thyrotoxicosis (hyperthyroidism) and some types of thyroid cancer that absorb iodine. The 131I is thus used as direct radioisotope therapy to treat hyperthyroidism due to Graves' disease, and sometimes hyperactive thyroid nodules (abnormally active thyroid tissue that is not malignant). The therapeutic use of radioiodine to treat hyperthyroidism from Graves' disease was first reported by Saul Hertz in 1941.

The 131I isotope is also used as a radioactive label for certain radiopharmaceuticals that can be used for therapy, e.g. 131I-metaiodobenzylguanidine (131I-MIBG) for imaging and treating pheochromocytoma and neuroblastoma. In all of these therapeutic uses, 131I destroys tissue by short-range beta radiation. About 90% of its radiation damage to tissue is via beta radiation, and the rest occurs via its gamma radiation (at a longer distance from the radioisotope). It can be seen in diagnostic scans after its use as therapy, because 131I is also a gamma-emitter.

Because of the carcinogenicity of its beta radiation in the thyroid in small doses, I-131 is rarely used primarily or solely for diagnosis (although in the past this was more common due to this isotope's relative ease of production and low expense). Instead the more purely gamma-emitting radioiodine Iodine-123 is used in diagnostic testing (nuclear medicine scan of the thyroid). The longer half-lived iodine-125 is also occasionally used when a longer half-life radioiodine is needed for diagnosis, and, in brachytherapy treatment (isotope confined in small seed-like metal capsules), where the low-energy gamma radiation without a beta component, makes iodine-125 useful. The other radioisotopes of iodine are never used in brachytherapy.

The use of 131I as a medical isotope has been blamed for a routine shipment of biosolids being rejected from crossing the Canada—U.S. border. Such material can enter the sewers directly from the medical facilities, or by being excreted by patients after a treatment.